Medicine and Health Sciences Commons^™

Location And Type Of Vertebral Compression Fractures In Aged Women With Acute Back Pain, Ching-Kai Lin, Ta-Sen Wei, Po-Jen Yang

Rehabilitation Practice and Science

In many cases acute back pain in aged women is caused by vertebral compression fractures. Although the indirect mortality rate among these patients is not as high as in those with hip fractures, the effect of acute back pain on patients’ daily lives and social activities should not be underestimated. This study was performed to understand the distribution of the location and type of vertebral compression fractures in this particular group of women and their relations to bone mineral density.This retrospective study consisted of medical record and X-ray examinations of 126 women patients who complained of acute back pain, were …

The Pediatric Functional Performance Scales: Establishment And Preliminary Report On Taiwanese Children, Yung-Wen Hsu, Ting-Yi Li, Tsan-Hsun Huang, Nai-Wen Guo, Rong-Ju Cherng, Ta-Shen Kuan, Chii-Jeng Lin

Rehabilitation Practice and Science

This study planed to develop a functional performance measure in order to systematically describe and evaluate the ability and limitation of Taiwanese children in their daily life activities. This study includes two pilot studies investigating content validity of this newly developed test: The Pediatric Functional Performance Scales (PFP Scales).Parents of 49 children aged 2-12 years were interviewed face to face or through telephone in the first study. After revised, the test was administered to another 203 children aged 2-8 years. According to the result of the first pilot study, total items of the PFP Scales were increased from 14 to …

Quantitative Emg Evaluation In Spastic Upper Extremity After Botulinum Toxin Injection-A Preliminary Report, Chiao-Wen Hwang, Ching-Hsiang Lu, Pei-Te Sheu, Ya-Wen Hsu, Kun-Shou Tsai, Ji-Long Wang

Rehabilitation Practice and Science

Spasticity of the upper limb muscles is a common complication following stroke. Injection of botulinum toxin can decrease upper limb spasticity. The effects of botulinum toxin treatment are usually evaluated by activities of daily living, range of motion (ROM), or modified Ashworth scale. However, in this study, we evaluated the effect of botulinum toxin injection by quantitative EMG, and investigated the relationship between EMG and conventional evaluation methods.Twenty patients with chronic stroke-related spasticity of the upper limb muscles received botulinum injections. All injections were guided by EMG. Outcome measures included total modified Ashworth scale score on the elbow, wrist, metacarpal …

Diffuse Positive Sharp Waves In A Patient With Left Radial Nerve Palsy: “Emg” Disease, Meng-Jer Lee, Jan-Wei Chiu, Han-Wen Lee, Tcho-Jen Liu, Rai-Chi Chan

Rehabilitation Practice and Science

Positive sharp waves (PSW) and fibrillations are frequently seen together in a variety of neuromuscular diseases and share the same clinical significance. However, PSW alone are also reported to occur in myotonic disorders, periodic hypokalemic paralysis, and local muscle trauma.Our patient, a 32-year-old man, fractured his left humerus in a traffic accident 3 weeks prior to presentation. He was referred to our electrodiagnostic laboratory due to left wrist and hand drop. On physical examination, he was found to have grade 0 muscle power in his left wrist and finger extensors. There was numbness over the dorsal aspect of the first …

Trauma-Related Vertebral Artery Dissection With Delayed Onset Cerebellar Infarction: A Casereport, Tsung-Ying Li, Liang-Cheng Chen, Shuu-Hai Jiang, Shiou-Ping Lin, Kao-Chung Tsai

Rehabilitation Practice and Science

Cerebellar stroke is uncommon in young patients. We report the case of a 22-year-old man with a delayed cerebellar infarction secondary to vertebral artery dissection caused by trauma. While riding a bicycle as part of an extreme sport, his left clavicle struck a bicycle handle. Evaluation in the emergency room led to a diagnosis of left shoulder contusion without fracture of clavicle or cervical spine. Headache, severe vomiting, and weakness of the right-sided limbs developed three days later, and he presented to emergency staff again. Head injury was initially suspected, but the diagnosis was left vertebral artery dissection with delayed-onset …

The Improvement Of Pain Symptoms And Activities Of Daily Living In People With Knee Osteoarthritis After Intra-Articular Hyaluronic Acid Injection, Carl P. C. Chen, Chih-Kuang Chen, Max J. L. Chen, Yin-Chou Lin, Tony H. C. Hsu, Ju-Wen Cheng, Simon F. T. Tang

Rehabilitation Practice and Science

Osteoarthritis (OA) is a slowly evolving articular disease that appears to originate in the cartilage and affects the underlying bone, soft tissues, and synovial fluid. This condition usually occurs late in life, principally affecting the large weight-bearing joints such as the knee. It is particularly disabling when the knees are affected, because it limits the ability to walk, to rise from a chair, and to use stairs.The treatment selections for OA knees include analgesic drugs, physiotherapy, intra-articular (IA) drug administration, and surgical total knee replacement. We chose IA hyaluronic acid injection as the treatment method as it was documented as …

The Effects Of Education Level On Physical Fitness Among Middle-Aged Adults In Taiwan, Shih-Wei Chou, Yin-Chou Lin, Chi-Te Li, Alice M. K. Wong

Rehabilitation Practice and Science

Health-related physical fitness can be assessed with four main attributes: body composition, muscular strength and endurance, flexibility, and cardiorespiratory endurance. Regular exercise is thought to improve physical fitness, and objective physical fitness assessment and appropriate exercise prescriptions may help unfit individuals to become fit. Assessment of physical fitness among the general population can aid the understanding of general levels of physical fitness in the community, promote healthy habits, and reduce the burden of chronic illness caused by physical inactivity. A total of 13,187 healthy adult Taiwanese citizens between 40 and 65 years of age were enrolled in this study between …

Clinical Effects Of Botulinum Toxin On Spasticity Management In Children With Cerebral Palsy, En-Shiuan Wu, Chia-Ling Chen, Alice M.K. Wong, Ching-Kai Wong, Jun-Xiao Chen, Shin-Ming Lo

Rehabilitation Practice and Science

Botulinum toxin type A (BTA) has treated spasticity in cerebral palsy (CP) in recent years. This study investigated both the clinical effects and gait improvements of BTA on spasticity management in children with CP.Twenty-nine children with spastic CP (2-10 years old) were recruited into this study. All subjects received complete clinical assessments, video recording and functional assessments before and 1-3 months after BTA treatment. A questionnaire was employed for the evaluation of parents’ subjective satisfaction. Clinical assessments included muscle tone and joint range of motion (ROM) of bilateral lower limbs. ROMs, including dynamic (R1) and static (R2), were measured by …

Effect Of Temperature On Type Of Cerebrovascular Accident, Sen-Yung Liu, Ta-Sen Wei, Cheng-Hsiung Hong

Rehabilitation Practice and Science

Monthly or seasonal change of climate has been suggested to associate with the incidence and type of stroke, but this association is not conclusive owing to variation in study design and geographic area. The aim of this study was to investigate the short-term effect of temperature variation on type of cerebrovascular accident in first-time stroke patients.There were 1008 in-patients enrolled in this study, including 718 ischemic (infarct) stroke and 290 hemorrhagic stroke patients. The age was 68.9±11.0 years in the infarct and 62.9±13.6 years in the hemorrhagic group; 62%(181 cases) of the infarct group and 55%(395 cases) of the hemorrhagic …

Differential Impairment And Recovery Of Two Languages In A Bilingual Aphasic Patient: A Casereport, I-Ru Chen, Su-Fen Liao, Ta-Sen Wei

Rehabilitation Practice and Science

According to the definition proposed by Grosjean, more than half of the world population is multilingual. Bilingual aphasia is more complex and variable; thus it may need a more individualized rehabilitation program than monolingual aphasia. However, many instances of bilingual aphasia may have been misdiagnosed and treated as monolingual aphasia due to a lack of comprehensive assessment.We present here a change in the language pattern of a bilingual Chinese woman, who initially spoke Cantonese (mother language) and Mandarin (2nd language) very well. She was afflicted by aphasia due to a stroke involving cortical and subcortical lesions in 1999. After rehabilitation …

Relationships Between Clinical Symptoms And Electrodiagnosis In Carpal Tunnel Syndrome, Pei-Ying Chao, Hui-Lin Lin, Shin-Liang Pan, Chein-Wei Chang

Rehabilitation Practice and Science

Carpal tunnel syndrome is one of the most common peripheral entrapment neuropathies. Patients with carpal tunnel syndrome experience numbness, pain, and/or weakness in the hands over the median nerve distribution area. In current practice, diagnosis of carpal tunnel syndrome is based on subjective symptoms and objective findings from physical examinations and electrodiagnosis. We examined 40 hands with carpal tunnel syndrome in 24 patients and evaluated the relation between symptom severity and electrodiagnosis. Subjective hand symptoms were obtained by self-administered questionnaire and were categorized as numbness, pain, or motor function according to factor analysis methods. Numbness symptoms were significantly related to …

Long-Term Prosthesis Use And Functional Outcome Among Patients With Lower Extremity Amputations, Je-Kuei Yang, Ming-Chuan Lin, Ssu-Yuan Chen, Ching Lan, Jin-Shin Lai, I-Nan Lien

Rehabilitation Practice and Science

The purpose of this study was to investigate prosthesis use among patients who underwent lower extremity amputation owing to peripheral vascular disease and evaluate their functional outcome after returning to the community. We retrospectively reviewarticleed medical charts of patients who underwent lower extremity amputation from 1993 to 1999. The causes of amputation, the level of amputation and patient's health condition were recorded. We then surveyed the patients by telephone, and recorded the stump condition, difficulties encountered in daily activities, and functional status. From January 1993 to December 1999, 347 patients underwent lower-limb amputations in our hospital. Of them, 174 died, …

Supratentorial Primitive Neuroectodermal Tumors: A Casereport, Chien-Min Chen, Chin-Man Wang, Shih-Ming Jung, Pao-Tsai Cheng, Alice M.K. Wong

Rehabilitation Practice and Science

Supratentorial primitive neuroectodermal tumors are a very rare brain tumor. This reports the case of a 14 year old girl who visited our emergency department owing to severe headache and vomiting. One 72mm×45mm mass located at the left corpus callosum and extending to the left ventricle was identified by Brain magnetic imaging. The tumor was removed and the pathology demonstrated highly cellular tumor with poorly differential cells and brisk miotic activity. Based on the tumor location and pathology, a supratentorial primitive neuroectodermal tumor was diagnosed. Following the surgery the patient presented with right side weakness, unsteady gait, and speech difficulty. …

Thickening Of Finger Extensor Tendons In Hemiplegic Hands Of Stroke Patients, Nai-Hsin Meng, Sui-Foon Lo, Ting-I Han, Yi-Fang Hu, I-Shien Tseng, Mu-Jung Kao

Rehabilitation Practice and Science

Thickening of finger extensor tendons in hemiplegic hands of stroke patients has never been reported. We reported 11 patients with stroke who experienced gradual onset of a painless swelling at the dorsal aspect of the hemiplegic wrist. Soft tissue sonography revealed that the swellings were mainly composed of thickened finger extensor tendons. This thickening typically involved the tendons of the 4th dorsal extensor compartment between the proximal carpal and mid-metacarpal levels. The maximal thickness of these tendons could reach over three times that of the corresponding tendons of the contralateral hand. The synovial tissue surrounding the thickened tendon was also …

Primary Adrenal Insufficiency Developing After Traumatic Brain Injury: A Casereport, June-Kai Chen, Tien-Wen Chen, Ming-Cheng Weng, Mao-Hsiung Huang

Rehabilitation Practice and Science

There have been isolated reports in the literature of the natural history and less than complete knowledge of the epidemiology and the pathophysiology of endocrine alteration occurring after traumatic brain injury (TBI). This article describes one primarily adrenal-dysfunction patient with severe TBI who had no evidence of present or prior adrenal autoimmune disease, infection, hemorrhage, or malignancy. It is suggested that this distinct condition can be labeled as ”primary adrenal insufficiency (PAI) developing after TBI”.

Metatarsal Stress Fracture: A Casereport, Chwan-Chin Leu, Chorng-Song Chou, Chin-Teng Chung, Chun-Fu Wang

Rehabilitation Practice and Science

A stress fracture is defined as a partial or complete fracture of bone due to the inability to withstand non-violent stress applied in a rhythmic, repeated, subthreshold manner. It could occur in any kind of sport. However, it usually occurs in running-based sports and running or jogging. Initial diagnosis of stress fracture is difficult. A careful study of the patient's history amd physical examination combined with appropriate radiographic examination, or if indicated, scintigraphy, provides a highly accurate diagnosis.A 19-year-old male athlete suffered from insidious onset of pain in the right forefoot after judo training. This focal pain eventually precluded any …

Lumbar Pathological Fracture Due To Salmonella Osteomyelitis Mimics Compression Fracture, Ming-Fong Tsai, Zong-Jing Wang, I-Chiun Lu, Chi-Hung Chiu

Rehabilitation Practice and Science

We describe a patient with Salmonella vertebral osteomyelitis who presented with severe low back pain. An initial diagnosis of compression fracture was based on clinical symptoms and signs, as well as imaging studies. During hospitalization, the patient developed a fever. A repeat MRI, positive blood cultures, and abscess culture results obtained during an operative procedure confirmed the diagnosis of Salmonella vertebral osteomyelitis. Salmonella vertebral osteomyelitis is rare, and its clinical presentation may mimic other common diseases such as compression fracture. This case illustration suggests that in patients with rapidly progressive low back pain, fever, and poor response to treatment, vertebral …

Alcohol-Related Central Pontine Myelinolysis: A Casereport, Tai-Te Lee, Vikey Huang

Rehabilitation Practice and Science

Central pontine myelinolysis (CPM) characterizes demyelinolysis of the central basal pons without involving the nerve axon. The etiology and incidence are unclear. According to previous reports, CPM occurs most often in chronic alcoholism, followed by hyponatremia due to rapid correction of electrolyte imbalance. Clinical manifestations of CPM include consciousness disturbance, lethargy, impaired brain function, dysphasia, dysarthria, four limbs weakness, ataxia, decreased deep tendon reflex, hypotension and seizure. The treatment of CPM includes supportive management with enough nutrition intake and rehabilitation programs. Our casereport is a 47 year old male with the history of diabetics mellitus, hypertension and chronic alcoholism. He …

Long-Term Treatment Of Hemifacial Spasm With Type A Botulinum Toxin, Yu-Ching Llin

Rehabilitation Practice and Science

Hemifacial spasm is a rare movement disorder. It is characterized by recurrent, involuntary tonic or clonic contraction of the muscles innervated by unilateral facial nerve. It may affect patient’s vision and has great cosmetic or psychological impacts. Oral drugs including anticonvulsants, baclofen and benzodiazepines often have little effect. Surgery has potentially serious complications. After numerous clinical studies, botulinum toxin is now recommended as the primary treatment of choice for most hemifacial spasm cases.The purpose of this study is to retrospectively evaluate the dose, effect and side effects of long-term treatment of hemifacial spasm with type A botulinum toxin. Between November …

Market Analysis For The Need Of Individualized Assisted Device In Patients With Physical-Mental Disabilities, Chau-Peng Leong, Shih-Wei Chou, Tsong-Hwa Lin, Jen-Li Pan, Yu-Cheng Pei, Ngok-Kiu Chu, Kin-Chung Lai, Kuo-Hsien Tu, Simon F.T. Tang

Rehabilitation Practice and Science

The number of people with physical-mental disabilities in Taiwan was 711,064 in the year 2000. The difficulties in performing activities of daily lives and social function handicaps in these people can often be alleviate with the proper application of assisted device. The individualized need of assisted device in people with physical-mental disabilities was never investigated in Taiwan. Therefore, the objectives in this investigation were to: 1. understand the need of assisted device in people with physical-mental disabilities, 2. understand the need of individualized assisted device in people with physical-mental disabilities, 3. observe the similarities and differences in the need for …

Orthoses Utilization And Daily Functional Status In Patients With High Level Cervical Cord Injury, Yao-Ting Wu, Chin-Hung Tseng, Ming-Shun Wu, Chia-Li Chen, Chi-Ming Shih, Liu-Ing Bih

Rehabilitation Practice and Science

Patients with high-level cervical cord injuries are dependent in most activities of daily living (ADL) because they possess very little residual motor function. The utilization of appropriate assistive devices could enhance their independence and improve their quality of life.A prospective study was conducted with 11 male tetraplegic patients between 22 to 51 years of age (mean, 32.0±10.0 years), living in central Taiwan, with C4 or C5 cord injuries; the duration of their injuries ranged between 16 to 125 months (mean, 56.8±28.6 months). After a home visit and an individual interview, we found that these patients could perform 1 to 8 …

Childhood Traumatic Brain Injury: Recovery Of Working Memory Function And Behavioral Adjustment, Gayle L. Crahen

All-Inclusive List of Electronic Theses and Dissertations

Children and adolescents with a traumatic brain injury (TBI) were the focus of this investigation using an extant data set. The 3 7 participants were between the ages of 5 and 15 years at the time of injury, and the majority had a severe TBI. Participants were evaluated soon after injury for a Baseline description of functioning on measures of cognition and memory and re-evaluated at one and/or two year return appointments. Parents provided estimates of adaptive, internalizing, and externalizing behaviors at Baseline and at follow-up appointments on the V ABS and CBCL. It was expected that parents' descriptions of …

A Closer Look At Development Of Self-Awareness And Compensatory Strategy Use In Adults With Traumatic Brain Injury, Melissa A. Byrne

Masters Theses

My study investigates the development of self-awareness and use of compensatory strategies in eight adults with traumatic brain injuries using the Awareness Questionnaire (AQ) and three additional questions of descriptive nature. This study also examines whether or not the severity of brain injury (mild, moderate, severe) impacts the development of self-awareness. In addition, the spouses' perceptions of client awareness are compared to the relatives' to determine existence of potential variance.

Results indicate that while there is no significant difference in self-awareness_ between the mild and moderate groups, the severe group significantly varies from both the mild and moderate groups. Also, …

The Effectiveness Of Personal Data Assistants In Improving Daily Function Of Adults With Mild Traumatic Brain Injury, Connie Lee Budiwarman

Masters Theses

This study evaluated the effectiveness of using Personal Data Assistants to help with memory and/or organizational difficulties with adult patients who had survived mild Traumatic Brain Injury. Utilizing an AB single subject design method with a training period, one subject ultimately completed the study. The study demonstrated mixed results. Through the use of daily record sheets, the subject reported improvement in three areas of daily function but reported negative improvement in three areas of daily function. This study suggests, but does not completely support, the potential use of Personal Data Assistants with patients with Traumatic Brain Injury.

Relationship Of Urinary Incontinence To Hysterectomy And Episiotomy, Elizabeth Oakley, Debra Buchtel, Rachel Atanosian, A. Lynn Millar

Faculty Publications

BACKGROUND: Urinary incontinence (UI) is a problem that affects women of all ages. Research has identified many risk factors for the development of UI but is inconclusive regarding the relationship between episiotomy and hysterectomy and the development of UI symptoms. Physical therapists are emerging as primary care providers which increases the importance of attention to and knowledge of risk factors facilitate timely screening and care for women at risk or who have UI signs and symptoms. PURPOSE: The purpose of this study was to examine the relationship between episiotomy and hysterectomy and incidence of urinary incontinence. SUBJECTS: The subjects included …

Influence Of Aging On Sex Differences In Muscle Fatigability, Sandra K. Hunter, Ashley Critchlow, Roger M. Enoka

Exercise Science Faculty Research and Publications

The purpose of this study was to compare time to task failure for a sustained isometric contraction performed at a submaximal intensity with elbow flexor muscles by young and old men and women. Twenty-seven young (14 men and 13 women, 18–35 yr) and 18 old (10 men and 8 women, 65–80 yr) adults sustained an isometric contraction at 20% of maximal voluntary contraction torque until target torque could no longer be achieved for ≥5 s. Young adults were stronger than old adults (66.8 ± 17.9 vs. 47.7 ± 18.1 N·m, P < 0.05), and men were stronger than women (69.8 ± 17.9 vs. 47.1 ± 15.3 N·m, P < 0.05), with no interaction between age and sex (P > 0.05). Time to task failure was longer …

Beyond Bloodletting: Fda Gives Leeches A Medical Makeover, Carol Rados

Harold W. Manter Laboratory of Parasitology: Library Materials

In June 2004, the Food and Drug Administration cleared the first application for leeches (Hirudo medicinalis) to be used in modern medicine as medical devices. By definition, a medical device is an article intended to diagnose, cure, treat, prevent, or mitigate a disease or condition, or to affect a function or structure of the body, that does not achieve its primary effect through a chemical action and is not metabolized.

Visual-Motor Integration Skills Impact On Handwriting, Amber M. Kapnick

Masters Theses

The purpose of this study was to evaluate if a visual-motor integration intervention improved handwriting legibility and visual-motor integration in first grade students as measured by the Minnesota Handwriting Test (MHT) and the Developmental Test of Visual-Motor Integration (VMI). Intervention was based on sensory-motor learning theories. Sixty-six children from four first grade classrooms in a suburban elementary school were randomly assigned to an intervention or a control condition. The intervention group received eight weeks of visual-motor integration training twice a week for 30 minute sessions. The control group received regular academic instruction. All children were tested on the Minnesota Handwriting …

The Understanding And Utilization Of Occupational Therapy Services By Medical Doctors In Acute Hospital Settings, Naina Jamani

Masters Theses

The purpose of this study was to determine what medical doctors working in the Canadian healthcare system know about occupational therapy, and if this understanding of occupational therapy is deemed valuable by the rate of referrals generated by these practitioners. This study will examine the relationship between physician's knowledge level and referrals to occupational therapy. The study instrument was a survey that consisted of eight questions, seven multiple choice and one open-ended response. The study took approximately five minutes to complete. A total of forty surveys were distributed at three different acute hospital settings. A total of fourteen or thirty-five …

Spousal Congruence On Disability, Pain, And Spouse Responses To Pain, Annmarie Cano, Ayna B. Johansen, Michael Geisser

Psychology Faculty Research Publications

We examined congruence between chronic pain patients and their spouses on their reports of patient pain severity, patient disability, and spouse responses to pain. Patients reported that they were more physically and psychosocially disabled than their spouses reported them to be. However, spouses reported that the patients’ pain was more severe than patients reported. Depressive disorders in the patient and gender interacted with patient–spouse ratings. For physical and psychosocial disability, depressed patient couples reported significantly larger differences in disability ratings than nondepressed patient couples. In addition, female patients’ disability was rated as more severe by the female patients than by …