Medicine and Health Sciences Commons^™

The Research Of Medical Service Quality Evaluation: From The Viewpoint Of Predicting Reclaimed Rate Using Neural Networks, Horng-Jeng Shyu, Chao-Chang Chiu, Pei-Lun Hsu, Meei-Fang Lin

Rehabilitation Practice and Science

The goal of this study was to investigate the subtle interrelationships between the insurance claim’s data and clinic performance of medical institutes. Because the medical claims data increase drastically, the review efforts and processes become rather complex and inefficient. The physicians of review committee should have an enterprise view of the claims.We create the performance indicators from consistent data & meta data established from the clinic performance of medical institutes. We adopted 16 outpatient review indicators. We collected rehabilitation claims in middle branch of NHIB since July 1996 till Feb 1997. The prediction model created using both the neural network …

Lumbar Disc Herniation Along With Ruptured Abdominal Aortic Aneurysm: A Casereport And Literature Review, Woan-Chwen Wu, Chen-Liang Chou, Ming-Chi Yung, Shing-Su Chen, Tcho-Jen Liu, Rai-Chi Chan

Rehabilitation Practice and Science

Abdominal aortic aneurysm is a condition affecting nearly 4% of the elderly population. It has a potential for producing a wide range of symptoms, including abdominal pain and back pain. It is rare that abdominal aortic aneurysm presents with paraplegia. From literature review there have been very few reports of patients who sustained lumbar disc herniation along with ruptured abdominal aortic aneurysm. We reported a 68-year-old man with a previously undiagnosed abdominal aortic aneurysm presenting with acute paraplegia. This patient had a history of lumbar disc herniation and was receiving pelvic traction. He survived after operation, but some long-term sequelae, …

Metastatic Prostate Cancer Associated With Lumbar Compression Fracture And Spinal Stenosis: A Casereport And Literature Review, Shwu-Fen Sun, Jue-Long Wang, Ping-Hong Lai

Rehabilitation Practice and Science

We reported a 72 y/o male who had past history of old L1 compression fracture for 1 year. He suffered from falling down accidentally and was operated under impression of L1 burst fracture with cauda equina syndrome. He could ambulate with walker, but persistent back pain was still complained. Two months after operation, he became paralyzed rapidly in 2 days. Neurological examinations showed decreased motor strength of bilateral lower extremities to grade 0-1/5, sensory deficit below T10 dermatome and bilateral extensor plantar response. X-ray film showed an osteoblastic lesion in T9 vertebra body. Magnetic resonance Imaging (MRI) of thoracic spine …

The Interaction Between Antidepressants And Spasticity Of Stroke: Casereport, Shih-Wen Lin, Zong-Jing Wang, Young-Hue Yu

Rehabilitation Practice and Science

The upper motor neuron diseases (such as cerebrovascular accidents, traumatic brain injury, spinal cord injury, and multiple sclerosis) frequently cause spasticity of extremities. The medications for treating spasticity include baclofen and diazepam, which take their effect in the central nervous system through their GABAergic action. The incidence of depression in patients with spasticity is much higher than that of the normal population. Many doctors prescribe antidepressants for these patients. Two common used antidepressants are tricyclic antidepressants (TCA) and selective serotonin reuptake inhibitors (SSRI). They could increase serotonin amount in synapses, and induce increased excitability of motor neurons, which in turn …

A Design Of Rehabilitation Information System For Inpatients: An Experience Of A Medical Center, Mu-Jung Kao, Chih-Tsung Hsieh, Rong-Lin Yang, Mei-Wun Tsai

Rehabilitation Practice and Science

Rehabilitation Information System for Inpatients (RISI) was designed for medical administration in the Department of Rehabilitation at a medical center in Taiwan. The RISI includes administration system, patient consultation system, rehabilitation order entry system, rehabilitation therapy system for physical therapy, occupational therapy, and speech therapy, check out system for time and frequency of therapy, and statistic function system.The characteristics of this system includes: 1) integration of systems between outpatients and inpatients; 2) integration of available administration system and patient consultation system; 3) integration of administration and medical system in the department of rehabilitation and 4) operation without paper work. The …

Clinical Experience In Asian Type Multiple Sclerosis, Der-Sheng Han, Jau-Jia Lin, Yen-Ho Wang, Chih-Chao Yang

Rehabilitation Practice and Science

Multiple sclerosis is a heterogeneous disease entity, and also the most common disabling neurological disorder of people in middle life in USA. The prevalence of multiple sclerosis in Asia is lower than that in Western countries of similar latitude. Besides, there are some different features, clinically as well as pathologically, between this disease in Asia and in Western countries. We collected 27 cases diagnosed as clinically definite MS at NTUH between 1990-2000, whose clinical presentations are restricted to optic nerves and spinal cord. Their clinical charts were reviewed retrospectively, and the data was collected in a standard coding sheet. The …

The Pizzi Holistic Wellness Assessment, Michael Pizzi

Occupational Therapy Faculty Publications

This paper describes the Pizzi Holistic Wellness Assessment tool. Using theory from the field of health promotion and expertise gained in his private home health practice, the author developed and pilot tested this assessment on a variety of individuals. The assessment is designed to be used with different populations in a variety of settings to help clients self assess their health and well-being.

Etiology And Rehabilitation Effect Of Stroke In Child: A Casereport, Li-Chen Tung, Kwok-Tak Yeung, Chun-Hou Wang, Wen-I Liang, Liu-Ing Bih

Rehabilitation Practice and Science

The incidence of strokes in childhood is 2.5/100,000. Of these, occlusive stroke accounts for 57 to 85 percent, and hemorrhagic stroke accounts for 15 to 51 percent. Occlusive stroke is primarily caused by congenital heart defects, and the principal symptom is acute hemiplegia. Hemorrhagic stroke is caused mostly by abnormalities of blood vessels, and is characterized by headache and loss of consciousness. Compared to adults, children have better collateral circulation and incompletely developed brains. The clinical and recovery courses those in children are different from those of adults. The prognosis and the incidence of stroke recurrence are largely determined by …

Long-Term Outcome Of Gastrostomy Feeding In Dysphagic Stroke Patients, Tung-Chou Li, Mei-Hue Hsu, Tzong-Hsi Lee

Rehabilitation Practice and Science

Dysphagia is a common reason for long-term enteral feeding in stroke patients. It has been shown that gastrostomy feeding provides better nutrition for stroke patients than nasogastric tube feeding in short term period. However, little is known about the long-term outcome of gastrostomy-assisted feeding in them. In recent years, some of the dysphagic stroke patients began to accept gastrostomy feeding in Taiwan. We herein conducted this study to find and analyze the characteristics and long-term outcome of dysphagic stroke patients who had underwent gastrostomy. Forty-two stroke patients underwent gastrostomy between Jan. 1998 and May 2000 were enrolled in this study. …

Abuse Assessment Screen–Disability (Aas-D): Measuring Frequency, Type, And Perpetrator Of Abuse Toward Women With Physical Disabilities, Judith Mcfarlane, Rosemary B. Hughes, Margaret A. Nosek, Janet Y. Groff, Nancy Swedlend, Patricia Dolan Mullen

Rural Institute Journal Articles

An interview questionnaire was presented to a multiethnic sample of 511 women, age 18–64 years, at public and private specialty clinics to determine the frequency, type, and perpetrator of abuse toward women with physical disabilities. The four-question Abuse Assessment Screen–Disability (AAS-D) instrument detected a 9.8% prevalence (50 of 511) of abuse during the previous 12 months. Using two standard physical and sexual assault questions, 7.8% of the women (40 of 511) reported abuse. The two disability-related questions detected an additional 2.0% of the women (10 of 511) as abused. Women defining themselves as other than black, white, or Hispanic (i.e., …

Conflict Of Interest And Physical Therapy, Mike W. Martin, Donald L. Gabard

Philosophy Faculty Books and Book Chapters

'In a chapter entitled “Conflict of Interest & Physical Therapy”, authors Martin & Gabard offer a cogent definition. They write simply, “conflicts of interest are situations in which individuals have interests that significantly threaten their role responsibilities, or would do so for a typical person having their role.” Likewise, Davis describes the standard view of conflict of interest as a situation in which a person P is in a relationship requiring P to exercise some judgment on another’s behalf and P has an interest “tending to interfere with the proper exercise of that judgment”. With regard to professional conflicts of …

Prescott V.A. Medical Center, Megan E. Edwards

Honors Theses

Discusses therapy techniques, including MOHO, COTE, and KidCOTE, and their implementations. Also presents the case of fictional patients and their proposed treatment plans.

Cervical Anterior Spinal Artery Syndrome：A Casereport, Jiann-Perng Chen, Baii-Jia Yang

Rehabilitation Practice and Science

A 30 year-old male was sent to the emergency department due to chest pain and radiation to left shoulder. Heart disease was suspected but the electrocardiography and cardiac enzyme examination were negative. Tetraplegia with the dissociated sensory loss occurred later. Pain and temperature sensation decreased, but vibration sensation and proprioception were preserved. Urine retention was also noted, but the bladder sensation seemed to be preserved. The anterior spinal artery syndrome at the lower cervical cord level was diagnosed by the clinical presentation and MRI findings. The negative findings of laboratory examination helped exclude other possible causes. The rehabilitation program was …

The Role Of Hula-Hoop Exercise In Training Balance Function Of The Elderly, Der-Jiun Yin, Li-Fang Wu, Chorng-Sonq Chou

Rehabilitation Practice and Science

These years, geriatrics is highly regarded because of increase of the elderly population. The weakness of physical functions caused by aging is natural; therefore, the ability of daily life and activity of the elderly degenerate. Mounting evidence of researches showed that the solution for this problem is internal medicine diagnosis in early stage and regular treatment. Moreover, exercise was also an eff-ective method to improve functional activity in the elderly. The major factors of improving functional activity include the nerve system, musculoskeleton system and body balance. The latter has been an important theme for geriatrics recently. In this study, hula-hoop …

The Study Of Post-Polio Syndrome In Tao-Yuan Area, Yau-Wai Wai, Wai-Keung Lee, Ying-Po Hsu, Tsai-Ching Yip

Rehabilitation Practice and Science

This study aims to investigate the disease process, living environment, physical condition, and current problems of the patients with poliomyelitis in Tao-yuan area. Through a total 151 responses and 55 patients coming to the hospital for follow up, a data base was established to determine the impacts of the direct and indirect factors, including social environment, poor medical resources and lack of public health education. Unfortunately, the number of patients who showed up for further check up is unsatisfactory in schedule due to lack of convenient transportation. However, the data collection of this study would be sufficient for long term …

Gait Analysis And Energy Expenditure Of Walking Among Patients With Unilateral Transtibial Amputation, Gwo-Feng Huang, You-Li Chou, Fong-Chin Su, Pei-Hsi Chou

Rehabilitation Practice and Science

Amputations not only cause the loss of limb but also accompany with inconvenience of physical mobility for the patients. The newly developed prosthetic designs make possible to the replacement of amputated parts, thus greatly improve the body mobility and life independence of the patients. However, the real manifestation of the prosthetic gait and the discrepancy between the prosthetic and normal gaits is still lacking, especially there are significant difference in kinematics and kinetics between the sound side and prosthetic side with different type of prosthetic feet.There are two steps in these studies: The first step is analyzing the gait of …

The Prognosis And Academic Performance In Children With Hydrocephalus: A Preliminary Report, Chung-Lan Kao, Tai-Tong Wong, Hong-Shin Chen, Chi-Yu Kang, Rai-Chi Chan

Rehabilitation Practice and Science

This study is to determine the prognosis and academic performance in hydrocephalic children with different etiologies. We reviewed the medical records of all the patients who had the diagnoses of hydrocephalus and had been regularly followed between 1983 and 1997. The patients were categorized into six different etiological groups as 1. premature type hydrocephalus, 2. idiopathic hydrocephalus, 3. hydrocephalus occurring after meningitis, 4. hydrocephalus associated with congenital anomalies, 5. hydrocephalus associated with myelomeningocele and 6. hydrocephalus not receiving any surgery. The ages at first shunt insertions, shunt revision rates, causes of shunt revisions, percentage of physical and mental handicap and …

The Effect Of Meditation On Cardiopulmonary Fitness In Patient With Stroke: A Preliminary Report, Nien-Tzu Kao, Chang-Ming Chern, Chen-Liang Chou, Sun-Don Lee, Su-Ying Hung, Tacho-Jen Liu, Rai-Chi Chan

Rehabilitation Practice and Science

It is well documented that regular exercise can improve cardiopulmonary function and health-related fitness. However, major limitation of exercise therapy lies in physiologic and environmental factors, which is particularly true for patients with physical disability such as stroke. A standardized Buddhist meditation skill, Forshang Meditation (FM), was adopted; and this paper described the long-term effects of FM on cardiopulmonary fitness.Seventeen patients ( 1 female and 16 males; mean age 70.8 ± 4.8 years, range 61-78 years ) with a history of cerebrovascular disease and low extremity of hemiplegic side above Brunnstrom stage V were recruited. Baseline data of cardiopulmary function …

Ptosis Following Treatment Of Botulinum Type A For Hemifacial Spasm : A Casereport, Chun-Pei Chuang, Baii-Jia Yang

Rehabilitation Practice and Science

Hemifacial spasm is an intermittent, synchronous contraction of ipsilateral facial muscles. Botulinum toxin A injection is an effective and safe symptomatic treatment for hemifacial spasm. In the traditional method, physicians omitted the central upper eyelid area to prevent the development of ptosis, but there may remain some twitches.Here we report a case of Botulinum toxin A injection for left hemifacial spasm with complication of ptosis. Apraclonidine 0.5% ophthalmic solution was used in this patient to facilitate the recovery of ptosis. A 53 y/o woman with Grade 3 left hemifacial spasm received first treatment with total dosage of 45 units of …

Diffused Involvement Of The Spinal Cord In A Patient With Lupus-Related Acute Transverse Myelitis：A Casereport, Huei-Yu Tzeng, Shu-Min Cheng, Jo-Tong Chen, Ta-Shen Kuan, Chrong-Reen Wang

Rehabilitation Practice and Science

Acute transverse myelitis ( ATM ) is a rare but severe complication of systemic lupus erythema-tosus ( SLE ). Magnetic resonance imaging ( MRI ) is the leading imaging study for diagnosing ATM and monitoring the treatment and/or the progression of the disease. Lesions of the spinal cord of ATM are usually less than 4 spinal segments. Currently, high dose corticosteroid plus cytotoxic agents is recommended to obtain the maximal therapeutic efficacy.A case of lupus-related ATM with diffuse spinal cord involvement is presented. A 21-year-old woman had a 4-year history of SLE. Acute onset of weakness and numbness of bilateral …

Axillary Nerve Injury And Rotator Cuff Rupture After Glenohumeral Joint Dislocation: A Casereport And Literature Review, Jin-Long Jiang, Chin-Teng Chung, Chorng-Sonq Chou, Howard Haw-Chang Lan

Rehabilitation Practice and Science

Dislocation of the glenohumeral joint is a frequent disorder that occurs among traumatic injuries of the shoulder. There are differences in the dislocation between young and older patients. Recurrent instability is more common to follow traumatic anterior dislocation of the glenohumeral joint in young patients than older patients. Neurologic complications and associated soft tissue injuries after a glenohumeral dislocation occur more frequently in patients around 40 years of age and older.A 73-year-old patient suffered from dislocation of left glenohumeral joint after falling down. Paralysis of left shoulder muscle was found after the close reduction. Physical examinations disclosed loss of active …

Application And Interpretation Of Simple Odds Ratios In Physical Therapy-Related Research, Pamela Levangie

All PTHMS Faculty Publications

Over the past several decades, physical therapists have demonstrated an increasing responsiveness to the profession's obligation to generate objective evidence for examination and intervention strategies employed in physical therapy practice. This trend is evident, not only in the increasing number of journals that are publishing physical therapy research, but in the growing sophistication of research design and analytic options used by investigators. At the same time, physical therapists are held increasingly accountable for adopting an evidence-based approach to practice. The result for many of us is a growing concern about our ability to interpret study findings. The ability to independently …

A Practice Analysis Survey: Defining The Clinical Practice Of Primary Care Physical Therapy, Edsen Bermudez Donato

Loma Linda University Electronic Theses, Dissertations & Projects

Background and Purpose. Due to changes in the health care delivery systems, physical therapy services have moved toward a primary care model of practice. The purpose of this study was to identify the professional responsibilities, procedures, and knowledge areas of physical therapists practicing in primary care settings.

Subjects. A sample of 212 physical therapists practicing in primary care settings, and a control group of 250 physical therapists not practicing in primary care settings were surveyed.

Methods. The survey instrument was developed with the assistance of a National Advisory Committee (NAC) consisting of 12 subject matter experts. A modified Delphi …

The 6-Minute Walk Test And Alternatives: A Brief Review Of Literature, R. W. Bohannon, K. Sadaria

Physical Therapy

No abstract provided.

Quality Of Life As Defined By Chinese Americans With Disabilities: Implications For Rehabilitation Services, Nan Zhang Hampton, Vickie Chang

Institute for Asian American Studies Publications

We hypothesized that Chinese Americans with disabilities may remain culturally attached to their ancestors' homeland and this cultural attachment may have influences on the concept of Quality of Life (QOL). That is, QOL may be perceived, by Chinese Americans with disabilities, not only as an individual's satisfaction with his or her life, but also the person's fulfillment of his or her responsibilities to his or her family and community. Of course, this hypothesis needs to be examined. Such an investigation may provide rehabilitation counselors with insights into the meaning of QOL from the viewpoint of Chinese Americans with disabilities. It …

A Survey Of In-Line Skaters' Injuries In Taipei, Teh-Ken Yang, Lin-Fen Hsieh

Rehabilitation Practice and Science

In-line skating has grown to become a popular sport and recreational activity in the past few years. This study was designed to survey the sport injuries in in-line skaters and its relating factors. 240 subjects (136 males and 104 females) were sampled from two public parks in Taipei (Ta-An Park and Sun Yat-Sen Memorial Hall), which are the most representative of the in-line skaters’ population in Taipei city. Ages ranged from 3 to 50 (mean, 17) years old. 126 (52%) subjects had skated for more than one year, and 159 (66.5%) had injury while skating.Data collected revealed four most commonly …

Return To School After Spinal Cord Dysfunction In Central Taiwan, Hong-Li Lee, Liu-Ing Bih, Hua Ting, Shih-Chung Chang, Li-Chen Tung

Rehabilitation Practice and Science

This retrospective study explores the physical and emotional barriers faced by individuals with spinal cord dysfuntion when returning to school. All subjects lived in central Taiwan. The questionnaires of 20 cases were successfully completed. The ages of them at the time of the disorder ranged from 0 to 20 years (mean of 10.9 years). Regarding the education level, 7 of 20 were graduated from or remained in university or college, 8 in high school, 3 in junior high school, and 2 in kindergarten. More than half (52%) stated the architectural barrier, most commonly mentioned, was lack of the elevator to …

Ischemic Degeneration Of The Posterior Tibial Tendon In Rabbits, Jeng-Yi Shieh, Tyng-Guey Wang, Jan-Show Chu, Chung-Li Wang

Rehabilitation Practice and Science

脛後肌肌腱斷裂的病態生理現象至今仍未有廣泛的研究。本文的目的乃利用兔子動物模型來探討缺血在脛後肌肌腱退化中可能扮演之角色。我們利用40隻紐西蘭白兔將之分為四組，將一段脛後肌肌腱的內行性與外行性營養供應途徑阻斷其一或同時阻斷，三星期後將此段肌腱取出，做病理學之觀察。實驗結果顯示，缺血的確可以造成兔子脛後肌肌腱的退化甚至斷裂。而肌腱內行性的血流循環乃脛後肌肌腱主要的營養供應途徑，從外面滑膜囊液滲透進入肌腱的養份並不足以維持脛後肌肌腱的完整性。脛後肌肌腱所承受的張力會加重缺血對肌腱所造成的傷害。

Exercise Training During Hemodialysis For The Patients With End-Stage Renal Failure, Hang-Tan Lin, Chiu-Chu Lin, Yu-Lin Wang, Rong-Bin Hong, Meng-Huei Lin, Wen-Chun Huang, Li-Wen Hsien, Wil-Ly Chou

Rehabilitation Practice and Science

The purposes of this study were to explore the feasibility of exercise training during hemodialysis for end-stage renal failure patients, and the effect of exercise training on cardiopulmonary endurance, blood and biochemical changes. The purposive sample was recruited from a medical center in southern Taiwan. A total of 20 hemodialysis patients underwent a 30-50 minutes stationary bicycle training ( 3 times a week for 12 weeks ) within the first two hours of the hemodialysis period. Exercise testing was administered to measure cardiopulmonary endurance and the change of blood and biochemical data before and after the 12-weeks exercise training program. …

Factors In Predicting The Number Of Home Care Physical Visits, Bruce D. Bradley

Loma Linda University Electronic Theses, Dissertations & Projects

There has been a significant increase in the utilization of home health care during the past decade. Medicare has attempted to control home care costs by 1) allowing Medicare beneficiaries to join Health Maintenance Organizations, and 2) requiring the use of the Outcome and Assessment Information Set (OASIS) for all patients admitted to home care services. These changes have challenged the home care physical therapist to be a better predictor of the total number of visits needed to complete the rehabilitation process. This was a retrospective study of 335 patients who received home health care physical therapy. The first part …