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Multidisciplinary perspectives on disability. 残疾的多学科视角。
Pub Date : 1991-10-01 DOI: 10.3109/03790799109166274
D Müller
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引用次数: 0
Driving after stroke: a controlled laboratory investigation. 中风后驾车:一项对照实验室调查。
Pub Date : 1991-07-01 DOI: 10.3109/03790799109166688
S Lings, P B Jensen

The importance of illness or disability for traffic safety is unknown. By means of a mock car, 46 individuals suffering from left-sided hemiparesis and 67 with right-sided hemiparesis after stroke were compared with 109 healthy controls. Only patients without complicating disorders were included in the study groups. They coped far worse than the control group in almost all respects. Reaction times were longer, not merely for the paretic but also for the contralateral extremities. Strength in the 'healthy' part of the body was also significantly reduced. Sometimes patients completely failed to react to given signals. In right-sided hemiparesis a high frequency of directional errors was observed. Neuropsychological functional disorders were well in accordance with the number of erroneous reactions, but to only a minor extent with reaction times. The results of the mock car test could not be predicted on the basis of mere clinical examination.

疾病或残疾对交通安全的重要性尚不清楚。采用模拟车的方法,将46例脑卒中左偏瘫患者和67例脑卒中右偏瘫患者与109例健康对照进行比较。只有没有并发症的患者被纳入研究组。他们在几乎所有方面的应对都比对照组差得多。反应时间更长,不仅对双亲,对侧四肢也是如此。身体“健康”部分的力量也明显减弱。有时病人完全不能对给定的信号做出反应。在右侧偏瘫中观察到高频率的方向错误。神经心理功能障碍与错误反应次数密切相关,但与反应时间关系不大。单纯的临床检查不能预测模拟车试验的结果。
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引用次数: 45
The RSI syndrome in historical perspective. 从历史角度看RSI综合征。
Pub Date : 1991-07-01 DOI: 10.3109/03790799109166692
J Quintner

The pain syndrome repetition strain injury (RSI) has been variously interpreted as a psychogenic disorder, an overuse injury of upper limb musculature, and a state of peripheral neural irritability. A review of the history of work-related upper limb disorders was undertaken to ascertain whether RSI is a new medical phenomenon or an older syndrome in a new guise. In the mid-nineteenth century these disorders were known as either craft palsies or writer's and other occupational cramps. Not withstanding clinical evidence suggesting that most were associated with peripheral neural or muscular dysfunction, a body of influential medical opinion considered them all to be disorders of the central nervous system, appropriately termed the occupation(al) neuroses. During the twentieth century, as discrete occupational upper limb nerve lesions were delineated and the spasmodic form of writer's cramp was recognized as a torsion dystonia, a unifying concept of aetiology for the occupational neuroses of the nineteenth century became untenable. The RSI syndrome of the 1980s can be identified from early case descriptions of both scrivener's palsy and the neuralgic variety of writer's cramp. Contemporary hypotheses proposed to explain RSI are remarkably similar to those proposed for the occupation(al) neuroses.

疼痛综合征重复性劳损(RSI)被不同地解释为一种心因性障碍、上肢肌肉组织的过度使用损伤和周围神经激惹状态。回顾了与工作相关的上肢疾病的历史,以确定RSI是一种新的医学现象还是一种新的伪装的老年综合征。在19世纪中期,这些疾病被称为手工艺麻痹或作家和其他职业痉挛。尽管临床证据表明大多数与周围神经或肌肉功能障碍有关,但有影响力的医学观点认为它们都是中枢神经系统的疾病,适当地称为职业性神经症。在20世纪,随着离散的职业性上肢神经病变被描绘出来,痉挛性痉挛被认为是一种扭转性肌张力障碍,19世纪职业性神经症病因学的统一概念变得站不住脚。20世纪80年代的RSI综合征可以从早期的病例描述中识别,包括作家麻痹和作家痉挛的神经痛。当代提出的解释RSI的假说与职业神经症的假说非常相似。
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引用次数: 17
An evaluation of the effectiveness of group therapy for memory problems. 记忆问题团体治疗的有效性评估。
Pub Date : 1991-07-01 DOI: 10.3109/03790799109166689
S M Jennett, N B Lincoln

Objective: To investigate the effectiveness of group treatment for memory problems.

Design: A cross-over design was employed to compare the memory improvement of subjects while attending a weekly memory therapy session with a waiting period.

Setting: Outpatients.

Treatment: A variety of memory strategies were taught, and practical advice was provided in the use of external aids.

Results: No improvement in memory function was detected on the Behavioural Memory Test or Subjective Memory Questionnaire. There was an increase in the number of memory aids reported as being used after attending the group (p less than 0.05). The number of items reported on the Subjective Memory Questionnaire as 'bothering' the patient decreased in frequency (p less than 0.05) after group treatment.

Conclusions: Attendance at a memory group increased the use of memory aids but did not affect memory impairment.

目的:探讨小组治疗记忆障碍的效果。设计:采用交叉设计来比较受试者在参加每周一次的记忆治疗与等待期的记忆改善。设置:门诊病人。治疗方法:教授多种记忆策略,并在使用外部辅助工具方面提供实用建议。结果:在行为记忆测试和主观记忆问卷中,没有发现记忆功能的改善。参加该小组后,报告使用记忆辅助工具的数量增加(p < 0.05)。主观记忆问卷中“困扰”条目的出现频率在分组治疗后有所下降(p < 0.05)。结论:参加记忆组增加了记忆辅助工具的使用,但对记忆损伤没有影响。
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引用次数: 19
Isometric back strength in different age groups. 不同年龄组的等长背部力量。
Pub Date : 1991-07-01 DOI: 10.3109/03790799109166690
J A Balogun, A G Olawoye, V A Oladipo

Normative data on isometric back strength (IBS) are presented. The IBS of both sexes increased with chronological age, peaked at the third decade of life, and gradually declined thereafter. Males were significantly (p less than 0.001) stronger than females in all age groups, the difference ranging between 16 and 56%. A multiple regression equation was derived to predict IBS, as follows: Male IBS (kgf) = -77.71 - 0.91 age (yrs) + 0.67 height (cm) + 1.50 weight (kg) + 0.24 Quetelet index (R2 = 0.78; SE +/- 16.67 kgf) Female IBS (kgf) = -72.42 - 0.39 age (yrs) + 10.65 height (cm) + 0.08 weight (kg) + 1.04 Quetelet index (R2 = 0.62; SE +/- 10.75 kgf).

给出了等距背压强度(IBS)的规范数据。男女的IBS均随年龄增长而增加,在30岁时达到顶峰,此后逐渐下降。在所有年龄组中,男性都明显强于女性(p < 0.001),差异在16%至56%之间。建立预测IBS的多元回归方程:男性IBS (kgf) = -77.71 - 0.91年龄(yrs) + 0.67身高(cm) + 1.50体重(kg) + 0.24 quette指数(R2 = 0.78;女性IBS (kgf) = -72.42 - 0.39年龄(yrs) + 10.65身高(cm) + 0.08体重(kg) + 1.04 quette指数(R2 = 0.62;+/- 10.75 kgf)。
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引用次数: 6
Impairment/function and disability/activity 3 years after cerebrovascular incident or brain trauma: a rehabilitation and occupational therapy view. 脑血管事件或脑外伤后3年的损伤/功能和残疾/活动:康复和职业治疗观点。
Pub Date : 1991-07-01 DOI: 10.3109/03790799109166687
I Söderback, J Ekholm, G Caneman

A consecutive series of 195 individuals who had had a stroke or brain trauma in 1986 responded in 1989 to a questionnaire about the consequences of the incident for occupational performance. The questionnaire contained 86 questions organized to correspond to the WHO International Classification of Impairments, Disabilities and Handicaps (ICIDH). The questions were distributed over 11 areas of occupational performance: work, leisure activities/social role, life satisfaction, sensori-motor, perceptual, intellectual, emotional function, sleep, personal care, domestic/housework/gardening, and temporal adaptation. None of the individuals considered they had attained the same level of occupational performance in all 11 areas as before the incident. Eight patterns of occupational performance were identified: 35% considered that they performed personal care at the same level and had the same temporal adaptation as before the incident, and that they had minimal impairment/disability in the other areas of occupational performance; 27% thought that they had a considerable degree of disability in all areas of occupational performance except for temporal adaptation; 8% thought that they had imbalance in temporal adaptation and severe performance difficulties in all 11 areas of occupational performance; 4% were dissatisfied with their life situation, and had a changed family role, did not practise the leisure activities they wanted, and had severe sleep problems; and for 9% the levels of performance varied a great deal and depended on the particular area of performance. The consequences of stroke or brain trauma for function and activity 3 years afterwards are considerable.

连续调查了195名在1986年中风或脑外伤的人,他们在1989年回答了一份关于事故对职业表现影响的问卷。问卷包含86个问题,按照世卫组织《缺陷、残疾和障碍国际分类》(ICIDH)组织。这些问题分布在11个职业表现领域:工作、休闲活动/社会角色、生活满意度、感觉-运动、知觉、智力、情感功能、睡眠、个人护理、家庭/家务/园艺和时间适应。没有一个人认为他们在所有11个领域的职业表现都达到了事件发生前的水平。鉴定出八种职业表现模式:35%的人认为他们的个人护理水平和时间适应与事件发生前相同,他们在其他职业表现领域的损害/残疾最小;27%的人认为除了时间适应外,他们在职业表现的所有领域都有相当程度的残疾;8%的人认为自己在11个职业绩效领域均存在时间适应失衡和严重的绩效困难;4%的人对自己的生活状况不满意,家庭角色发生了变化,没有进行自己想要的休闲活动,并且有严重的睡眠问题;对于9%的人来说,他们的表现水平变化很大,这取决于具体的表现领域。中风或脑外伤对3年后的功能和活动的影响是相当大的。
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引用次数: 29
A survey of disablement in a British population using an action-orientated measure, physical independence handicap: problems with activities of daily living and level of support. 一项针对英国残疾人的调查,使用行动导向的测量方法,身体独立障碍:日常生活活动和支持水平的问题。
Pub Date : 1991-07-01 DOI: 10.3109/03790799109166691
E M Badley, A Tennant

A population survey with the aim of obtaining information to facilitate the planning of services for younger physically disabled people provided the opportunity to explore the use of physical independence handicap in this context. A Phase 1 sift questionnaire was sent to one in three (25,167) occupied households in Calderdale, a district in Yorkshire, England, with a final 87% response rate. A Phase 2 in-depth interview was carried out on a stratified random sample of those identified as disabled in Phase 1. Interviews were obtained with 570 individuals aged 16-64 years, 93% of those available. The measure of physical independence handicap was derived from data obtained in the interview indicating need for help at infrequent or short intervals and immediate-needs dependence. The estimated prevalence of dependent people aged 16-64 in Calderdale is 26.6 per 1000 population (95% CI: 24.9-28.3). Rates were higher in females, and both prevalence and level of dependence increased with age. Disability in activities of daily living and locomotion was linked to the level of physical independence handicap. Problems with housework and collecting (including shopping) were most frequent for those who needed help on an infrequent basis, while self-care needs were substantial for the short and immediate-needs dependence groups. Only a small proportion reported receiving services in their home during the previous 12 months; 20% received services from a nurse and 10% the services of a local authority home help. Overall, 91% reported contact with the primary health care team within the previous 12 months and 68% with hospital and rehabilitation services.(ABSTRACT TRUNCATED AT 250 WORDS)

一项人口调查的目的是获取信息,以便为年轻的身体残疾者规划服务,这为探索在这方面使用身体独立障碍提供了机会。第一阶段的筛检问卷被发送到三分之一(25167)居住在英国约克郡卡尔德代尔地区的家庭,最终的回复率为87%。第二阶段的深度访谈是对在第一阶段被确定为残疾人的分层随机样本进行的。对570名年龄在16-64岁之间的人进行了访谈,其中93%是可用的。身体独立障碍的测量是从访谈中获得的数据中得出的,表明需要帮助的次数很少或间隔很短,需要立即依赖。在Calderdale,年龄在16-64岁的受抚养人群的患病率估计为每1000人中26.6人(95% CI: 24.9-28.3)。女性的比例更高,而且患病率和依赖程度都随着年龄的增长而增加。日常生活活动和运动障碍与身体独立障碍的水平有关。家务和收集(包括购物)的问题对于那些不经常需要帮助的人来说是最常见的,而自我照顾的需求对于短期和即时需要依赖的人来说是实质性的。只有一小部分人报告在过去12个月内在家中接受过服务;20%的人接受护士的服务,10%的人接受当地政府的家政服务。总体而言,91%的人报告在过去12个月内与初级卫生保健小组接触,68%的人与医院和康复服务机构接触。(摘要删节250字)
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引用次数: 7
The social dimension of health status measures in rheumatoid arthritis. 类风湿关节炎健康状况测量的社会维度。
Pub Date : 1991-04-01 DOI: 10.3109/03790799109166680
R Fitzpatrick, S Ziebland, C Jenkinson, A Mowat, A Mowat

Fifty-six patients with rheumatoid arthritis (RA) were assessed on two occasions three months apart. They completed two health status instruments--the Arthritis Impact Measurement Scales (AIMS) and the Nottingham Health Profile (NHP)--and the Beck Depression Inventory. In addition, clinical and serological data were gathered in order to calculate severity of disease according to the Mallya and Mace index. Health status instruments and the severity of disease index showed agreement in the assessment of mobility; similar agreement was found for different assessments of emotions. However, the two instruments provided social interaction scores with little agreement either cross-sectionally or in terms of change over time. It is argued that the generic NHP may be a valid instrument as an outcome measure in RA but the NHP and AIMS assess different aspects of social interaction. Care is needed in the selection of outcome measures to evaluate interventions.

56例类风湿关节炎(RA)患者进行了两次评估,间隔三个月。他们完成了两项健康状况工具——关节炎影响测量量表(AIMS)和诺丁汉健康概况(NHP)——以及贝克抑郁量表。此外,收集临床和血清学数据,根据malya和Mace指数计算疾病的严重程度。健康状况工具和疾病严重程度指数在评估流动性方面显示一致;在不同的情绪评估中也发现了类似的共识。然而,这两种工具提供的社会互动得分无论在横截面上还是在随时间变化方面都不太一致。有人认为,一般的NHP可能是一种有效的工具,作为RA的结果测量,但NHP和AIMS评估的是社会互动的不同方面。在选择评价干预措施的结果指标时需要谨慎。
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引用次数: 18
Trend line influence on visual analysis of single-subject data in rehabilitation research. 趋势线对康复研究中单受试者数据视觉分析的影响。
Pub Date : 1991-04-01 DOI: 10.3109/03790799109166685
M B Johnson, K J Ottenbacher

Single-subject design and n of 1 randomized clinical trials are being advocated as methods of conducting clinical research in rehabilitation environments. The traditional procedure for interpreting data from such designs is visual analysis. This study examined the effect of including trend lines on the visual judgements made from single-subject data. Twenty-four hypothetical single-subject A-B designs were presented to 20 rehabilitation therapists for visual interpretation. The graphs represented traditional single-subject designs, including a baseline and treatment phase. Trend lines were computed and included in both phases of the design as an adjunct to visual analysis. The interrater reliability of the visual judgements was calculated using the intraclass correlation coefficient and ranged from 0.54 to 0.90. The results suggest that adding trend lines to graphed data presented in single-subject designs can improve the consistency of visual judgements. Implications for using adjuncts to graphing data points in single-subject rehabilitation research are discussed.

提倡采用单受试者设计和n of 1随机临床试验作为在康复环境中开展临床研究的方法。从这种设计中解释数据的传统程序是视觉分析。本研究考察了包含趋势线对单主体数据视觉判断的影响。24个假设的单受试者A-B设计提交给20名康复治疗师进行视觉解释。图表代表传统的单受试者设计,包括基线和治疗阶段。趋势线被计算并包括在设计的两个阶段,作为视觉分析的辅助。使用类内相关系数计算视觉判断的互信度,范围为0.54 ~ 0.90。结果表明,在单受试者设计的图形数据中添加趋势线可以提高视觉判断的一致性。本文讨论了在单受试者康复研究中使用附属物来绘制数据点的意义。
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引用次数: 14
The Rivermead Mobility Index: a further development of the Rivermead Motor Assessment. Rivermead Mobility Index: Rivermead Motor Assessment的进一步发展。
Pub Date : 1991-04-01 DOI: 10.3109/03790799109166684
F M Collen, D T Wade, G F Robb, C M Bradshaw

This paper reports on a development of the Rivermead Motor Assessment Gross Function scale, the Rivermead Mobility Index (RMI), a new measure of mobility disability which concentrates on body mobility. An early development included a second scale concentrating on elective mobility, but the results showed this to be unreliable. The RMI comprises a series of 14 questions and one direct observation, and covers a range of activities from turning over in bed to running. Its inter-observer reliability was tested on two groups of patients (n = 23 and 20 respectively) and it is reliable to a limit of 2 points (out of 15). Its validity as a measure of mobility after head injury and stroke was tested by concurrent measurement of mobility using gait speed and endurance, and by standing balance. The RMI does form a scale. It is short, simple, and clinically relevant, and can be used in hospital or at home.

本文报道了Rivermead运动评估总功能量表的发展,即Rivermead运动能力指数(RMI),这是一种专注于身体运动能力的新的运动障碍衡量标准。早期的发展包括第二种侧重于选择性流动性的量表,但结果表明这是不可靠的。RMI包括一系列14个问题和一个直接观察,涵盖了从在床上翻身到跑步的一系列活动。对两组患者(n = 23和20)进行了观察者间信度测试,其可靠性达到2点(满分15分)。通过同时测量步态速度和耐力以及站立平衡来测试其作为脑损伤和中风后活动能力的有效性。RMI确实形成了一个尺度。它简短,简单,具有临床相关性,可在医院或家中使用。
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引用次数: 753
期刊
International disability studies
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