Medicine and Health Sciences Commons^™

Delayed Neuropathy Due To Organophosphate Intoxication: A Casereport, Chiao-Chien Chen, Lin-Fen Hsieh

Rehabilitation Practice and Science

Organophosphates (OP) are inhibitors of acetylcholinesterase. OP intoxication results in an accumulation of acetylcholine. Clinical signs and symptoms of acute OP poisoning include salivation, incontinence, vomiting, muscle weakness, hypertension, palpitation, restlessness, headache, drowsiness, confusion and seizure. After the acute stage of OP intoxication some patients recover fully, but others have neurologic sequelae, including central and peripheral neuropathy. Individuals with milder cases may recover fully within several months; however, more severe cases may result in persistent sequelae.A 20-year old woman attempted suicide by drinking organophosphate pesticide in 1995. Although emergency and acute medical treatments saved her life, she developed delayed neuropathy, …

復健醫學之眞義, The Editors

Rehabilitation Practice and Science

No abstract provided.

The Relation Between Pre-And Postoperative Anxiety And Uncertainty In Orthopaedic Surgical Patients, Kuang-Chi Huang, Shing-Sheng Wu, Jane Liang, Kao-Chung Tsai

Rehabilitation Practice and Science

To understand the concerns of orthopaedic surgical patients and to enhance the quality of nursing care, the pre-and postoperative anxiety and uncertainty levels of orthopaedic surgical patients were determined and the relations among these factors explored. A descriptive correlation design was used and 44 adult orthopaedic surgical patients were selected by convenience sampling from a medical center in Taipei. Data were collected through structured questionnaires to obtain relevant demographic variables, the State-Trait Anxiety Inventory (STAI), and Mishel's Uncertainty in Illness Scale (MUIS). The main results included: (1) Mean scores of pre-and postoperative anxiety of 40.68 (SD=13.39) and 37.94 (SD=9.87), respectively; …

Event-Related Potentials Of Visual Spatial Attention In Healthy Subjects, Chu-Hsu Lin, Yu-Cheng Pei, Chia-Ying Chung, Pao-Tsai Cheng, Chia-Ling Chen, Alice M.K. Wong

Rehabilitation Practice and Science

Visual attention can be manipulated by temporal and spatial factors of stimuli. The purpose of this study is to investigate the underlying mechanism of visual spatial attention of healthy subjects through event-related potential (ERP) study.The subjects of the study were 17 healthy adults, mean age 23.3 years. The visual stimuli were generated by the Neurostim system and presented in groups of eight under three different conditions: cueing (valid, invalid), delay (100 ms, 800 ms) and visual field sides (right and left). ERPs were recorded by 10 Neuroscan systems electrodes placed on each subject's scalp. The latencies and amplitudes of ERPs …

Phenomena Correlated To Stroke Patients With Pusher Syndrome, Hung-Che Wang, Ling-Fu Meng

Rehabilitation Practice and Science

Stroke patients who cannot maintain a balanced sitting or standing position fall toward one specific side. There can be a strong tendency to actively use non-hemiplegic extremities to push the body away from the sound side. As well, patients may resist any attempt to correct their postures and finally fall toward the hemiplegic side. This falling asymmetry phenomenon has been termed ”Pusher syndrome.” The syndrome often occurs coincident with frequent lapses in consciousness, poor motor control, impaired sensory status, spatial neglect, and limited perceptual function. Recent observations have indicated that Pusher syndrome is strongly related to body orientation deficit and …

Down Syndrome With Os Odontoideum And Spinal Cord Injury: A Casereport, Li-Chen Tung, Yu-Lin Wang, Chen-Yu Chou, Hui-Chun Juan, I-Hsien Wu, Willy Chou

Rehabilitation Practice and Science

Down syndrome is a genetic disorder caused by trisomy on chromosome 21 that occurs in 1 of every 800 live births. Down syndrome can involve skeletal malformations that include patella or hip dislocation, genu valgus and atlanto-axial instability (AAI). Prompt recognition and treatment of the latter is important. This casereport describes an odontoid fracture due to AAI in a seven-year-old with Down syndrome.
Since October 2000, the child had involved in robust activities including floor tumbling and hand stands. Beginning in April 2001, the right extremities showed signs of weakness and there was an unsteady gait. Upon physical examination, AAI …

Critical Illness Polyneuropathy: A Casereport, Chin-Man Wang, Li-Fang Lee, Chu-Chi Chen, Alice M.K. Wang, Fuk-Tan Tang, Pao-Tsai Cheng

Rehabilitation Practice and Science

It is often difficult to isolate the etiology of acute weakness in the critically ill population because of multiple etiologies. Recently, critical illness polyneuropathy (CIP), a syndrome of unknown etiology was added to the differential diagnosis. The frequency of CIP is approximately 50-70% in patient with sepsis and/or systemic inflammatory response syndrome and multiple organ dysfunction syndrome. This casereport presents a 66 year-old male who has diabetic mellitus for five years. He suffered from distal limbs numbness without muscle atrophy for nearly two years. Prior to admission, he was treated as muscle strain over right thigh in another hospital repeatedly, …

The Impact Of Low Back Pain On Patient's Sexual Life, Tien-Sung Yeh, Ta-Shen Kuan, I-Ning Tang, Chia-Hui Chen, Chang-Zern Hong

Rehabilitation Practice and Science

Low back pain (LBP) has various adverse effects on the functional status of a patient's life, including a patient's sex life. This study evaluated the impact of LBP on the sexual life of patients. Forty-eight patients, including 27 men and 21 women, were recruited for this study. Their mean age was 44 years old. The average duration of LBP was 47.7 months. The mean visual analog scale (VAS) before the treatment of LBP was 5.9, while mean VAS at the time of the study was 3.6.Frequency of intercourse affected by LBP was noted in 60.9% of our patients. Forty percent …

Spontaneous Spinal Epidural Hematoma: A Casereport, Shiou-Ping Lin, Da-Tong Ju, Kao-Chung Tsai, Ming-Fu Hsieh

Rehabilitation Practice and Science

Spontaneous spinal epidural hematoma (SSEH) refers to a spinal epidural hematoma that is not secondary to trauma, incidental, and iatrogenic (such as lumbar puncture or spinal anesthesia). SSEH represents 0.3%-0.9% of spinal epidural space-occupying lesions. It is a rare spinal emergency, yet a diagnostic challenge. We reported a 21-year-old young male who was admitted with sudden weakness of bilateral lower limbs and difficulty in urination. The cervical epidural hematoma was noted by spinal magnetic resonance imaging examination. After emergency decompressive operation and postoperative rehabilitation, the patient had gradual improvement of neurological function, yet the presence of slight neurogenic bladder dysfunction. …

A Ganglion Cyst Of Posterior Cruciate Ligament Detected By Ultrasonographic Examination: A Casereport, Yu-Chou Hung, Jeng-Yi Shieh, Tyng-Guey Wang, Chein-Wei Chang

Rehabilitation Practice and Science

A ganglion cyst of the posterior cruciate ligament (PCL) is a rare condition and it is usually an incidental finding of magnetic resonance imaging (MRI) or arthroscopy. Recent advances in ultrasound technology and the development of high-resolution transducers have enabled detailed imaging of musculoskeletal structures. We describe a 21-year-old female who complained of left knee pain after a slip and fall. A sonogram showed an echo-free, multilocular lesion with posterior enhancement, just posterior to the PCL. A ganglion cyst of the PCL was suspected, and the diagnosis was subsequently confirmed by MRI. To the best of our knowledge, this is …

Gait Deviations In Patients With Early Osteoarthritis Of The Knee, Yin-Chou Lin, Chih-Kuan Chen, Ngok-Kiu Chu, Jung-Feng Chang, Yiu-Chung Liu, Simon Fuk-Tan Tang

Rehabilitation Practice and Science

We design a case control study to evaluate the gait deviations of patients with early osteoarthritis(OA) of the knee, which are subtle and difficult to observe clinically. Twenty-six patients with symptomatic OA were recruited from the outpatient department. The control group consisted of 20 normal subjects who were matched for age, body weight, and body height. Both the patient and control groups were subjected to a similar protocol of gait analysis with comfortable speed. The peak value of angular displacement of pelvic tilt up, pelvic tilt down, knee valgus, ankle dorsifexion, and ankle rotation were significantly lower (p＜0.05) in the …

Short-Term Results In Patients After Transmyocardial Laser Revascularization, Chen-Liang Chou, Benjamin Ing-Tiau Kuo, Chih-Jou Lai, Shun-Ping Cheng, Tcho-Jen Liu, Shian-Ting Lai

Rehabilitation Practice and Science

Patients with symptomatic end-stage coronary artery disease, who had poor response to percutuneous transluminal coronary angioplaoty or coronary artery bypass grafting, the transmyocardial laser revascularization (TMR) seems to be an alternative method to relieve disabling ischemic symptoms. The purpose of this study was to evaluate the short-term results (about post-op 12 weeks) after TMR.Thirty patients were enrolled in the study. We used ”New York Heart Association functional classification” and ”stages of stable angina” to evaluate the functional changes after operation. The drug medicine was also reviewarticleed. All functional evaluation showed significant improvement after TMR but increased in using cardiac drug …

Study On Treatment Effects Of Integrated Approach For Stuttering Adults, Feng-Chu Tseng, Shu-Lan Yang

Rehabilitation Practice and Science

There are 200 thousand stutterers in Taiwan. In addition to disfluency, they may have social or work adaptation problem. The purpose of this research is to study the efficacy of integrated approach combining stuttering modification therapy and fluency shaping therapy in stuttering adults. Seventeen stuttering adults were included in this study. The experimental group consisted of 7 males and 4 females with average age of 26.73 (SD=7.37). The average age of the control group was 26.67 (SD=7.92), which consisted of 5 males and 1 female. The members of experimental group attended a two-day stuttering workshop for 14 hours, then participated …

Risk Factors Of Post-Stroke Depression In Middle-Aged Adults And The Elderly, Yuan-Yang Cheng, Chen-Liang Chou, Shun-Ping Cheng, Tcho-Jen Liu, Rai-Chi Chan, Wen-Jang Wong

Rehabilitation Practice and Science

In order to evaluate the prevalence and risk factors of post-stroke depression, this study collected the data of 102 stroke patients from the outpatient clinic of the neurology and rehabilitation departments in a medical center in Taipei. The patients' objective data, such as age, infarction area of the brain, duration from the stroke attack to the time of our study, number of stroke attacks, antidepressant use, and rehabilitation program, were obtained from the history chart. A questionnaire evaluation of the swallowing function, depression status, and functional independence measure was also done by interviewing the patients individually. The results showed that …

Design And Application Of Integrated Pointing Device Apparatus, Hsieh-Ching Chen, Yung-Ping Liu, Chia-Ling Chen, Chih-Yong Chen

Rehabilitation Practice and Science

Despite the great number of computer input devices available commercially, many disabled persons still rely on special equipment to operate computers. Providing those persons with an adequate human-computer interface should improve their productivity and efficiency. However, the specialized equipment needed is usually expensive, difficult to obtain and difficult to maintain. This study developed an economical apparatus that, flexibly integrated commercial computer mice and trackballs to tailor them for individual needs. This led to improved individual performance and resolved the problems of cost and poor maintainability of special equipment. The apparatus conforms to and work on a standard USB 1.1 interface …

Femoral Neuropathy After Reconstruction Of A Defect Due To Buccal Cancer Excision Using A Thigh Flap: A Casereport, I-Ning Tang, Jo-Tong Chen, Chang-Zern Hong

Rehabilitation Practice and Science

A case of femoral neuropathy as a complication of flap excision for reconstruction of a defect due to buccal cancer excision is presented. A 51-year-old man developed numbness over his left anteromedial thigh and medial lower leg, left quadriceps weakness, and absence of left knee jerk after a flap was obtained from his anterolateral thigh. Electromyographic examination revealed evidence of denervation in the left quadriceps. A nerve conduction study showed prolonged latency, reduced amplitude of the compound muscle action potential, decreased velocity in the left femoral nerve and prolonged latency, reduced amplitude of the sensory nerve action potential, and decreased …

Winging Scapula Due To Traumatic Trapezius Muscle Disuse Atrophy: A Casereport, Tsung-Ching Lin, Cheng-Liang Chou, Chen-Ming Chiu, Tcho-Jen Liu, Rai-Chi Chan, Hong-Jen Chiou

Rehabilitation Practice and Science

Winging scapula is uncommon clinically and easily ignored. It not only leads to a limited range of motion of the upper extremities, but impairs functional activity and body appearance as well. Many etiologies can induce winging scapula, including trauma, infection, iatrogenic injury, congenital abnormality, and the impairment of periscapular nerves, muscles, bones and joints. Traumatic winging scapula is often the result of long thoracic nerve, spinal accessory nerve, or dorsal scapula nerve stretch or compression, which causes weakness and atrophy of the serratus anterior muscle, trapezius muscle, or rhomboid muscle. Winging scapula due to disuse atrophy of the traumatic trapezius …

The Bony Fractures In Patients With Chronic Spinal Cord Injury In Southern Taiwan, Liang-Shiuan Chen, Ta-Shen Kuan, Jo-Tong Chen, Wei-Jang Yen, Shu-Min Chen

Rehabilitation Practice and Science

Immobilization following spinal cord injury (SCI) is a condition known to be associated with osteoporosis, which leads to increased risk of fractures. The aim of this study was to survey the incidence of bony fractures and its associated factors among chronic SCI patients in southern Taiwan. We recruited 194 patients, including 153 men and 41 women. Their mean age was 46 years old. The average duration of SCI was 12 years. There were 110 paraplegics (56.7%) and 84 tetraplegics (43.3%). Fractures after SCI were noted in 16 of the 194 patients (8.2%). There were no significant differences in age, sex, …

Ultrasonography Diagnosis Of A Neglected Femoral Fracture In A Child: A Casereport, Yi-Chia Yeh, Shu-Min Chen, Ta-Shen Kuan, Chii-Jeng Lin

Rehabilitation Practice and Science

Ultrasonography is sensitive and reliable for detecting pediatric fractures, including incomplete fractures, clavicle fractures, and fractures in unossified bones. Ultrasonography is also a good imaging modality for pediatric bone healing.A 1-year-5-month-old boy suffered from a painful mass on the left thigh due to a traction injury. His parents brought him to the emergency room, and the initial impression was soft tissue injury. The patient presented with disabling pain and was unable to walk for a few days following the injury. Ultrasonography was scheduled and revealed cortical disruption of the femoral shaft with irregular hyperechoic materials over the area of cortical …

Limbus Vertebral Fracture Associated With Herniated Intervertebral Disc: A Casereport, Ching-Ming Shueh, Chen-Liang Chou, Chi-Ming Shih, Ren-Guang Liew, Wen-Chieh Tseng, Hong-Chang Chen

Rehabilitation Practice and Science

Limbus vertebral fracture results from the herniation of disc material into a vertebral body, and in the formation of one or more isolated bony fragments. It is mostly found in adolescents and young adults. Clinically it resembles an acute disc prolapse with low back pain and radiculopathy. Trauma plays a significant etiologic role in up to one half of cases reported in the literature. The diagnosis of limbus vertebral fracture can rarely be based on conventional radiographs. CT scan shows the fracture fragments in most cases and should be considered the most accurate procedure. Complete discectomy with removal of bony …

Vertebroplasty On Patients With Osteoporotic Vertebral Compression Fractures, Tsung-Ying Li, Shuu-Hai Jiang, Ho-Jui Tung, Ming-Chi Lin, Kao-Chung Tsai

Rehabilitation Practice and Science

Introduction: There are more than three hundred thousand cases of osteoporotic vertebral compression fractures in Taiwan. To hasten the healing process and minimize the related complications of fracture, various treatments have been evolved. In 1987, the technique of percutaneous vertebroplasty was first developed in Europe by a group of radiologists. Before that, conservative treatment, rehabilitation intervention and a surgical approach had been used, with diverse outcomes, as reported in various studies. Although these methods had been developed over several years, they had rarely been compared in terms of outcome and prognosis, in our hospital. Methods: A retrospective study of treatment …

Rehabilitation Therapy For Women With Urinary Incontinence, Ted Fang, Yi-Hui Lu, Jan-Wei Chiu, Tsui-Fen Yang, Ling-Chun Chang, Rai-Chi Chan, Kem-Jem Yu

Rehabilitation Practice and Science

Urinary incontinence is a very common but also very debilitating problem for older women. It has been estimated that the incidence of urinary incontinence among women older than 65 of age is about 30-60%. The management includes surgical therapy and conservative treatment such as drug therapy and rehabilitation. Rehabilitation therapy offers an alternative intervention for patients who are afraid of invasive surgery or experience intolerable side effects from drugs.This study evaluated the clinical efficacy of rehabilitation therapy for urinary incontinence. We collected a total of 30 patients. Fifteen had stress urinary incontinence, 2 had urge urinary incontinence, 5 had mixed …

Using Fitts' Law To Evaluate Functional Performance Of Operating Computer Input Devices In Patients With Cervical Cord Injury, Chien-Hsiu Liu, Shu-Chun Liu, Hsu-Tung Chu, Chi-Ming Shin, Yung-Wen Tang, Liu-Ing Bih

Rehabilitation Practice and Science

Due to the recent development of the assistive technology, patients with cervical cord injury may use an adapted computer input system to participate in various computer related activities, and as a result patients improve their quality of daily living and leisure activities. Fitts' Law is a reliable reference to compare the performance of normal persons using an input device like a mouse. The purpose of this study is to apply Fitts' Law to understanding the functional performance of patients with cervical cord injury when operating a mouse, trackball, and sip-and-puff controller.Twenty-five subjects were included in this study. The controls consisted …

Central Pontine And Extrapontine Myelinolysis After Surgical Removal Of Pituitary Adenoma: A Casereport, Hui-Tai Yang, Yen-Hung Chang, Hung-Chih Hsu

Rehabilitation Practice and Science

Central pontine myelinolysis(CPM) and extrapontine myelinolysis(EPM), sharing the same pathology, are the same disease, although different symptoms and signs developed according to different lesion sites. The etiology and pathogenesis of CPM/EPM remain unclear, meanwhile rapid correction of the serum sodium level for hyponatremic patient has proven to be one of the major causes of CPM/EPM. Therefore an appropriate correction of the sodium level could prevent the development of CPM/EPM. The incidence of hyponatremia after surgical removal of pituitary adenoma reported varies from 8.4% to 38.8%. Most patients with symptomatic hyponatremia after the surgery recovered without neurological deficits. Only three cases …

Intraarticular Injection Of Sodium Hyaluronate In Adhesive Capsulitis Of The Shoulder, Shu-Fen Sun, Chiao-Wen Hwang, Pei-Te Hsu, Ya-Wen Hsu, Shin-Lung Tsai, Jue-Long Wang, Chien-Wei Hsu, Yi-Jiun Chou

Rehabilitation Practice and Science

The etiology and natural history of adhesive capsulitis remain obscure, which limited subsequent management. Traditional treatments include conservative medical therapy and physical therapy, but severe shoulder pain may constitute an obstacle to joint mobilization. Local steroid injection into or around the shoulder joint has been shown to alleviate pain in early stages of the disease. Late disease appears less responsive and there are many known risks of complications. Many different protocols to treat the disease have been reported, but the results are generally unsatisfatcory and difficult to compare.Our goal was to determine the efficacy of a combined treatment-intraarticular injection of …

Bimalleolar Fracture After Spinal Cord Injury: A Casereport, Shie-Fu Shieh, Huey-Wen Liang, Wen-Hsung Hou, Yen-Ho Wang, Shih-Fong Huang

Rehabilitation Practice and Science

The incidence of fracture is higher in patients with chronic spinal cord injury (SCI), particularly female and elderly patients, than in healthy people. Functional impairment due to SCI may lead to accidental falls and fractures, most of which are due to trivial injury or without known trauma. In addition, the inevitable osteoporosis in the paralyzed limbs of individuals with chronic SCI increases their risk of fracture. The lower limbs are more often involved than the upper limbs. Because of the sensory impairment associated with SCI, fractures may be difficult to diagnose, and treatment may be delayed. The treatment of fractures …

Rehab Exercise Prescription Sequencing For Shoulder External Rotators, Jason Brumitt, Erik Meira

Faculty Publications - College of Physical Therapy

Overhead athletes are susceptible to shoulder injuries. One component of a complete rehabilitation program is a systematic exercise prescription for the shoulder's external rotators. An overhead athlete should be progressed from basic rehab exercise positions to dynamic, sport-specific positions prior to returning to sport.

The Effectiveness Of Aquatic Therapy With Persons Who Have Experienced A Cerebral Vascular Accident, Heather L. Tweedie

Masters Theses

This study examined the effectiveness of using aquatic therapy (AT) as a technique in the treatment of cerebral vascular accidents (CVA). The unique properties of the aquatic environment were manipulated to determine change in range of motion, muscle tone, balance, functional ambulation, and psychological functioning particularly social relationship and positive and negative feelings.

A single subject design was conducted using two subjects that participated in a twelve week aquatic therapy program. Aquatic therapy showed to be effective in treating common symptoms of a CVA. More research needs to be completed to ensure the effectiveness of aquatic therapy in congruency with …

Caregivers’ Perceptions Of Accessibility And Quality Of Services In The Community For Children With Mental Health Diagnoses: A Pilot Survey, Karin E. Brems

Masters Theses

This pilot study was intended to explore caregivers' perceptions of the mental health services available in the community for children with mental health diagnoses. A study-specific survey was developed to look at demographic characteristics, service accessibility, and service quality. This survey was distributed to caregivers through Michigan support groups. Returned surveys were analyzed for themes that could assist in the development of further research to improve community services for children with mental health diagnoses.

This pilot study yielded rich qualitative data. Upon review and analysis, five themes emerged: (1) bureaucratic hassles and getting the runaround, (2) closed doors, (3) support …

Wound Debridement With 25 Khz Ultrasound, Margaret Mccarty Stanisic, Barbara Provo, David L. Larson, Luther C. Kloth

Physical Therapy Faculty Research and Publications

Several methods of wound debridement are described in the literature and are available to health care providers who specialize in wound management. Methods include the use of sharp surgical instruments; mechanical methods, such as whirlpool and pulsed lavage with suction; proteolytic and collagenolytic enzymes; autolysis; and sterile fly larvae (maggots). The use of surgical debridement is generally considered the most efficient method when performed by a skilled physician, who may in one session use his or her discretion to excise some viable tissue along with necrotic tissue in the wound. Sharp debridement performed in a clinical setting is a less …