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Retrospective Study Of Long-Term Medical Complications In Spinal Cord Injured Patients, Hui-Wen Yu, Su-Ju Tsai, Fan-Fei Tseng, Yu-Hui Huang, Ying-Ju Shih, Liu-Ing Bih

Rehabilitation Practice and Science

In order to determine the prevalence of medical complications after spinal cord injury, 52 patients who received regular follow up in a rehabilitation hospital (average 14.1 years) were studied. Medical records were reviewarticleed and analyzed, including demographic data, onset duration, neurological level, locomotion, reason for visiting doctor's office, rehospitalization, medication usage, and surgical intervention. The most common complication encountered was constipation (82.7%). Other common complications were neurogenic bladder dysfunction (80.8%), urinary tract infection (75.0%), musculoskeletal pain (71.2%), spasticity (67.3%) and gastrointestinal disturbance (51.9%). reviewarticleing the medical records in the most recent year, constipation was still the most common complication (46.2%). …

Therapeutic Effect Of Air-Jet Therapy In Breast Cancer-Related Lymphedema: A Preliminary Report, Wan-Chia Lee, Cheng-Liang Chou, Cheng-Min Chiu, Tcho-Jen Liu, Rai-Chi Chan

Rehabilitation Practice and Science

Lymphedema is a common sequela of breast cancer therapy. The decreased arm function with swelling, pain, numbness, and a limited range of motion, is associated with a psychological distress that affects the quality of life. There is no cure for breast cancer-related lymphedema. Complex physical therapy is currently the mainstream of therapy, combined with manual lymphatic drainage, pneumatic compression pumps and compression bandaging. The purpose of this study is to evaluate compressed air therapy as a new approach to lymphedema management.Eleven women with breast cancer-related arm lymphedema were recruited into the study. Air-jet therapy was performed to massage limb in …

Comparison Of Thermal Effect With Ultrasound In Rat Calf Muscles After The Application Of Five Non-Steroidal Anti-Inflammatory Drugs, Yueh-Ling Hsieh, Chen-Chia Yang, Hui-Wen Kuo

Rehabilitation Practice and Science

Background and Purposes: Phonophoresis has been defined as the migration of drugs through the skin under influence of ultrasound (US). The phonophoresis of nonsteroidal anti-inflammatory drugs (NSAIDs) was studied in vivo through hairless rat skin to determine the temperature changes in superficial and deep tissues in response to NSAID phonophoresis.Study Design and Objectives: To measure and compare the temperature changes in tissues in response to five NSAIDs under phonophoresis. Methods: Male Wistar rats weighing 250 to 350 g had one of five drugs; i.e., piroxicam (Feldene), indomethacin (Indocin), etofenamate (Rheumon), methylsalicylate (Salomethyl), or diclofenac (Voren) applied to one hindlimb followed …

Survey Of Spinal Cord Injuries Due To Diving Accidents In Taiwan, Ya-Wen Tu, Huey-Wen Liang, Yen-Ho Wang, Jiunn-Horng Kang, Liu-Ing Bih, Fuk-Tan Tang

Rehabilitation Practice and Science

Objective: To examine the clinical characteristics of diving-related spinal cord injuries (SCI) in Taiwan.Methods: This study is a retrospective reviewarticle of all hospitalized patients with spinal cord injuries due to diving accidents in three rehabilitation centers between January 1982 and July 2002. Demographic data and clinical features were presented and analyzed. Results: A total of 1216 spinal cord injuries were reviewarticleed, and 16 cases (1.3%) met the inclusion criteria. Their mean age at the time of injury was 26.8 years and 15 (94.0%) of the cases were male. All of the injuries resulted in tetraplegia and 11 (69.0%) were neurologically …

The Influence Of Nasogastric Tube To Post-Stroke Depressive Tendency And Functional Outcome, Nai-Chiung Huang, Ta-Sen Wei, Sen-Yung Liu

Rehabilitation Practice and Science

Depression is reported in a portion of stroke patients during the period of their stay in acute and rehabilitation hospitals. Depression may influence the patient's motivation to participate in the rehabilitation program and result in slower functional recovery and poor functional outcome. In addition, patients with prolonged usage of nasogastric tube for food intake experience a stronger degree of physical impairment, slower functional recovery, and less motivation. The purpose of our study was to determine the correlation between prolonged usage of nasogastric tube and post-stroke patients' depression tendency, and their effects on the patients' functional outcome. Eighty-six patients participated in …

Bilateral Sciatic Neuropathy Due To Drug Overdose With Coma, Susan Y Fan, Chang-Zern Hong, Lin-Fen Hsieh, Yii-Jiun Shao, Hsu-Yi Chen

Rehabilitation Practice and Science

Limb compression in an unattended comatous patient often results in peripheral nerve injuries; however, bilateral sciatic neuropathy in these patients has rarely been described in literature. A 37-year-old woman with bilateral numbness and paralysis of the lower limb after drug overdose with coma was reported. After onset of unconsciousness, she was in a seated position with trunk and hips flexed and knees nearly fully extended for approximately ten hours. In the department of emergency, she was found to have bilateral thighs and buttocks swollen as well as myoglobulinuria. Electrodiagnostic studies supported a diagnosis of complete denervation bilaterally in the distribution …

Acute Neuropathy Mimicking Guillain-Barré Syndrome After Diabetic Ketoacidosis: A Casereport, Po-Hong Chen, Hsiu-Fang Hsueh, Chang-Zern Hong

Rehabilitation Practice and Science

A 42 year-old woman was admitted in a comatose state after exhibiting polydipsia and progressive body weight loss of 4-week duration. Diabetic ketoacidosis was diagnosed due to an increased blood glucose level (956 mg/dl), metabolic acidosis, and positive urinary ketone bodies. On the fourth hospital day, despite recovery from the critical state of ketoacidosis, the patient suffered from progressively ascending paresthesia and weakness in the lower limbs. On the basis of clinical and electrophysiological findings, axonal Guillain-Barré syndrome presenting as a paraparesis variant, a very unusual neuropathy related to diabetic ketoacidosis, was diagnosed. The patient reached satisfactory functional outcome after …

Mirror Writing After Left Anterior Cerebral Artery Infarction: A Casereport, Rong-Bin Hong, I-Hsien Wu, Yi-Ming Lo, Hui-Chun Juan, Mei-Ju Ko, Willy Chou

Rehabilitation Practice and Science

Mirror writing is characterized by the writing of alphanumeric characters in the direction opposite to normal. It has been reported infrequently in patients with stroke. We present a 67-year-old male patient who is left-handed but writes with his right hand. He developed sudden onset of right side weakness. CT scan and MRI both revealed acute left anterior cerebral artery infarction involving cingulated gyrus and corpus callosum. His right side weakness gradually improved after rehabilitation. Mirror writing was found when he wrote with his left hand but not with his right hand. The frequency of his mirror writing gradually dropped and …

The Relationship Between Nasogastric Tube Feeding And Hemineglect In Patients After Right Hemisphere Stroke, Kwo-Shieng Tuo, Shu-Fen Sun, Ken-Hao Hsu, Jue-Long Wang

Rehabilitation Practice and Science

The purpose of this study was to evaluate impairment of swallowing, nasogastric tube feeding, feeding function, and complications of pneumonia in 42 patients hospitalized following a right hemispheic stroke with or without hemineglect. Twenty-three patients with diagnoses of right hemispheric stroke and left hemineglect, as demonstrated by computed tomographic scan or magnetic resonance imaging, comprised the experimental group. The diagnosis of hemineglect is based on the Schenkenberg test (i.e., line bisection test) of greater than 10% right deviation. Nineteen age-, lesion-, and Brunnstrom stage-matched right hemispheic stroke patients without hemineglect were designated as the control group. The 23 patients with …

Analysis Of Speech Motor Control In Children With Normal Development: Preliminary Report, Liang-Yi Yang, Chai-Ling Chen, Wei-Hsien Hong, Hsieh-Ching Chen, Ching-Yi Wu, Alice M.K. Wong

Rehabilitation Practice and Science

Speech is a complex motor skill. It requires the coordination of articulatory and phonation systems, including the chest wall, larynx and oral system, to produce precise oral motor control. Treatment of motor speech dysfunction is based on understanding the mechanism underlying normal speech development and motor control. The purpose of this study is to establish speech motor control patterns in children with normal development (ND) by kinematic analysis.Twenty-eight children with ND (16 males and 12 females) aged 4 to 12 years participated in this study. The children were split into three groups based on age: group A aged 4 to …

A Forty-Year Retrospective Of Assessment Of Activities Of Daily Living, Hsi-Ying Chang, Yu-Wei Hsieh, I-Ping Hsueh, Ching-Lin Hsieh

Rehabilitation Practice and Science

Background and Purpose: The term activities of daily living (ADL) refers to the basic skills that a person needs in order to carry out the fundamental physical functions of self-care and independent living. In this survey paper, we reviewarticle the studies on ADL that involve theories of ADL, the concepts and items of measurement, and the test theory developed for ADL assessment. Unfortunately, the issues mentioned above have not been well integrated systematically. With this reviewarticle, we would like to provide a picture of past and current trends in ADL assessment.Method: We searched literature reviewarticles and rehabilitation or measurement textbooks …

Metastatic Tumor In The Atlantoaxial Spine: A Casereport, Hsin-Chi Wu, Chieh-Tsai Chiu, Pu-Sheng Yeh, Yi-Shiung Horng

Rehabilitation Practice and Science

Atlantoaxial involvement is rare in metastatic tumors of the spine. We report a case of atlantoaxial metastatic adenocarcinoma of pulmonary origin, which was treated as cervical spondylosis because the first clinical manifestations were cervical pain followed by limitation of rotation. In the literature, most authors stated that in patients with cervical spine metastases but without neurological signs, pain may be the only complaint. Most metastasized tumors of the atlantoaxial spine originate in the lung or breast. The goal of treatment for these cases is palliative. Posterior fixation is indicated for patients having intractable pain or whose cervical spine is unstable. …

A Pitfall Of Using Ultrasonography In Evaluating Ruptured Long Head Tendon Of The Biceps Brachii: A Casereport, Chien-Hung Shih, Chung-Che Lin, I-Ru Chen, Ya-Fang Lee

Rehabilitation Practice and Science

Musculoskeletal ultrasonography is a widely used diagnostic tool to visualize shoulder tendon pathology. The diagnostic accuracy for biceps tendon pathology is high. An empty groove may be seen when there is complete rupture, and the long head tendon markedly retracts into the arm. We report a case of ruptured tendon of the right biceps brachii in a 55-year-old male injured during pull-up exercise 2 years ago. Sonography demonstrated the presence of echoic material filling the bicipital groove. This material erroneously resembled the biceps tendon and resulted in a false first impression of intact tendon. However, a careful longitudinal scan failed …

Gabapentin For Treatment Of Neuropathic Pain In Patients With Spinal Cord Injury, Chao-Min Wang, Yen-Ho Wang

Rehabilitation Practice and Science

The patients with spinal cord injury suffer from motor and sensory impairment with bowel and bladder dysfunction. However, chronic neuropathic pain is also a common complaint after spinal cord injury and is usually refractory to many therapies. The exact mechanism of relieving hyperalgesia and allodynia is still unknown, but most believed it is related to N-methyl-D-aspartate (NMDA) receptor and voltage-dependent calcium channel. Gabapentin is supposed to be an antagonist of NMDA receptor complex which mediates an influx of calcium ions when activated. In addition, gabapentin inhibits neuronal calcium influx in a calcium channel by binding to the α2δ subunit of …

Analysis Of The Characteristics Of Pressure-Time Curve Under Peak Metatarsal Plantar Pressure Site Of Healthy Adults, Jiunn-Horng Kang, Shih-Ching Chen, Jin-Shin Lai, Wei-Li Hsi

Rehabilitation Practice and Science

The purpose of this study was to describe the characteristics of the pressure-time curve under the peak metatarsal pressure site during walking. Plantar pressures were measured at the forefoot area of 30 healthy adults during walking using high resolution transducers with the first step method. The pressure data at each time frame under the peak metatarsal pressure site were extracted and analyzed. A mathematic model was calculated to approximate this curve with the least square residual. The patterns of pressure-time curves under the peak metatarsal pressure sites were very similar in all subjects. After forefoot contact, it was an increasing …

An Investigation Of Communication Attitudes, Quality Of Communication, And Locus Of Control In Stutterers And Non-Stutterers, Feng-Chu Tseng, Lin-Fen Hsieh

Rehabilitation Practice and Science

Adults with stuttering are not only disfluent in speech, but also have problems in social adjustment and social interactions. That is, stuttering is a speech disorder, as well as a communication disorder. This study was aimed to examine the communication attitudes, the quality of communications, and the locus of control in adults with stuttering. Twenty-five males and six females, aged between 18 and 47 (mean 26.8) participated as the stutter-group in the study. Another group of twenty-five males and six females, aged between 18 and 48, participated as the non-stutter group. All of the participants were administered with Modified Erickson …

The Hypoalgesic Effect Of Tens During Needle Emg Study, Wang-Lin Su, Hsuan-Yi Lin, Gwo-Chi Hu

Rehabilitation Practice and Science

Needle electromyography (EMG) is an important diagnostic and prognostic tool in physical medicine. However, some patients are unable to tolerate the pain associated with the procedure. While there has been research in methods aimed at reducing the pain from needle EMG, all have obvious disadvantages.TENS is a widely accepted tool for producing analgesia, but it has not been studied as an analgesic adjunct to needle EMG. We designed a double-blind, randomized, placebo-controlled study to investigate the effectiveness of TENS on alleviating the pain during a needle EMG study.Fifty-nine subjects undergoing needle EMG study in an upper extremity were randomly assigned …

Ultrasonographic Diagnosis Of An Intramuscular Hemangioma In The Thigh: A Casereport, Jau-Jia Lin, Hsien-Hua Liao, Su-Ju Tsai, Chien-Wen Chou, Liu-Ing Bih

Rehabilitation Practice and Science

We reported a case of a 21 years old male with left distal medial thigh pain and palpable mass after sports injury. The symptoms persisted for four years even with several kinds of treatment. He was referred to our hospital for ultrasonographic examination and we found a cystic lesion with blurred margin and hypoechoic texture, which was highly suspecious of intramuscular hemangioma within left rectus femoris muscle. After further confirmation by magnetic resonance images, he was referred to our plastic surgeon and then received surgical excision. A cavernous hemangioma was demonstrated by the pathologic stain. He got obvious relief of …

Spontaneous Intracranial Hypotension With Multiple Ischemic Stroke: A Casereport, Won-Jean Lin, Wai-Keung Lee, Yau-Wai Wai, Li-Rong Chen, Cheng-Chih Liao

Rehabilitation Practice and Science

The causes of cerebrospinal fluid leakage leading to intracranial hypotension are generally iatrogenic or due to trauma. Postural headache is usually a characteristic symptom of intracranial hypotension, although other presenting neurologic symptoms occur, such as cranial nerve injury, vomiting, dizziness, photophobia, ataxia, dementia, coma, or death. A spontaneous cause for intracranial hypotension is uncommon. Intracranial hypotension with ischemic stroke, as described herein, has not been previously reported.A 43-year-old man complained of intermittent headaches for approximately one year, but the symptoms remitted with bedrest. He was ultimately sent to the hospital due to a severe headache. Although there were no significant …

Rehabilitation Problems In An Adult Patient After Acute Disseminated Encephalomyelitis: A Casereport, Hsiao-Huei Chen, Lin-Fen Hsieh, Feng-Chu Tseng

Rehabilitation Practice and Science

Acute disseminated encephalomyelitis is a monophasic disorder of unknown pathogenesis, characterized by demyelination of the central nervous system. The possible T-cell immune-mediated inflammatory process, affecting mainly children and young adults, typically follows a recent infection or immunization. Meningeal symptoms are common early in the course and often begin 1-3 weeks after infection. Abnormalities of motor, sensory, gait, visual, and cognitive function are variable and depend on the location (cerebral white matter, brainstem, cerebellum, or spinal cord) of the most severely damaged areas of the nervous system. Acute disseminated encephalomyelitis is unusual in middle-aged or elderly adults. The mortality rate is …

Effect Of Kinesio Taping Over Frontal Region On The Attention Of Normal Subjects, Wei-Chi Hsieh, Su-Hsien Lin, Hung-Chih Hsu, Alice May-Kuen Wong, Ka-Kit Siu, Yu-Cheng Pei

Rehabilitation Practice and Science

”Kinesio taping” is a newly developed technique frequently used for the treatment of soft tissue lesions. The Kinesio Tex tape has the skin like elastic property and can be applied with tension at the soft tissue lesion site. This study was designed to assess the effectiveness of ”Kinesio taping” on the attention in normal subjects. In several ways that can be used to assess attention, the well-known Posner paradigm was chosen. This paradigm can assess visual spatial attention by presenting the target participants with cues that direct attention to regions of the visual space within which an imperative stimulus may …

The Effect Of Transcutaneous Electric Nerve Stimulation On Local Skin Temperature, Chien-Ting Liu, Pei-Ying Chao, Shin-Liang Pan, Chein-Wei Chang, Yen-Ho Wang

Rehabilitation Practice and Science

Previous reports have shown that transcutaneous electric nerve stimulation (TENS) can accelerate the rate of chronic wound healing, but the mechanism for such is unknown. It has been proposed that TENS may enhance healing by increasing cutaneous blood flow. In the present study, we investigated the effects of TENS on local skin temperature. Infrared thermography was used to measure the changes of local skin temperature after treatment with TENS. Twelve subjects, 6 men and 6 women, were enrolled and underwent the following four different TENS modes in random sequences: (1) sham stimulation (control), (2) perception threshold TENS, (3) below motor …

Investigation Of The Probe Position For Ultrasonography Of The Long Head Of The Biceps Brachii Tendon, Yi-Pin Chiang, Min-Jung Hsu, Ying-Hung Liu, Chia Lee

Rehabilitation Practice and Science

Musculoskeletal ultrasound has been utilized in rehabilitation medicine for many years. However, the accuracy and speed of the examination are very operator-dependent. It is often difficult for inexperienced operators to locate target structures quickly. We therefore designed this study to determine the best positioning for the transducer to detect the tendon of the long head of the biceps brachii on shoulder ultrasonography.One hundred people (200 shoulders) were recruited, including 33 men and 67 women, with a mean age of 50.8±12.5 years. Patients sat upright with the arm flexed and the forearm supinated. The ultrasound transducer was placed on the anterior …

Waveform Symmetry During The Habituation Process Of Sympathetic Skin Response, Wei-Ting Wu, Ya-Ping Huang, Chi-Lun Rau, Hao-Pai Ni, Shin-Liang Pan

Rehabilitation Practice and Science

For investigating autonomic function, sympathetic skin response (SSR) is usually used as a non-invasive test. In previous studies, SSR was applied in the patients with neurological diseases (such as stroke), and the amplitude of SSR was compared between the left and right hand (or foot). Most researchers used electrical limb stimulation to elicit SSR in both limbs. However, the symmetry of SSR in healthy subjects has not been well established. Besides, SSR testing may affect the symmetry of SSR. Moreover, although habituation phenomena are commonly seen during SSR testing, few studies have discussed the symmetry of SSR during repetitive SSR …

The Pressure Distribution Of Hemiplegics At The Femoral Greater Trochanter And Sacrum In Different Bed Positions, Chin-Teng Chung, Wei-Feng Tang, Chorng-Song Chou, Lu-Han Liu, May-Hua Liao, Yu-Chun Yin

Rehabilitation Practice and Science

Pressure ulcers frequently develop in hemiplegic stroke patients who are immobilized and bedridden. Common sites for pressure ulcers include the sacrum, greater trochanter of the femur, lateral malleolus, and the heel. Such ulcers cause extra burdens for the whole medical team, the caregiver, and the patients themself. The ulcers also increase more medical cost at the same time. Patients with pressure ulcers also become depressed and less motivated to undergo rehabilitation. The prevention of pressure ulcer formation has thus become an important issue among stroke patients.The most important factor in pressure ulcer formation is the direct pressure of the mattress …

Rehabilitation Of Heat Stroke With Cerebellar Motor Dysfunction: A Casereport, Tsung-Ming Yang, Jo-Tong Chen, Wei-Chih Hung, Nai-Wen Guo, Ta-Shen Kuan

Rehabilitation Practice and Science

Heat stroke is a medical condition, which in its severest form, may lead to multiple organ failure and death. A previous study showed that most survivors recover completely without sequelae, but some survivors have long-term neurological dysfunction, especially cerebellar motor dysfunction. The rehabilitative outcome of such patients with neurological dysfunction has rarely been reported.We present herein a case of a 31 year old male who suffered from heat stroke, followed by acute rhabdomyolysis, renal failure, respiratory failure, cardiac arrhythmia, and cerebellar motor dysfunction. He was transferred to our rehabilitation ward 36 days after the heat stroke injury due to ataxia, …

Language Delays And The Influence Of Therapeutic Riding: A Case Study Of An Autistic Child, Nadia Suckarieh

Graduate Theses

Autism is a Pervasive Development Disorder characterized by stereotype behavior and trouble with communication. One focus of working with this population is increasing the verbal and communication ability of the nonverbal individuals. The present study focused on the effects a six-week therapeutic horseback riding program would have on the stereotypical behaviors present in a six-year-old autistic child, and if this program would help the his verbalization and communication ability. The Psychoeducation Profile, 3rd Edition was used to measure possible changes the intervention might have influenced. The result of the study indicated there was a decrease in the child’s physical stereotype …

Functional Ankle Instability Does Not Effect The Average Center Of Pressure Position In The Coronal Plane, Jessica A. Presnell

All-Inclusive List of Electronic Theses and Dissertations

Context: It is not known if functionally unstable ankles have a different medial to lateral center of pressure placement compared to the contralateral uninjured limb. Objective: To compare the average medial/lateral position of the center of pressure, from the midline of the foot, in functionally unstable ankles to the contralateral uninjured ankle. Design: A 1 X 2 within subject design guided this study. The independent variable was ankle health (functional ankle instability or uninjured). Setting: Laboratory. Patients or Other Participants: Twenty-six, physically-active, volunteers who suffer from unilateral functional ankle instability (F AI) [M: 10 F: 16 age: 21±2.1 y ht: …

Sensory Integration: It's Not Just For Children, Renee Watling, Stefanie Bodison, Diana A. Henry, Heather Miller-Kuhaneck

Occupational Therapy Faculty Publications

Sensory integration theory and intervention techniques were originally developed by A. Jean Ayres, PhD, OTR, beginning in the late 1960s. Her pioneering work integrated scientific information from neuroscience, psychology, occupational therapy, and human development in an effort to help explain the relationship among experience, brain development, and function. Ayres's theory of sensory integration provides a solid foundation for understanding the impact of sensation on occupational performance across the life span. Although much of the existing work related to sensory integration addresses occupational performance issues in children, some believe the theory and framework to be important across the life span. However, …

Liver Transplant Recipient With Calcineurin-Inhibitor Induced Pain Syndrome: A Case Report, Nethra S. Ankam, Md, Stanley R. Jacobs, Md

Department of Rehabilitation Medicine Faculty Papers

Setting: University Hospital

Patient: 65-year-old female status-post liver transplant secondary to cirrhosis.

Case Description: Prior to the rehabilitation consult on post-operative day 42, she had an episode of acute rejection requiring rapid escalation of cyclosporine dosage, later changed to high dose tacrolimus for immunosuppression, resulting in high blood levels of both calcineurin inhibitors. She then complained of paroxysms of 10/10 pain over her entire body not relieved by opioids despite escalation in medication by the acute pain service. She was not participating in a rehabilitation program because of pain. Examination revealed an anxious woman for whom any tactile stimulation …