Medicine and Health Sciences Commons^™

Occupational Therapists' Interests And Attitudes Toward Animal Assisted Therapy As A Treatment Modality, Lori Susan Buckley

FIU Electronic Theses and Dissertations

One hundred seventy-nine occupational therapists (OTs) responded to a survey regarding their interests and attitudes toward animal assisted therapy as a treatment modality. It was found that most of the practitioners would be interested in learning more about animal assisted therapy and most felt it is a valid treatment modality to be used by occupational therapists. Furthermore, the most common answer to the question "why would you not be interested in participating in an AAT program," was "I feel I don't know enough about it". It was also found that therapists' most commonly selected patient goals for AAT were in …

Pharmacotherapy In Acute Spinal Cord Injury, Yen-Ho Wang, Tien-Shang Huang

Rehabilitation Practice and Science

Acute traumatic spinal cord injury (SCI), a devastating event, results in huge costs to patients and society. Current management emphasizes general supportive care and stabilization of associated spinal columnar injury to prevent worsening of the cord lesions. Most of the numerous experimental studies to investigate pathophysiological changes following acute SCI suggest a two-step mechanism of damage to the spinal cord in which the primary (direct) or mechanical injury caused by trauma initiates secondary (indirect) or progressive autodestructive injury of the cord. During recent years, free oxygen radical generation and lipid peroxidation have been implicated in the secondary injury.Several pharmacological agents …

The Reliability Of Ice-Water Test In Detecting Detrusor Reflex In Patients With Chronic Spinal Cord Lesions, Ya-Wei Cheng, Yu-Gin Na, Tyng-Guey Wang, Yen-Ho Wang, Jin-Shin Lai

Rehabilitation Practice and Science

This study attempts to define the reliability of ice-water test (IWT) in detecting the detrusor reflex in patients with chronic spinal cord lesion (SCL) and further explore its clinical application. 220 patients with SCL over a period of four years were included in this study. 105 of the patients were rated as the acute group with the injury less than six months. 115 patients with lesions over six months were grouped as the chronic one. All the patients underwent gas cystometrogram (CMG) and IWT within 48 hours. CMG revealed the presence of detrusor reflex. Comparing the results of CMG and …

Evaluation Of The Interface Pressure Of Conventionally Used Cushions By Sci Patient At The Ischial Tuberosites, Yiu-Chung Lau, Chau-Peng Leong, Hsueh-Wen Chang

Rehabilitation Practice and Science

Spinal cord injury (SCI) patients confined to a wheelchair for long periods are prone to pressure sores occurring at ischial tuberosity. This study used Expert-Seat pressure evaluation pad to record the pressure of the ischial tuberosities. Twenty-nine spinal cord injury subjects and twenty normal subjects participated in this study. The pressure distributed over ischial tuberosities during sitting was measured five times, including one measured without cushion. Four wheelchair cushions with different types of materials were evaluated in two population groups: spinal cord injured and normal control. The subjects sat on various types of wheelchair seats: (1) gel cushion: skil care …

Clinical Studies Of Voiding Dysfunction Among Asymptomatic Diabetic Subjects, Liu-Ing Bih, Su-Ju Tsai, Chien-Ning Huang, Ming-Miau Tsai, Ya-Chun Lai

Rehabilitation Practice and Science

Uroflowmetry and ultrasonic residual urine measurements had been done to 85 urologically asymptomatic diabetic patients and 20 control subjects. The prevalence of voiding dysfunction was 60% (51/85), and increased residual urine was found in 27% (23/85) of diabetic patients. The abnormal findings included increased residual urine (23/85), interrupted urine stream (9/85), voiding with abdominal strain (31/85), low flow rate (28/85), and enlarged bladder capacity (6/85). The group with voiding dysfunction had lower maximal and average flow rate, longer voiding time, and larger residual urine amount than the diabetic patients with normal voiding function and the healthy controls. The voiding volume …

Recurrence Of Transverse Myelitis After Long Term Neurological Recovery Associated With Antiphospholipid Antibodies In A Patient With Systemic Lupus Erythematosus : A Casereport, Yen-Ho Wang, Woei Tsay, Guang-Dar Yin, Kou-Mou Huang, Tien-Shang Huang

Rehabilitation Practice and Science

A 44-year-old female Taiwanese developed T5 transverse myelitis (TM) in 1984, eight years before the diagnosis of systemic lupus erythematosus (SLE). She responded very well to prednisolone and azathioprine administration and had complete neurological recovery. In August 1997, a relapse of TM at vicinal level, T6, occurred. Magnetic resonance image of the spinal cord revealed long segment involvement from T4 to T8. High titer of antiphospholipid antibodies and various serological markers of lupus activity were found to correlate with this relapse of TM. She responded very well to methylprednisolone pulse therapy with nearly complete neurological recovery. Follow-up examination of magnetic …

Cerebral Infarction Due To Traumatic Internal Carotid Artery Dissection : A Casereport And Review Of The Literature, Shwu-Fen Sun, Sau-Chin Mei, Chien-Wei Hsu, Kuo-Hua Hung, Ping-Hong Lai

Rehabilitation Practice and Science

Traumatic carotid artery dissection is often not recognized at the time of admission, possibly leading to cerebral infarction. This article reports on a 77-year-old man suffering from headache and neck pain after a traffic accident. Although the initial head computed tomography ( CT ) scan revealed no intracranial lesion, progressive left limbs weakness, slurred speech and blurred vision of his right eye developed on the next day after the accident. The color-coded duplex ultrasonography showed an intima flap and a false lumen in his right proximal internal carotid artery ( ICA ), which was compatible with dissection of the vessel. …

A Study On Structural Analysis Of Functional Independence Measure In Taiwan, Nai-Wen Guo, Shu-Hui Yeh, Jau-Hong Lin, Hsin-Ying Chen, Ching-Kuan Liu, Hui-Shin Yuan, Li-Fa Yu, Huey-Tzy Chen

Rehabilitation Practice and Science

A total of 827 Functional Independence Measure (FIM) scores, which from three separate cohorts research from 1995 to 1998 in Taiwan, were conducted the structural analysis of FIM. The 872 subjects included residents of nursery center, outpatients of neurology and neuro-surgery clinics as well as inpatients and outpatients of rehabilitation department. Both principle factor analysis and Rasch model analysis were able to identified two major factors of FIM in Taiwan. There were thirteen items in the first factor which was named as motor function factor, and five items in the second factor which was named as cognitive function factor. From …

Delayed Myelopathy After Electrical Burn : Report Of Two Cases, Cheng-Jen Lo, Yao-Chia Chuang, Baii-Jia Yang

Rehabilitation Practice and Science

Electrical burns dramatically affect the nervous system, muscles, bones, and other tissues within the human body. Myelopathy after an electrical burn has seldom been mentioned.This article describes two cases of myelopathy admitted to our burn center after a high-voltage electrical burn incurred in the workplace, with symptoms onset around 16th and 4th day, respectively. The patients both experienced a course of deterioration, followed by a slow and partial recovery. The possible mechanisms and pathophysiology associated with electric burns are discussed.

The Navicular Arch Index : A Reliable And Valid Footprint Parameter To Evaluate Arch Height, Tso-Liang Wang, Rocky F. Comberiati

Rehabilitation Practice and Science

Recent studies have shown a close correlation between arch height of the foot and activity-related injuries. In the past, attempts to evaluate arch height from footprint parameters have yielded conflicting results. This could be caused by their failure to take anatomy into consideration in the proposed footprint parameters. This study investigates the relationship between arch height and Navicular Arch Index (NAI) - a new footprint parameter developed by us to incorporate anatomical consideration into footprint measurements. NAI is defined as the ratio of modified footprint width to foot width at the site corresponding to the navicular tuberosity. The arch height …

Four Clinical Tests Of Sacroiliac Joint Dysfunction: The Association Of Test Results With Innominate Torsion Among Patients With And Without Low Back Pain, Pamela Levangie

All PTHMS Faculty Publications

Background and Purpose. The purpose of this study was to assess the association between innominate torsion (asymmetric anteroposterior positioning of the pelvic innominates) and the Gillet, standing forward flexion, sitting forward flexion, and supine-to-sit tests. Subjects. A sample of 21- to 50-year-old patients with low back pain (n=150) and a comparison group of patients with upper-extremity impairments (n=138) were recruited from outpatient physical therapy facilities. Methods. The association of single and combined test results with innominate torsion (calculated from pelvic landmark data) and with presence or absence of low back pain were estimated via odds ratios, sensitivities, specificities, and predictive …

Visual-Vestibular Habituation And Balance Training For Motion Sickness, Rose Marie Rine, Michael C. Schubert, Thomas J. Balkany

Physical Therapy Faculty Research

Background and Purpose. This case report describes physical therapy for motion sickness in a 34-year-old woman. The purpose of the report is twofold: (1) to provide an overview of the literature regarding motion sickness syndrome, causal factors, and rationale for treatment and (2) to describe the evaluation and treatment of a patient with motion sickness.

Case Description and Outcomes. The patient initially had moderate to severe visually induced motion sickness, which affected her functional abilities and prevented her from working. Following 10 weeks of a primarily home-based program of visualvestibular habituation and balance training, her symptoms were alleviated and she …

Kinematic Analysis Of Obstacle Clearance During Locomotion, Gary P. Austin, Gladys E. Garrett, Richard W. Bohannon

All PTHMS Faculty Publications

This study investigated the effect of obstacles of different heights on the locomotion of 15 healthy subjects. The following parameters were studied: (1) the distance of the toe and heel markers from the obstacle during toe-off and heel contact, respectively, (2) the minimum clearance distance of the toe and heel markers, and (3) the angular displacements and velocities of the hip, knee, and ankle. Results show significant differences in joint angular kinematics and clearance distances as obstacle height increased. The kinematic and distance differences exhibited both strong linear and non-linear trends. Toe-off distance and heel contact distance did not change …

Neurobehavioral And Neuromotor Long-Term Sequelae Of Prenatal Exposure To Cocaine And Other Drugs: An Unresolved Issue, Yvette Blanchard

All PTHMS Faculty Publications

When the cocaine epidemic began, predictions were made that the children of cocaine users would demonstrate devastating negative developmental sequelae. In infants and young children prenatally exposed to cocaine most frequently the neurobehavioral and neuromotor systems have been studied. Although clinically described as irritable, difficult to console, and jittery as infants, research findings have not been able to clearly describe a pattern of long-term developmental sequelae. The mechanisms of action of drug exposure on developmental outcome have shown to be more complex than originally suspected. Many factors, other than the drug use, can influence developmental outcome. In most studies of …

Effects Of Selective Posterior Rhizotomy On Motor Control And Gait In Children With Cerebral Palsy, Alice May-Kuen Wong, Chia-Ling Chen, Tai-Ngar Lui, Fuk-Tan Tang, Wei-Hsien Hong, Shih-Wei Chou

Rehabilitation Practice and Science

This study evaluates how selective posterior rhizotomy (SPR) affects the motor control pattern of children diagnosed with cerebral palsy (CP) by using polyelectromyography and gait performance. Twenty-four spastic children diagnosed with CP aged 3 to 16 years old were included in this study. Another twenty children diagnosed with CP who had only undergone rehabilitation were selected as the control group. The children diagnosed with CP received polyelectromyography and gait analysis within one month before treatment (SPR or only rehabilitation) and 9 months to 1 year after treatment. Gait analysis included gait patterns and kinematic parameters. The gait pattems were scored …

Prediction Of Motor Recovery Following A Stroke Using Motor Evoked Potential, Pao-Tsai Cheng, Ai-Ling Hu, Mei-Yun Liaw, May-Kuen Wong

Rehabilitation Practice and Science

Electromagnetic stimulation of the motor cortex to produce motor evoked potentials (MEP) recorded from the surface electromyogram in skeletal muscleis a painless, safe and non-invasive means of evaluating the descending motor pathway function in humans.Seventy nine ischemic stroke patients with hemiplegia or hemiparesis participated as the control group(in this study. Electromagnetic stimulation was performed to identify the correlation between MEP findings and clinical motor functional status as well as findings of CT scans. In addition, the motor status of the hemiplegic limb was evaluated by using Brunnstrom staging and the functional status of the stroke patient was evaluated by using …

An Investigation Of Gait Analysis For Stroke Patients By Computer Dynography System, Alice May-Kuen Wong, Chrong-Jyue Tsai, Fuk-Tan Tang, Pao-Tsai Cheng, Wei-Hsien Hong, Ming-Yih Lee

Rehabilitation Practice and Science

There are many techniques and methods for gait analysis, but the data are not easy for the clinician to read and to correlate clinically in patients with neurological deficits such as stroke. In this study, we tried to simplify the kinetic gait data of 102 functionally ambulant stroke patients in a more simple way through pattern recognition in addition to conventional gait parameters and compared them with 50 healthy subjects. All of the stroke patients had received rehabilitation programs and were functionally ambulant. The computer DynoGraphy (CDG) system was used for gait analysis. The foot contact patterns based on pattern …

Dermatomyositis Associated With Dysphagia ：A Casereport And Literatures Review, Keng-Yu Chao, Tyng-Guey Wang, Yeun-Chung Chang

Rehabilitation Practice and Science

Dysphagia frequently occurs in patients inflicted with dermatomyositis. Dysphagia in dermatomyositis patients is occasionally overlooked and misdiagnosed since it is not a major clinical manifestation. This article presented on a 31 years old woman inflicted with dermatomyositis. Dysphagia developed during her hospitalization, as evidenced by her difficulty in swallowing solid food and choking with nasal regurgitation while taking liquids. Psychogenic dysphagia was diagnosed simply owing to the lack of positive findings of esophagogram. The patient subsequently visited OPD of Physical Medicine and Rehabilitation Department. Although videofluoroscopic examination of swallowing study in our department revealed only mild oral stasis without aspiration, …

Occupational Therapy With Children With Pervasive Developmental Disorders, Jane Case-Smith, Heather Miller-Kuhaneck

Occupational Therapy Faculty Publications

Objective. Although the prevalence of children with pervasive developmental disorders (PDD) has increased, empirical data about the role and practices of occupational therapists have not been reported in the literature. This descriptive study investigated the practice of occupational therapists with children with PDD.

Method. A survey was mailed to 500 occupational therapists in the Sensory Integration Special Interest Section or School System Special Interest Section of the American Occupational Therapy Association in eastern and midwestern United States. The valid return rate was 58% (292 respondents). The survey used Likert scale items to measure frequency of performance problems observed in children …

Reliability Study And Features Of Falling Tendency When Standing In Unilateral Hemispheric Stroke Patients, Ling-Fu Meng, Shi-Dong Jush, Mei-Hsiang Chen

Rehabilitation Practice and Science

”Astasia(inability to stand)” is a popular and immediate result after onset from stroke. Health professionals usually label astasia as ”poor” standing performance. However, few studies substantiate the falling tendency of astasia. The result of inability to stand is to fall toward one specific direction; therefore, this study used ”falling direction” as a medium to analyze the falling tendency of astasia. Three major results were found in this study. Firstly, the measurement used in this study to judge falling direction demonstrated good inter-rater reliability. Two raters' kappa value was .89, .88, .87 respectively(each p value ＜ .001). Secondly, while comparing 5 …

Lateral Medullary Syndrome And Brachial Plexopathyin Heroin Addiction：A Casereport, Hong-Li Lee, Shih-Jei Tsai, Lu-Ing Bih, Wu-Chung Shen, Yaw-Zen Chen, I-Fu Lin

Rehabilitation Practice and Science

As a serious social problem, heroin abuse may induce toxic encephalopathy, cerebrovascular accident, or peripheral neuropathy. This article describe a 40 year old male diagnosed as lateral medullary syndrome ( Wallenberg syndrome), possibly resulted from heroin abuse. Possible causes for his symptoms are ischemic stroke and toxic demyelination. This patient also suffered from brachial plexopathy of left side. This malady may be attributed to nerve inflammation reaction from heroin and adulterants. This article also discussed heroin-related neurological disorders. Results presented herein provide a valuable reference for clinical diagnosis and management.

Rehabilitation Cost Of Long Term Care System - Analysis Of Stroke Patients Sampled From A General Hospital, Huey-Jen Lai, Horng-Jeng Shyn

Rehabilitation Practice and Science

Following implementation of the national health insurance system in Taiwan, only home health care is covered by insurance for long-term-care, possibly owing to the lack of financial coverage.Since Japan's economy reached full maturity in 1963, social benefits, including free health care, have been provided. This subsequently led to abuses of health care resources, cost expansion and acute beds occupied by chronic patients, thus straining governmental finances severely. This situation has been alleviated by providing general health care, elevating the deductable amount, constructing less expensive health facilities for the elderly, and performing home health care, day care and home nursing so …

Race, Gender, And Partnership In The Patient-Physician Relationship, Lisa Cooper-Patrick, Joseph J. Gallo, Junius Gonzales, Hong Thi Vu, Neil R. Powe, Christine Nelson, Daniel E. Ford

Publications from Provost Junius J. Gonzales

Context Many studies have documented race and gender differences in health care received by patients. However, few studies have related differences in the quality of interpersonal care to patient and physician race and gender.

Objective To describe how the race/ethnicity and gender of patients and physicians are associated with physicians' participatory decision-making (PDM) styles.

Design, Setting, and Participants Telephone survey conducted between November 1996 and June 1998 of 1816 adults aged 18 to 65 years (mean age, 41 years) who had recently attended 1 of 32 primary care practices associated with a large mixed-model managed care organization in an urban …

Association Of Low Back Pain With Self-Reported Risk Factors Among Patients Seeking Physical Therapy Services, Pamela Levangie

All PTHMS Faculty Publications

Background and Purpose. This study investigated the magnitude of association between low back pain (LBP) and self-reported factors thought to increase the risk of LBP. Subjects and Methods. Questionnaires were completed by 150 patients who were receiving physical therapy for LBP and by 138 patients who were being treated for other reasons. The solicited information was used to estimate odds ratios and 95% confidence intervals for the LBP-risk factor association. Results. Low back pain was positively associated with smoking status, pregnancy, industrial vibration exposure, and time spent in a car (odds ratios [is greater than or equal to] 2.21). Daily …

The Association Between Static Pelvic Asymmetry And Low Back Pain, Pamela Levangie

All PTHMS Faculty Publications

Study Design: A cross-sectional case–control approach was used to estimate the association between low back pain of less than 12 months’ duration and pelvic asymmetry among 21–50-year-old patients seeking physical therapy services. Objective. To evaluate the premise that asymmetrical positioning of the innominates of the pelvis is a source of low back pain. Summary of Background Data: No published studies have been conducted to evaluate systematically the association between low back pain and pelvic asymmetry in a clinic-based sample. Methods: Pelvic landmark data were obtained in 144 cases and 138 control subjects. The associations of low back pain with levels …

The Association Between Static Pelvic Asymmetry And Low Back Pain, Pamela K. Levangie

Physical Therapy Faculty Publications

Study design: A cross-sectional case-control approach was used to estimate the association between low back pain of less than 12 months' duration and pelvic asymmetry among 21-50-year-old patients seeking physical therapy services. Objective: To evaluate the premise that asymmetrical positioning of the innominates of the pelvis is a source of low back pain. Summary of background date: No published studies have been conducted to evaluate systematically the association between low back pain and pelvic asymmetry in a clinic-based sample. Methods: Pelvic landmark data were obtained in 144 cases and 138 control subjects. The associations of low back pain with levels …

Growth Analysis For Cost Of Rehabilitation Service Under The National Health Insurance Program In Taiwan, Mu-Jung Kao, Mei-Wen Tsai, Mau-Roung Lin, Ming-Chuan Lin, Tyne-Guey Wang, Jin-Shin Lai

Rehabilitation Practice and Science

This study analyzes the structure and trends of costs associated with rehabilitation services under the National Health Insurance program. Statistical analysis was performed for costs associated with in-patient and out-patient rehabilitation services in northern Taiwan. 86.97% to 88.07% of total six-month costs were declared for out-patients. Most of the moderate items for physical therapy and occupational therapy were prescribed for out-patients. In contrast, most of the complicated items for physical therapy, occupational therapy and speech therapy were done for in-patients, especially at medical centers. Comparing the period from January to June of 1998 with the same period of 1997, six-month …

Evaluation Of A Novel Exercise Training Program For Patients With Chronic Obstructive Pulmonary Disease, Tyng-Guey Wang, Ssu-Yuan Chen, Shu-Fang Hsiao, Kuang-Hua Lin, Shou-Hsing Kuo, I-Nan Lien

Rehabilitation Practice and Science

This study evaluated a novel exercise training program for the individuals diagnosed with chronic obstructive pulmonary disease.Although sixteen patients (M:13; F:3) with moderate chronic obstructive pulmonary disease participated in this study, only six completed the training programs. Cycle ergometry was used to test and train the patients. The training was performed three times weekly and lasted three months, with each training section lasting 30 to 40 minutes. As obtained from cycle ergometry, the training intensity accounted for 40 %, 60%, and 80% of the maximum work rate in the first two weeks, the following 3 to 6 weeks. and the …

Adult Intramedullary Anaplastic Astrocytoma In The Spinal Cord: A Casereport, Liang-Cheng Chen, Kao-Chung Tsai, Fu-Kong Lieu

Rehabilitation Practice and Science

Adult anaplastic astrocytomas comprise a small subset of intramedullary spinal cord tumors and carry a dismal prognosis. Characteristically, a short prodrome occurs only several weeks before diagnosis, followed by progressive neurological deterioration and death. This article describes a 48-year-old male patient suffering from lower back pain with radiculagia and progressive weakness of both lower limbs for 5 months. The patient was initially diagnosed as having a lower lumbarintervertebral disc herniation and underwent laminectomy with spinal rods instrumentation two months following the diagnosis. The symptoms gradually worsened and cauda equina syndrome developed thereafter. Two months later, a second subtotal cytoreductive surgery …

Functional Improvement Of Upper Extremity In Cervical Spinal Cord Injured Patient After Tendon Transfer : A Casereport, Chih-Kuang Chen, Fuk-Tan Tang, Meao-Ming Chen, Ngok-Kiu Chu

Rehabilitation Practice and Science

Traumatic tetraplegia is a devastating malady caused by cervical spinal cord injury, leading to motor and sensory impairment of the four limbs. Loss of the upper extremities function severely impacts life quality of the victim. Early and comprehensive rehabilitation can provide good functional recovery and prevent long-term complications. Furthermore, the advanced reconstructive hand surgery that has been developed in the past two decades has become a viable alternative to enhance the function of paralyzed upper extremities. However, this surgical procedure is still rarely performed on tetraplegic patients in Taiwan. This article describes a cervical spinal cord injured patient receiving a …