Scandinavian journal of rehabilitation medicine. Supplement最新文献

{"title":"Attempts to influence movement disorders in hemiparetics.","authors":"T Radil,&nbsp;I Snýdrová,&nbsp;L Háĉik,&nbsp;J Pfeiffer,&nbsp;J Votava","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Step duration, measured in hemiparetic patients walking on a circular path, showed that step duration of the affected foot is usually longer. Functional electrical stimulation of the peroneal nerve in the swing phase of the step (eliminating foot drop) shortened step duration in the majority of cases. Hypnosis induced by the verbal fixation technique was used in hemiparetic patients (a) to ascertain whether the patient's mobility would increase during hypnosis and to determine (in positive cases) whether this approach might be used to predicting the effect of rehabilitation performed by classical methods; (b) to use hypnosis as a method of auxiliary treatment. The general finding was that the extent of movements of the hemiparetic upper extremity considerably improved during and immediately after hypnosis. This effect could be observed both at the level of severe impairment (at the beginning of treatment) and during the later stages when mobility greatly improved due to rehabilitation and recovery.</p>","PeriodicalId":76524,"journal":{"name":"Scandinavian journal of rehabilitation medicine. Supplement","volume":"17 ","pages":"157-61"},"PeriodicalIF":0.0,"publicationDate":"1988-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14388199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of functional capacity after stroke with special emphasis on motor function and activities of daily living.","authors":"B Lindmark","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In a multidisciplinary study comprising 280 patients with acute cerebrovascular disease (median age 76, range 30-96 years), instruments for functional assessment in stroke care were developed. The improvements of motor function and activities of daily living were investigated during a period of up to one year after a stroke. A new chart for motor capacity assessment, which includes both the paretic and the non-paretic side, modified after that of Fugl-Meyer et al, was tested for its reliability and validity. At the same time the Activity Index of Hamrin & Wohlin was further tested. The internal consistency reliability measured with the standardized item alpha method confirmed that the two instruments have high homogeneity. Construct validity was investigated by factor analysis and showed a logical structure. The predictive validity of the scores on admission was significant and the two tools had a satisfactory predictive capacity for survival and later functional outcome. The improvements in different motor functions were followed up for up to one year after the stroke among the 183 one-year survivors. In patients with minor impairment, the improvement occurred mostly during the first week. Patients with moderate or moderately severe impairment improved more continuously for up to three months, while the few surviving patients with very severe impairment continued to recover to some extent even after three months. Older patients with severe functional loss seemed to improve more slowly and not as well as younger patients with equivalent impairment. The patterns of instrumental activities of daily living (I-ADL), such as household work, locomotion, psychosocial functions and intellectual activities, were investigated in the 207 three-month survivors and the 183 one-year survivors. At both the three-month and the one-year follow-ups the scores had decreased considerably, compared with before the stroke, for all activities except locomotion, and many patients were dependent on somebody else for help. The same group of patients was also examined by a Standardized Practical Equipment (SPE) test constructed by Tömquist three months and one year after the stroke. The construct validity of the SPE test was estimated through factor analysis. Three factors emerged, one concerning mainly cognitive factors and co-ordination, one concerning hand function and one concerning mainly mobility and balance. The instruments developed in the course of this study have proved to be reliable and valid, and useful in assessing functional losses and following progress. The tools are well suited for any clinical settings and for home care examinations as well as research.</p>","PeriodicalId":76524,"journal":{"name":"Scandinavian journal of rehabilitation medicine. Supplement","volume":"21 ","pages":"1-40"},"PeriodicalIF":0.0,"publicationDate":"1988-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14204183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The coping process after traumatic brain injury.","authors":"A R Fugel-Meyer,&nbsp;K S Fugl-Meyer","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Based on the concept that health means ability to experience satisfaction of life, a paradigm for rehabilitation medicine is proposed: The primary task of rehabilitation after brain injury is to restore function and to turn residual disability to ability as much as possible. For this purpose we want to emphasize the necessity to identify the functions and dysfunctions which determine the coping process. Such analysis enables the team members to provide adequate support for the patients' reorientation towards new vital goals.</p>","PeriodicalId":76524,"journal":{"name":"Scandinavian journal of rehabilitation medicine. Supplement","volume":"17 ","pages":"51-3"},"PeriodicalIF":0.0,"publicationDate":"1988-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14293883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Language and speech defects.","authors":"M T Sarno","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A review of recent research conducted at the Rusk Institute of Rehabilitation Medicine in New York City concerning speech and language deficits in closed head injured patients (CHI). One hundred and twenty-five consecutive admissions of 125 closed head injured post coma patients were administered standardized aphasia tests to determine the presence and nature of verbal deficits. Mean time since injury for the group was 45 weeks. All patients, without exception, evidenced linguistic impairment. The population fell into three relatively equally sized groups: classic aphasia, dysarthria accompanied by linguistic deficits, and \"subclinical\" aphasic deficits. The study results suggest that linguistic functions are particularly vulnerable in severe head injury. A second study compared aphasia secondary to CVA and CHI. When age and time since onset were controlled, aphasic CHI and CVA patients are more similar than different in linguistic task performance and overall functional communication effectiveness. The results suggest that the therapeutic approaches traditionally implemented with CVA aphasic patients are appropriate for the management of CHI aphasic patients as well.</p>","PeriodicalId":76524,"journal":{"name":"Scandinavian journal of rehabilitation medicine. Supplement","volume":"17 ","pages":"55-64"},"PeriodicalIF":0.0,"publicationDate":"1988-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14293884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recovery of motor function after severe traumatic coma.","authors":"F Cohadon,&nbsp;E Richer,&nbsp;C Reglade,&nbsp;J F Dartigues","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This paper describes the resumption of motor activity during the successive stages of recovery following severe traumatic coma and discusses the likely mechanisms of such resumption. Even in severe brain injury a considerable amount of motor recovery is possible and leads to a normal level of function in half of the cases. The impairment of voluntary movements is often transitory and recovers spontaneously but in cases of persistent deficits probably from direct lesion of the pyramidal tract re-education efforts are relatively inefficient. The disorders of reflex and semi-automatic motor activity subserving tonic adjustments, gait and locomotion are nearly constant and often severe. The recovery of this basal function is the most important to attain and to secure and this can be achieved through extensive and prolonged retraining of reflex activity. Presumably these disorders are not caused by direct lesions of brainstem structures but rather to a functional denervation akin to spinal shock. A resumption of function in the denervated groups of neurons should necessitate the reopening of silent synapses and/or a structural reorganisation of synaptic connections, this dynamic process being highly influenced by retraining.</p>","PeriodicalId":76524,"journal":{"name":"Scandinavian journal of rehabilitation medicine. Supplement","volume":"17 ","pages":"75-85"},"PeriodicalIF":0.0,"publicationDate":"1988-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14293885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A quantitative method of evaluation of gait under the influence of electrical stimulation in hemiparetic patients.","authors":"M Kljajić,&nbsp;J Krajnik,&nbsp;U Stanic","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>To improve the procedure of selecting stimulation parameters for the best functional movement, quantitative gait evaluation was investigated. Based on the information obtained by force measuring shoes and a goniometric system, the method consists of computing average values and standard deviations of ground reaction and its point of action, goniometric functions, as well as the ankle joint torque in the sagittal and frontal plane, and their graphic representation. Deviation of the measured variables with respect to the normal gait pattern is the measure of the gait quality. Stimulation parameters were adjusted so that the patient's gait pattern approached normal.</p>","PeriodicalId":76524,"journal":{"name":"Scandinavian journal of rehabilitation medicine. Supplement","volume":"17 ","pages":"105-9"},"PeriodicalIF":0.0,"publicationDate":"1988-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14294241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic electrical stimulation for the modification of spasticity in hemiplegic patients.","authors":"A Stefanovska,&nbsp;N Gros,&nbsp;L Vodovnik,&nbsp;S Rebersek,&nbsp;R Acimović-Janezic","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The effects of long-term electrical stimulation on reflex hyperactivity and voluntary muscle control were studied. Eight hemiplegic patients with implanted peroneal stimulator were included. After six months of functional electrical stimulation (FES) there was a decrease of tonic activity in both tibialis anterior and triceps surae muscles. The phasic stretch reflex activity in the stimulated tibialis anterior muscle increased. The resulting resistance during passive movements decreased due to diminution of tonic activity. The absence of tonic activity also resulted in improvement of voluntary control, particularly in the tibialis anterior muscle.</p>","PeriodicalId":76524,"journal":{"name":"Scandinavian journal of rehabilitation medicine. Supplement","volume":"17 ","pages":"115-21"},"PeriodicalIF":0.0,"publicationDate":"1988-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14388198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electrical stimulation for control of paralysis and therapy of abnormal movements.","authors":"L Vodovnik,&nbsp;S Rebersek,&nbsp;A Stefanovska,&nbsp;J Zidar,&nbsp;R Aćimović,&nbsp;N Gros","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>After a short review of the functional aspects of electrical stimulation in rehabilitating paralysed patients, the article describes its effects on spasticity. Three different studies are briefly described. In the first one paraplegic patients' knee extensors and flexors were stimulated with four channel stimulator. In the second one two channel stimulation was applied to the ankle joint flexors and extensors in hemiplegic patients, while in the third, the effects of spinal cord stimulation were studied in multiple sclerosis patients. Although the parameters and sites of stimulation were different in each study, the effects were similar. In approximately 50% of paraplegic and hemiplegic patients stimulation caused decrease of reflex activity which lasted more than half an hour. In M.S. patients measurements were performed only in intervals of day and therefore short term effects were not documented. Two days after interruption of continuous spinal cord stimulation the reflex activity significantly increased in the majority of patients. In addition to this increase the volitional force decreased considerably.</p>","PeriodicalId":76524,"journal":{"name":"Scandinavian journal of rehabilitation medicine. Supplement","volume":"17 ","pages":"91-7"},"PeriodicalIF":0.0,"publicationDate":"1988-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14388200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Head injury. Integrated rehabilitation approach, optimal adaptation to disability.","authors":"O Höök","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Comprehensive rehabilitation of head injury means that all somatic, psychological and social consequences of the accident must be taken into account in order to plan the most appropriate individual therapeutic program. A review is given of the epidemiology, the different types of head injuries and the management in the acute stage and the rehabilitation stage with special reference to severe and moderate head injuries as well as minor head injuries and post-concussion syndrome.</p>","PeriodicalId":76524,"journal":{"name":"Scandinavian journal of rehabilitation medicine. Supplement","volume":"17 ","pages":"65-74"},"PeriodicalIF":0.0,"publicationDate":"1988-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14104409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrathecal application of drugs for muscle hypertonia.","authors":"J Siegfried,&nbsp;G L Rea","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The literature regarding the intrathecal use of morphine, baclofen, and midazolam to treat spasticity is reviewed. Nine patients with significant spasticity due to different etiologies were treated. Morphine and midazolam decreased spasticity but did not change the patient's functional status. Baclofen improved patient status, but was associated with significant CNS depression in two cases.</p>","PeriodicalId":76524,"journal":{"name":"Scandinavian journal of rehabilitation medicine. Supplement","volume":"17 ","pages":"145-8"},"PeriodicalIF":0.0,"publicationDate":"1988-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14173820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}