Pre-operatively (pre-op) and following arthroscopic partial meniscectomy (every 2 weeks for 12 weeks), bilateral knee extensor and flexor peak torques (PT) were evaluated at the Sports Medicine Lab (SML) and Sacre Coeur Hospital (SCH) via Cybex II or II+, in 22 subjects. Three submaximal contractions were followed by 3 maximal contractions at 60, 120, 180 and 240 deg/sec, with a 2 minute rest between sets. For both groups, the quadriceps had a significant deficit in PT at pre-op, except at 180 and 240 deg/sec at the SML, whereas the hamstrings only had a significant deficit at 60 deg/sec. Despite significant differences in PT (SML $>$ SCH) and percent deficit (SCH $>$ SML) the recovery pattern was similar in both groups. Extensor PT dropped significantly at 2 and 4 weeks post-op, returned to pre-op values by 6 weeks post-op and plateaued at this level until and including 12 weeks post-op. Flexor PT dropped significantly at 2 weeks post-op, except at the faster speeds, and was fully recovered 2 weeks later. These results indicate that while the hamstrings were minimally involved, the extensors were not able to recover beyond their pre-op level of strength within 3 months, without training. The differences between the SML and SCH may be attributed to differences in Cybex machines, thigh muscle cross sectional area and tourniquet time.

The Erhardt Developmental Prehension Assessment (EDPA) was designed as a measure of hand function for use with developmentally and physically disabled children. In this study the inter-observer reliability of the EDPA, and the concurrent validity of the EDPA with the fine motor scale of the Peabody Developmental Motor Scales (PDMS) were evaluated. The EDPA was initially revised by standardizing the procedures for administering the test and developing an objective scoring system. Thirty developmentally disabled children ranging in age from 3 to 18 months were tested in this study. / The results indicate that the EDPA has high levels of inter-observer reliability, and that it has concurrent validity with the PDMS in this population. Further test revisions are necessary, however, to improve the EDPA's discriminative power. Normative data needs to be gathered on a large, cross-sectional sample of children so that future measures of impaired hand function will be based on a good understanding of the sequence of normal development.

No description available.

No description available.

Transcutaneous electrical nerve stimulation (TENS) has been employed for over 2 decades in pain management, however, definitive analgesic parameters have yet to be determined. The objective of this study was to determine the influence of 10, 30 and 60 min of TENS on the time course and magnitude of modulation on flexion reflex (FR) and on subjective pain estimates (visual analogue scale, VAS), as well as determining the relationship between FR responses and VAS scores following TENS of different durations. / Ten (10) normal subjects received electrical stimuli of maximal tolerable intensity to the sole of their foot. Our results indicated that TENS could suppress the FR in 50% to 70% of subjects. However, longer durations (30 and 60 min) of TENS have a small, but discernible difference in the number of subjects that show inhibition of FR area and significant maximal FR suppression when compared to 10 min of TENS. Moreover, the 60 min of TENS generated significant depression of VAS scores in more subjects than 10 and 30 min of TENS and ensured that any increase in pain perception would not reach significance when compared to the shorter (10 and 30 min) durations of TENS. / Our results suggested that longer durations of TENS could be applied to produce antinociceptive and analgesic effects. (Abstract shortened by UMI.)

The purpose of this study was to identify the most responsive measure of aerobic fitness over a four week pre-surgical aerobic training program (prehabilitation) in patients undergoing major bowel resection. Twenty one subjects (14 in exercise, 7 in control) participated. Fourteen subjects underwent 26.5 +/- 8.6 days of progressive aerobic exercise training at 40 to 65% of heart rate reserve (%HRR). The results showed that peak power output was the only maximal measure that responded to training as it improved by 26 +/- 27% (ES = 0.24, SRM = 1.05) in the exercise group (p < 0.05) compared to no change in the control group. For the submaximal measures, 6-Minute Walking Test improved in both group. Submaximal V·O2 (V·O2submax) and Submaximal Heart Rate (HR submax) were the most responsive to training as they decreased by 13 +/- 15% (ES = -0.24, SRM = -0.57) and 7 +/- 6% (ES = -0.40, SRM = -0.97) at 76 +/- 47 W compared to no change in the control group.

The effectiveness of rehabilitation interventions has traditionally been measured using tests of physical capacity. The rehabilitation process, however, comprises many ingredients that set up a cascade of effects that impact beyond simple physical capacity. In this thesis, the vehicle of a clinical trial conducted to evaluate the efficacy of a walking intervention for persons with chronic stroke was used to illustrate the array of outcomes that are impacted upon by a rehabilitation intervention. First, the walking intervention was proven effective in enhancing two traditional capacity outcomes: functional walking capacity and walking speed. The intervention primarily benefited functional walking capacity, measured as the distance a person can walk in six minutes, indicating the task-specificity of training effects. Persons with a baseline walking deficit of moderate severity responded to the walking intervention to a greater extent than persons with mild or severe impairment. Following, the role of a less traditional construct---self-efficacy for balance activities---as an outcome of stroke rehabilitation was evaluated. Self-efficacy reflects perceived ability and it is measured not by direct testing but rather by self-report. It was hypothesized that the walking intervention would benefit balance self-efficacy in addition to functional walking capacity given that mastering a task is expected to enhance self-efficacy for that task. Thesis findings supported this hypothesis and suggested that the level of depressive symptoms may modify effects. Self-efficacy was also expected to influence physical functioning as much as physical capacity and this hypothesis was verified. Self-efficacy was also an independent predictor of perceived health status. Additional associations were observed between balance self-efficacy and age, gender, depression and functional capacity. Before recommending the evaluation of balance self-efficacy in rehabilitation

The ability to fully activate the motor units of the quadriceps femoris muscle when performing an isometric maximal voluntary contraction (MVC) was assessed in 30 subjects. The twitch interpolation technique (TIT) was used to measure the increase in force superimposed on the MVC by a supramaximal shock to the femoral nerve. The superimposed force was compared to the potentiated twitch (PtP) force, and an activation ratio (A.R.) was calculated. The resting twitch (PtR) force, MVC force, and the inverse relationship between the level of voluntary force and the superimposed twitch force were also measured. Subjects were compared on the basis of activity level (15 sedentary and 15 trained) and gender (14 males and 16 females). The mean A.R. was 95% regardless of activity level or gender. Males were stronger than females but there was no difference in strength between the sedentary and trained groups. PtR and PtP force values showed the same pattern of results. The nature of the relationship between the level of voluntary force and the superimposed twitch force was curvilinear, and indicates that the TIT may not be accurate in measuring the amount of activation for a muscle as large as the quadriceps when voluntary contractions greater than 70% of the MVC are performed. The intra-subject reliability of the TIT used in this lab was acceptable (ICC = 0.78).

Despite its relative importance, "use" of the affected upper extremity (UE) following stroke has obtained very little attention. This can be explained in part by the fact that effective means of measuring "use" are not readily available to clinicians. The objective of this cross-sectional study was to examine whether measures of manual dexterity and UE function, commonly used by clinicians and researchers, can effectively gauge at-home "use" of the affected UE by patients who have suffered a stroke. / Methods. Gross and fine manual dexterity, UE specific function, UE related independence, grip strength and endurance were evaluated on 47 chronic stroke survivors living in the community. "Use" of the affected UE was measured using the Motor Activity Log. / Results. "Use" of the affected UE was found to have a linear relation with measures of UE capacity, once age and side of paresis were controlled in the analysis. In fact, up to 80% of the variance in "use" could be accounted for by some of the models. Both the TEMPA unilateral functional score and the Box & Block Test on the affected side were associated with an increase of ~20% in "use" for each increase of one standard deviation. All of the other measures were associated with substantially lower increase in "use" per standard deviation change. / Conclusion. Measures involving movement of the affected shoulder and elbow such as the TEMPA or the Box & Block Test are more closely associated with increased "use" of the affected UE in comparison to other measures such as the Nine Hole Peg Test or grip strength that can be completed without incorporating the shoulder and elbow.

Individuals with burn injuries increasingly survive their injury, but we know little about their psychological outcomes following the injury. This study examines life satisfaction outcomes for 260 individuals who sustained burn injuries and were assessed repeatedly over a five year period post-discharge with the Life Satisfaction Index (LSI), Functional Independence Measure (FIM), and Family Satisfaction Scale (FSS). Structural equation modeling was used to predict life satisfaction (LSI) based on functional impairment (FIM), family satisfaction (FSS), pain, and employment variables. Study participants were assessed at 12 months, 24 months, 48 months, and 60 months post discharge. Each time period assessed was analyzed as a model of life satisfaction predictors; additionally, a prospective model was proposed which combined data from all four time points in one path analysis of predictors of life satisfaction at 60 months post discharge. Results indicate that family satisfaction, functional independence, employment, and pain did not explain the variance associated with life satisfaction scores (variance explained ranged from 4% at 24 months post discharge to 11% at 60 months post discharge). Few paths in all five of the models proposed proved significant, suggesting that other factors influence life satisfaction in individuals with burn injuries. These results constitute an important addition to the limited literature surrounding psychological outcomes of those who suffer burn injury and have implications for future studies to advance research on this issue.