Stroke patient's hope for physical recovery influenced by relationship with therapist during rehabilitation, pg. 263
This study evaluates the interpersonal aspects of constraint-induced movement therapy (CIMT), analyzing how meaning is negotiated between therapist and patient. Findings suggest that several patterns of behavior are present during therapy sessions: coaching, cheerleading, reminding, changing, and contemplating. These behavior patterns indicate that learned nonuse of an affected limb does not exist in social isolation and that people who participate in CIMT routinely consider the balance of any improvement against the costs of using an affected limb that is still not fully functional. These patterns of social interaction that occur during therapy-which often influence a participant's hope for future physical progress-are an important part of CIMT.
One-third of veterans recovering from stroke suffer from depression, pg. 277
This study describes early poststroke emotional recovery in veterans. One hundred and twelve veterans discharged from the hospital one month poststroke completed in-home interviews and the Geriatric Depression Scale (GDS), which were compared to evidence of depression from patient records. Data indicated that 35 percent of the veterans were depressed. Respondents who were depressed were struggling with low expectations of recovery and finding it difficult to accept the losses they were experiencing. Few participants were diagnosed with a depressive disorder. Screening with the GDS is a first step in the detection of depression in patients recovering from stroke.
Veterans with spinal cord injury have more stress than civilians with spinal cord injury and general population, pg. 291
This study examines the effect of daily hassles and perceived stress on psychological health, as well as the role of social support in patients with spinal cord injury (SCI). One hundred and sixty-five veterans with SCI completed a telephone survey assessing sources of stress (daily hassles), perceived stress, social support, depression, anxiety, and life satisfaction. Physical abilities, health, money, and medical care were significant sources of stress. Veterans had significantly higher global stress scores than nonveterans with SCI and the general population. Veterans with more hassles and more perceived stress were likely to have more depressive symptoms and anxiety and were less satisfied with their lives.
Pamidronate fails to prevent bone loss in patients with acute spinal cord injury, pg. 305
This study addressed the efficacy of pamidronate (Novartis Pharmaceuticals), an intravenous bisphosphonate medication, to reduce bone loss in persons with acute spinal cord injury (SCI). Eleven patients within two months of acute SCI were administered pamidronate or placebo with subsequent administration six times over the first 12 months; follow-up evaluations were performed at 18 and 24 months. Patients receiving pamidronate had an early mild reduction in total bone loss at leg and pelvis compared with the placebo group. Despite an early reduction in bone loss, pamidronate failed to prevent major, long-term bone loss in persons with acute, neurologically complete SCI.
Innovative sensor holds promise to enhance the detection and treatment of diabetic ulcers, pg. 315
This study presents pilot work on a fiber-optic-based shear and pressure sensor to measure localized plantar pressure and shear. Shear, a diabetic complication, is thought to play a role in the development of ulcers that can lead to infection and subsequent amputation. Investigators constructed a prototype shear and pressure sensor consisting of two arrays (top and bottom) of fiber optic cables sandwiched between three layers of gel insole. They demonstrated the sensor responds to both shear and compressive loading in a repeatable manner and that it was sensitive to small displacements.
Reducing friction, backlash enhances extended physiological proprioception control of a powered prosthesis, pg. 327
This study identifies factors that contribute to the jerky behavior of extended physiological proprioception (EPP)-controlled elbows. Proprioception refers to the ability of a person wearing a prosthetic to receive sensory feedback originating in muscles, tendons, and other internal tissues. Results from this study indicate that clinical prosthetists and prosthesis component manufacturers must select and design components that possess as little friction and backlash as possible to most effectively implement EPP control of powered prostheses.
Modified Hybrid III test dummy has motion similar to a wheelchair user, pg. 343
This study discusses the development of a low-speed, low-impact test dummy for use in the study of fall prevention from wheelchairs. Investigators evaluated whether a modified 50th-percentile Hybrid III test dummy (HTD) has motion similar to a wheelchair test pilot (TP) with waist-level spinal cord injury. Test cases were seated in a Quickie P100 electrically powered wheelchair driven at three speeds. Three braking conditions-joystick release, joystick full reverse, and emergency power-off-were used to stop the wheelchair. Upper-body motion was recorded to create kinematic exposure profiles of the wheelchair riders. Data indicate that the HTD is a suitable surrogate for a wheelchair user in low-speed, low-impact wheelchair studies.
Insert earphones reliable in testing for high-frequency bedside ototoxicity monitoring, pg. 353
This study evaluates the use of insert earphones for obtaining reliable threshold responses at bedside for ototoxicity detection and monitoring. Ototoxicity is damage to the ear that happens when individuals come into contact with drugs or chemicals that are poisonous to the inner ear or the vestibulocochlear nerve. Investigators tested 20 adults during two different sessions in a sound proof booth and on the hospital wards using high-frequency audiometry. Thresholds were obtained with the use of insert earphones and headphones. Results indicate that insert earphones are reliable for testing on the ward for high-frequency ototoxicity monitoring.
High-frequency components do not enhance computer recognition of dysarthric speech, pg. 363
This study describes the development of an artificially intelligent communication/control tool for speech and motor-impaired individuals. A hidden Markov model (HMM)-based system for recognition of dysarthric speech was constructed, with special emphasis on the effect of high-frequency spectral components on the system's recognition rate. A set of 15 words and 10 digits were recorded from three male cerebral palsy patients with moderate dysarthria. Investigators found that inclusion of high-frequency components provided no significant useful information that would enhance speech recognition. The application of speech recognition technology to impaired speech would enable people with such impairments to control mobility and appliances.
New retinal motion tracking may improve evaluation of and training for people with low vision, pg. 373
This study investigates a technique that could be used to analyze the visual tasks performed by people with low vision. Investigators discuss the development of a technique to improve the speed and accuracy of the analysis of retinal motion from scanning laser ophthalmoscope image sequences. The new software technique was tested on both normal and low-vision subjects and compared with the results obtained with manual techniques. The findings indicate the new technique works very well for most patients. Retinal movement monitoring will help researchers investigate the visual patterns of people with low vision, which may lead to new rehabilitation therapies.
Added weight doesn't effect roll-over characteristics of walking, pg. 381
This study investigates the effects of added weight on roll-over characteristics of walking. Ten participants without physical impairment walked with added weight equally distributed about the torso in a harness. At each weight level, the participants walked at slow, normal, and fast self-selected walking speeds. Investigators examined roll-over characteristics by determining the ankle-foot and knee-ankle-foot roll-over shapes. The roll-over shapes of the ankle-foot and knee-ankle-foot systems did not change appreciably with added weight at any of the three walking speeds. The response of the lower limbs of persons without physical impairment to added weight should be considered an important design feature for prostheses and orthoses.
Radiation therapy negatively impacts quality of life and physical well-being in patients with prostate cancer, pg. 391
This study evaluates the relationship between quality of life, depression, fatigue, and sleep disturbances in patients diagnosed with prostate cancer and undergoing radiation therapy. Forty participants receiving seven to eight weeks of radiation therapy completed several quality of life scales during and postradiation therapy. Data indicate a significant decline in patients' bladder and bowel function and physical well-being during and upon completing therapy. Higher fatigue scores were associated with poorer quality of life and physical well-being. Investigators conclude that patients undergoing radiation therapy should expect a decline in quality of life and physical well-being, increased fatigue, as well as transiently worsening bladder and bowel problems. Understanding the negative impact of radiation therapy on quality of life will allow the development of rehabilitation interventions to minimize or negate it.
About the Journal JRRD has been a leading research journal in the field of rehabilitation medicine and technology for more than 40 years. JRRD, a peer-reviewed, scientifically indexed journal, publishes original research papers, review articles, as well as clinical and technical commentary from U.S. and international researchers on all rehabilitation research disciplines. JRRD's mission is to responsibly evaluate and disseminate scientific research findings impacting the rehabilitative healthcare community. For more information about JRRD, visit www.vard.org.
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The Journal of Rehabilitation Research and Development