Rehabilitation and Therapy Commons^™

The Basic Unit Of A Myofascial Trigger Point, Ta-Shen Kuan, Shu-Min Chen, Jo-Tong Chen, Chang-Zern Hong

Rehabilitation Practice and Science

This report summarized recent studies on the basic structures of a myofascial trigger point (MTrP). A MTrP is a hyperirritable spot in a palpable taut band of skeletal muscle fibers. Spot tenderness, recognized pain, and taut band are now demonstrated to be reliable diagnostic criteria of an MTrP. Referred pain (ReP) or local twitch response (LTR) is a confirmatory sign of MTrP. There are multiple loci in an MTrP region. The basic unit of an MTrP is the MTrP locus which contains a sensory component (the sensitive locus) and a motor component (the active locus). A sensitive locus is the …

Validation Of The Clinical Swallowing Evaluation In Stroke Patients, Yi-Nien Lin, Tyng-Guey Wang, Yeun-Chung Chang, Fu-Mei Hsieh, I-Nan Lien

Rehabilitation Practice and Science

Although it has variable reliability, the bedside clinical swallowing evaluation (CSE) of dysphagia has long been accepted as the basic screening tool in the examination of the swallowing function of stroke patients. The purpose of this study was to define the reliability of the CSE by comparing it to the standard videofluoroscopic study of swallowing (VFSS). Thirty six stroke patients within a period of two years were included in this study, and all of them received the CSE and VFSS simultaneously. Three of them had a normal VFSS, whereas 21 (58%) aspirated during the VFSS examination. Ten of the people …

The Risk Factors Of Cerebral Palsy In Very Low Birth Weight Prematurity, Jen-Wen Hung, Min-Yuan Yu, Hsueh-Wen Chang, Fang-Chih Hung, Chau-Peng Leong, Chung-Bin Huang, May-Kuen Wong

Rehabilitation Practice and Science

nfants with a birth weight less than 1500gm (very low birth weight, VLBW) are more likely to have disabling cerebral palsy(CP). The aim of this study was to identify prenatal, perinatal, postnatal risk factors for CP in VLBW infants and to determine the usefulness of cranial ultrasonographic (us) findings in predicting CP.The study group comprised 159 VLBW infants born at Chang Gung Memorial Hospital in Kaohsiung in the period from 1989 to 1996. CP was diagnosed via clinical evaluation in twenty-five (15.7%) of these Children. Univariate analysis identified antepartum hemorrhage, pre-eclampsia, birth weight, gestational age, the type of delivery, Apgar …

Paraplegia Following Epidural Anesthesia: A Casereport, Yu-Ching Lin, Yen-Ho Wang, Kou-Mou Huang, Tien-Shang Huang

Rehabilitation Practice and Science

This article reports the case of a 36-year-old woman who experienced a sudden sharp pain in her lower back and became paraplegic after epidural anesthesia for a cesarean section. Three months later, the appearance of an ascending sensory level despite motor recovery raised the prssibilite of another lesion causing the new neurologic symptoms. Magnetic resonance imaging revealed arachnoiditis with subarachnoid cysts that severely compressed the thoracic spinal cord. Surgical decompression relieved the neurologic symptoms at first, but the symptoms soon deteriorated due to re-formation of adhesions and probably intrinsic cord damage. Based on our experience, carefully history taking and detailed …

The Identification Of Domains And Competencies For Community Practice Occupational Therapy, Lisa Anne Werner

Masters Theses

Literature shows evidence of a shift in occupational therapy from traditional institutional settings to community-based settings. As increasing numbers of new and expert occupational therapists enter community-based practice, the need for competency identification for practice, education, and reimbursement becomes paramount. This qualitative research study sought to identify domains and competencies of community-based occupational therapy practice by interviewing three expert occupational therapists using the critical incident method in which each therapist described one therapeutic intervention with a client. This method, as seen in nursing studies (Benner, 1982, 1984), serves to elicit competencies embedded in expert practice. Thirty-nine competencies were described in …

Acquired Hip Subluxation And Dislocation In Cerebral Palsy, Li-Chen Tung, Chun-Hou Wang, Yu-Hui Huang, Liu-Ing Bih

Rehabilitation Practice and Science

The study group comprised eighty-nine cerebral palsy patients, 46 males and 43 females. The average age was 6.0±3.4 years old. Pelvic frontal view radiographs were made in a total of 178 hips. The migration percentage and acetabular index were measured by pelvic X-ray in all patients. Either hip subluxation or dislocation was diagnosed according to the criteria of Reimers, who considered a migration percentage greater than 33% to denote subluxation and a percentage greater than 100% to be denoted as dislocation. An overall incidence of hip subluxation and dislocation of 48.3% was found. According to the Pearson correlation coefficients data, …

Dysphagia And Videofluoroscopic Examination In Parkinson's Disease, Shin-Liang Pan, Tyng-Guey Wang, Yeun-Chung Chang

Rehabilitation Practice and Science

Parkinson's disease (PD) is a degenerative disorder of the nigrostriatal system, and frequently complicated with swallowing difficulties. This paper reviewed the current studies on the scope of the incidence, the clinical symptoms, the use of videofluoroscopic swallowing study (VFSS), and the management of dysphagia in PD. The awareness of dysphagia in PD patients in previous studies was around 31 to 72 %, however, this figure does not reflect the actual severity of swallowing disorders in this group patients. We found a great variability in the incidence of swallowing disorder on VFSS, depending on the patients selected. Around 31 to 92% …

The Relationship Between Congenital Muscular Torticollis And The Development Of Dominant Hand, Shu-Yi Wang, Chau-Peng Leong

Rehabilitation Practice and Science

We studied dominant hand development in 158 patients with congenital muscular torticollis who had received physical therapy in Chang Gung Memorial Hospital, Kaohsiung, from 1989 to 1995. There were 97 boys and 61 girls in the study group. The congenital muscular torticollis was right side in 84 patients and left side in 74 patients. We also enrolled 512 healthy children, aged from 3 to 5 years old, as the control group. Ninety-one percent of the control subjects were right handed, and nine percent of them were left handed. Subjects with right congenital muscular torticollis were right handed in 63.1% of …

Occupational Therapists' Assessment Of The Caregivers Of Their Elderly Patients, Ernest Vincent Corradetti

FIU Electronic Theses and Dissertations

The purpose of this study was to determine the methods and extent to which occupational therapists who are practicing in aging are assessing the caregivers of their elderly patients. A random sample of 500 therapists who subscribe to a special interest group publication of a professional organization were surveyed by mail and 204 responses were received.

Respondents were asked to indicate all of the activities related to caregiver assessments in which they engage. Methods of assessment included: (a) professional caregiving activities, (b) informal assessment methods, and (c) formal assessment methods. There were more than 90% of respondents who indicated that …

Sexual Life Of Patients With Spinal Cord Injury, Lin-Fang Chen, Liu-Ing Bih

Rehabilitation Practice and Science

Most patients with a spinal cord injury have some physical and psychological disabilities, which usually interfere with their sexual lives. In order to investigate the sexual activities of spinal cord injured patients in Taiwan, this study analysed the completed questionnaires of 137 persons (45.9%) and the letters of 298 spinal cord injured patients. The sexual activity rate was 32% and the major determining factors were lesion sites and severity of injury. Persons who had the most active sexual life were those between 30 to 40 years old. There was no difference in sexual activity between males and females. Sexual life …

Clinical Trial Of A Low-Temperature Plastic Anterior Ankle Foot Orthosis For Children With Habitual Toe Walking, May-Kuen Wong, Chin-Man Wang, Fuk-Tan Tang, Choon-Khim Chong

Rehabilitation Practice and Science

Six children with idiopathic (habitual) toe walking were fitted with a new type of plastic anterior ankle foot orthosis made from a low-temperature thermoplast. The age of the children ranged from 2 to 6 years and none had an associated neuromuscular disorder. The splint could be taken off and put on at will. The child wore it for a duration of 5 to 8 hours daily for a period of 3 to 8 weeks. At the end of treatment, all children had improved their range of dorsiflexion by at least 20 degrees. No recurrence was found at one to two …

Superior Sagittal Sinus Thrombosis Causing Bilateral Hemiplegia : Casereport, Nai-Hsin Meng, Tyng-Guey Wang, Chein-Wei Chang

Rehabilitation Practice and Science

Superior sagittal sinus thrombosis is an uncommon stroke syndrome which may cause serious complications, including increased intracranial pressure, seizures or unilateral or bilateral hemiplegia with motor deficit more prominent in the lower limbs and proximal upper limbs. We present a 57-year-old male patient who had seizures and recurrent transient ischemic attacks in 1995. He was shown to have superior sagittal sinus thrombosis on magnetic resonance imaging and received oral anticoagulation therapy. Four months after initial treatment he had hemorrhagic infarctions over bilateral cerebral hemispheres and bilateral hemiplegia resulted. Little neurologic recovery was noted during the two-year follow up. The possible …

Additional Ultrasound Therapy After Myofacial Trigger Point Injection For The Management Of Postinjection Soreness, Min-Way Lai, Chang-Zern Hong

Rehabilitation Practice and Science

Objective: The purpose of this study was to investigate the effectiveness of trigger point injection (TPI) and combined treatment on an active myofascial trigger point (MrP).Design: A controlled clinical trial Setting: Our study was performed in a rehabilitation outpatient clinic. Participants: One hundred and sixty-two patients with active MrPs in the upper trapezius were investigated over a two year period, from 1995 to 1996. Forty-six healthy adults were included as the control group. Control study: The healthy subjects were assigned into three different groups which included healthy subjects without treatment (control group), patients without treatment (patient group) and patients accepting …

Effects Of An Anterior Ankle-Foot Orthosis On Hemiplegic Gait, Chiung-Ling Chen, Kwok-Tak Yeung, Shin-Han Wu, Ping-Yen Chiang

Rehabilitation Practice and Science

Ankle-foot orthoses (AFOs) are frequently prescribed for hemiplegia to correct the ankle joint, provide mediolateral stability and improve ambulatory safety.Metal orthoses have gradually been replaced by plastic AFOs because metal orthoses are heavy and have a poor cosmetic appearance. Conventional plastic AFOs are designed in posterior leaf type and fabricated by a lamination or vacuum-forming technique over a positive plaster model of the limb. It takes time to fabricate a plastic AFO, and the effect of correcting for inversion of a hemiplegic foot is not obvious. Wu designed a low-temperature anterior direct molding AFO called an anterior AFO. It is …

Hereditary Spastic Paraplegia－Clinical Analysis And Experience Of Rehabilitation：A Casereport, Pong-Yuen Wong, Yun-Chyi Wang, Pin-Tang Ko, Yi-Lung Sun, Fuk-Tan Tang, May-Kuen Wong

Rehabilitation Practice and Science

Hereditary spastic paraplegia (HSP) is a rare degenerative disorder of the central nervous system. The mode of inheritance may be autosomal dominant, autosomal recessive, or X-linked. Clinical features include a normal perinatal and birth history, slow progressive spasticity of the bilateral lower limbs, hyperreflexia, increased extensor plantar responses, and positive knee and ankle clonus resulting in walking difficulty and an abnormal gait. Rehabilitation training for hereditary spastic paraplegia has seldom been discussed. We present a case of HSP who received physical and occupational therapies.A 12-year-old male patient was admitted to our hospital on July 23, 1995 due to insidious onset …

The Effects Of Sensory Processing Deficits On Occupational Performance In Children With Fragile X Syndrome, Grace T. Baranek, Yuki H. Chin, Laura Greiss Hess, Jann G. Yankee, Deborah D. Hatton, Stephen R. Hooper

Laura Greiss Hess

Gender-Specific Protection From Microvessel Rarefaction In Female Hypertensive Rats, Paula E. Papanek, Mark J. Rieder, Julian H. Lombard, Andrew S. Greene

Exercise Science Faculty Research and Publications

Epidemiologic studies reveal that women have a significantly lower age-adjusted morbidity and mortality from cardiovascular disease than men, suggesting that gender is a cardiovascular disease risk factor. The mechanism of the “gender protection” is unknown. In this study, we investigated the microvascular remodeling in reduced renal mass plus a high salt (4.0% NaCl) diet model of hypertension (RRM + HS). We hypothesized that women would be protected from the increase in blood pressure and from the microvascular rarefaction associated with RRM + HS hypertension. Studies were designed to determine whether female rats were less susceptible to changes in microvessel density …

Comparison Of The Emg Activity Of The Supraspinatus And Infraspinatus Muscles During Various Closed Chain Exercises, I-Chen Lin

Rehabilitation Sciences Theses & Dissertations

Advantages of closed chain exercises used in the lower extremity have been well documented. However, the effects of closed chain exercises on the upper extremities have not been studied very much. Thus, the purpose of this research is to analyze the EMG activity of the supraspinatus and infraspinatus muscles and compare the relative amounts of activities by performing different isotonic closed chain exercises and an open chain exercise in normal subjects. The supraspinatus and infraspinatus muscles in 1 o healthy subjects were studied with fine wire, intramuscular, electromyographic electrodes while performing 5 closed chain exercises and a D2. open chain …

The Effect Of Self-Operated Prompts On Leisure Participation By Persons With Mental Retardation, Tanya Michele Camper

FIU Electronic Theses and Dissertations

The use of permanent prompts for individuals with severe disabilities has been shown to be effective in acquiring new skills, improving the accuracy and maintenance of existing skills, and in eliminating the need for trainer prompts. However, this technology has not been evaluated for its potential impact in promoting leisure participation. In this study, two men with mental retardation were administered auditory and/or visual prompts to investigate their effect on increasing participation in a leisure activity. In addition, their performance was evaluated to establish whether continuous versus intermittent schedules of the prompts would influence participation. The data were collected using …

Icelandic Occupational Therapists' Attitudes Toward Educational And Professional Issues, Elín Ebba Ásmundsdóttir

FIU Electronic Theses and Dissertations

The entire population of Icelandic occupational therapists were surveyed concerning characteristics and attitudes toward professionalism and educational goals. There were 87 questionnaires sent out and 80 (92%) were returned and used for analysis. This data will have a positive impact upon the development of the first Icelandic occupational therapy curriculum. Icelandic occupational therapists, in general, value academic skills over technical skills, are active in their association, willing to take on duties for the advancement of the profession and are interested in conducting research. The attitudes of the Icelandic occupational therapists were generally quite uniform. T- tests and one-way ANOVAs (p < .05) revealed some significant differences in a number of attitudes by education level, length of professional experience and country of education. The results show the importance of providing Icelandic occupational therapy practitioners with the opportunity to take part in research. This study will serve as a foundation for future studies on Icelandic occupational therapists and provide reference data for later comparison.

Clinical Interpretation Of "Health And The Human Spirit For Occupation"., Janice P. Burke

Department of Occupational Therapy Faculty Papers

In reading and contemplating Yenca's (1998) article, I was immediately struck by the utility of the ideas she offers on a number of clinical fronts. We are presented with occupation-based strategies that are directly applicable to our work with patients and program development; we can make use of the language and ideas that are offered as a way to begin talking to one another (therapist to therapist) in clinical settings about occupation; and we are given the opportunity to think about the contribution, value, and efficacy of occupation and how we might convert those ideas into clinically based research actions. …

Electrophysiologic Study Of The Hand Ulnar - Median Nerves Anastomosis In Taiwanese, Yi-Pin Chiang, Baii-Jia Yang, Wang-Lin Su, Jiunn-Ming Wu

Rehabilitation Practice and Science

There are several variations of nerve communications between the ulnar and the median nerves in the hand, which are referred as the Riche-Cannieu anastomoses. The anatomic and clinical significances of these anastomoses have not been clarified. Because of these variations, electric stimulation may travel from the ulnar nerve, through the communications, to the median nerve impulse and thus induces the contraction of thenar muscles. When performing electrophysiologicexaminations, additional attention should be paid to the variations to avoid misinterpretations. In this study, one hundred hands of fifty normal persons were examined. The ulnar and the median nerves were stimulated, and the …

Drooling In The Children With A Neurological Deficit, Li-Rong Chen, May-Kuen Wong, Choon-Khim Chong, Chin-Man Wang

Rehabilitation Practice and Science

Drooling is a common problem among children with a neurological deficit. To establish the incidence of drooling and to determine the factors related to drooling in a population of the children with a neurological deficit, seventy-two children of Chang Gung Children Hospital were analyzed, prospectively. They were aged from 2 to 8 years. Of the seventy-two children, thirty-two children had cerebral palsy (CP), nineteen children had other neurological deficits, and nineteen children, without any neurological deficits, were used as the control group.All the children underwent two assessments for drooling: (1) the direct quantitative measurement of the amount of whole stimulated …

Relationship Between Ventilatory Equivalent For Carbon Dioxide And Ejection Fraction Of Left Ventricle, Shun-Ping Cheng, Chen-Liang Chou, Huey-Ling Yu, Tcho-Jen Liu, Tao-Chang Hsu

Rehabilitation Practice and Science

Cardiopulmonary exercise testing is a powerful non-invasive mean for objectively assessing the exercise response of patients with cardiovascular or respiratory disease. The ventilatory equivalent for CO2(V E/V CO2)derived from gas exchange analysis is considered to be an estimate of dead space ventilation and provides an assessment of the efficiency of minute ventilation during exercise. Clark and associates showed that the V E/V CO2 ratio differentiated patients into subgroups in terms of the severity of congestive heart failure by measuring the maximal oxygen consumption and theduration of exercise time. Our study was designed to differentiate patients into subgroups by measuring the …

The Grip And Pinch Strength In Taiwanese Children Of Primary School, Chia-Ling Chen, Wei-Hsien Hong, Shih-Chun Chu, Chin-Man Wang, May-Kuen Wong, Fuk-Tan Tang, Hsien-Ching Chen

Rehabilitation Practice and Science

This study analyzed the grip and pinch strength of children aged 7 to 12 years old in order to establish the relationship between hand strength and anthropometric factors. Two hundred and two children in primary school were divided into three groups based on age, with group A aged 7 to 8 years, group B aged 9 to 10 years, and group C aged 11 to 12 years old. A Jamar dynamometer was used to measure subjects’ grip strength, and a B&L pinch gauge was used to measure their tip, palmar, chuck, and key pinch strength.Significant differences were found between left …

The Influence Of Age On Functional Independence Outcome In Stroke Patients, May-Kuen Wong, Jen-Li Pan, Ting-Ya Su, Fuk-Tan Tang, Wen-Ko Chiou

Rehabilitation Practice and Science

Two hundred and one stroke patients who were admitted to the Rehabilitation Department of Chang Gung Memorial Hospital, Linkou, from April 1995 to March 1996 were evaluated by the Functional Independence Measure (FIM) in order to analyze the influence of age on stroke outcome. FIM scores on admission and discharge and the gain of FIM Two hundred and one stroke patients who were admitted to the Rehabilitation Department of Chang Gung Memorial Hospital, Linkou, from April 1995 to March 1996 were evaluated by the Functional Independence Measure (FIM) in order to analyze the influence of age on stroke outcome. FIM …

Exercise Training During Hemodialysis For End-Stage Renal Failure：A Casereport, Wil-Ly Chou, Kuang-Shin Chang, Su-Hwei Long, Mu-Jung Kao, Chen-Nan Go

Rehabilitation Practice and Science

Exercise training, especially aerobic exercise, is beneficial to one's health. This is also true for end-stage renal failure patients. However, exercise programs prescribed on non-dialysis days are not usually carried out by the patients, which can decrease the expected effectiveness of exercise training.We present an uremic patient who first underwent a 3 month non-exercise control period, then immediately followed by another 3 months of exercise training during hemodialysis, with a stationary bike. We found the patient's compliance rate for exercise training was 94% (34/36). His maximal oxygen consumption increased by 37.8%, and he was able to discontinue his anti-hypertensive agents …

Does The Oswestry Or Sf-36 Help A Therapist To Predict Treatment Classification, Amy Crawford, Denese D. Kaufeldt-Soliz

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to determine the relationship of two disability questionnaires, the Oswestry Low Back Pain Disability Questionnaire (Oswestry) and the Medical Outcome Study Short Form-36 (SF-36), and a standardized physical examination and diagnostic classification system. The physical examination was performed by the evaluating therapists from the clinic and classification was determined by the evaluating therapists and the investigators to ensure correct subject placement into treatment Stages la, lb, or II. Data collection occurred at an outpatient physical therapy clinic in a metropolitan area health maintenance organization, where a sample of 221 subjects with low back pain …

Prediction Of Discharge Destination From Initial Physical Therapy Assessment Using The Physical Assessment Key (Pak), Wendy L. Chung, Kimberly A. Vieten

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to determine if a patient’s discharge destination could be predicted by information available upon the physical therapy initial evaluation using the Physical Assessment Key (PAK). There were 141 subjects (58 male, 83 female) included in this study and their ages ranged from 19 to 89 years (mean age=57.1 years). Each subject was given a PAK score on the day of the initial physical therapy evaluation and on the day of discharge from the hospital. The PAK evaluates a patient in the areas of transfer activities, self-care activities, locomotion and excretion management. A patient was …

Screening For Scoliosis In Primary School, Pei-Chen Chung, Ming-Chuan Lin, Jin-Shin Lai

Rehabilitation Practice and Science

Idiopathic scoliosis is more frequently found in early adolescence. To prevent possible deterioration and thus, inevitable surgery, early diagnosis and treatment are strongly considered. Screening school children for scoliosis has been very popular in developed countries. The purpose of this study is to find (1) the best age to start screening and (2) the best way to screen. Using the forward bending test, one experienced physiatrist observed the backs of 5185 students from TaipeiMunicipal Dun-Hwa Primary School, which included 2618 boys and 2567 girls. Among them, 195 students had scoliosis. The prevalence rate was 3.76% which is similar to other …