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Biomedical subjects

A Helewa

Publications and source records attributed to A Helewa.

At least 19 recordsLinked to original sources
PubMed2001

Low back pain: prevalence and risk factors in an industrial setting.

OBJECTIVE: To examine various factors associated with low back pain (LBP) in an industrial setting. METHODS: A cross sectional study was carried out among 1,562 employees of a large utilities corporation in Ontario using a self-administered questionnaire. Abdominal muscle strength was measured using a modified sphygmomanometer. Statistical analysis was carried out with Student's t test, chi-square test, and logistic regression analysis. RESULTS: Among 1,302 male employees the lifetime and point prevalence of LBP were 60% and 11%, respectively. Low back pain was significantly more prevalent among married employees, with more physically demanding jobs, regular lifting, poor general health, and past major illness. Abdominal muscle weakness was associated with current LBP. The mean time lost from work due to LBP over 5 years was 17 days. Sedentary workers developing LBP were more likely to require hospital admission. CONCLUSION: This study confirms the high prevalence of LBP in industry and identifies several risk factors.

Abdominal Muscles↗
PubMed1999

Does strengthening the abdominal muscles prevent low back pain--a randomized controlled trial.

OBJECTIVE: To investigate the effects of abdominal muscle strengthening exercise on low back pain (LBP) risk reduction. METHODS: We compared the effects of abdominal muscle strength (AMS) exercise and back education with back education only on 402 asymptomatic subjects with weak AMS. The primary outcome was the percentage of subjects with at least one episode of LBP at 24 months. A diary was used to monitor compliance. RESULTS: There were no statistically significant differences between experimental (E) and control (C) subjects at 24 months for LBP episodes (E: 34.7%, C: 30.4%; C-E = 4.2%, P2 = 0.481; 95% CI -16.1%, 7.6%). The LBP episodes were also not statistically significantly different at 6 months (E: 13.2%, C: 16.1%; C-E: 2.9%, P2 = 0.493; 95% CI -5.3%, 11.0%) or at 12 months (E: 24.8%, C: 23.6%; C-E = -1.2%, P2 = 0.818; 95% CI -11.6%, 9.2%). Adjusting the data for strata and baseline AMS did not alter the findings. Imputed results for LBP episodes at 6 months (C-E: 4.8%, P2 = 0.191; 95% CI -2.4%, 12.0%), 12 months (C-E: -1.0%, P2 = 0.821; 95% CI -9.5%, 7.6%), and 24 months (C-E: -3.3%, P2 = 0.483; 95% CI -12.6%, 5.9%) were also not statistically significantly different. CONCLUSION: Back education and abdominal exercise instructions are similar to back education alone. There were no group differences in LBP episodes, possibly due to noncompliance with the exercise program. While the estimated benefit of 2.9% at 6 months from the complete data and 4.8% from the imputed data were not statistically significant, a larger study or future metaanalyses may be needed to confirm whether there is a clinical benefit or whether these results should be considered a chance finding.

Abdominal Muscles↗
PubMed1995

The effects of transcutaneous electrical nerve stimulation on skin temperature in asymptomatic subjects.

BACKGROUND AND PURPOSE: Several studies have evaluated the effects of transcutaneous electrical nerve stimulation (TENS) on skin temperature. The results of these studies, however, remain controversial. This study examined the effects of two modes of TENS, compared with a control condition, on skin temperature of the hand and finger. SUBJECTS: Twenty-four asymptomatic subjects (23 female, 1 male) with no previous experience with TENS participated. The subjects ranged in age from 19 to 28 years (means = 23.0, SD = 2.44). METHODS: All subjects participated in a 4-Hz TENS session, a 100-Hz TENS session, and a control (no TENS) session. Electrodes were placed on the medial and lateral aspects of the dorsal surface of the left hand. Each session consisted of a 60-minute stabilization period, a 30-minute stimulation period, and a 30-minute follow-up period. Hand temperature was measured using infrared thermography, and finger temperature was measured using a skin thermistor. RESULTS: Mean hand temperature after low-frequency TENS was 1.69 degrees C warmer than the mean hand temperature following the high-frequency TENS and 1.60 degrees C warmer than after the control condition. No differences in the finger temperature were found among the three conditions. CONCLUSION AND DISCUSSION: High-intensity, low-frequency TENS prevented cooling of the hand. High- and low-frequency TENS had no effect on finger temperature.

Adult↗
PubMed1994

Can specially trained physiotherapists improve the care of patients with rheumatoid arthritis? A randomized health care trial.

OBJECTIVE: To examine the influence of specially trained physical therapists (PT) on patterns and outcome of care, relating to inflammatory disease status as measured by disease outcomes. METHODS: Fifty-four patients were allocated at random to specially trained PT, and to traditional PT. Outcomes were measured at baseline and at 4 months by independent assessors. RESULTS: There was no statistically significant or clinically important difference in outcome between the 2 groups. The advice of specially trained PT significantly improved compliance with salicylates. CONCLUSION: The effectiveness of this therapy was not demonstrated, likely due to incomplete compliance along the therapeutic chain, beginning with the PT's report, through a variety of possible responses, and ending with patient outcome.

Adolescent↗
PubMed1994

The effects of comprehensive home physiotherapy and supervision on patients with ankylosing spondylitis--an 8-month followup.

OBJECTIVE: Our previous randomized clinical trial showed a 4-month home physiotherapy program was effective for patients with ankylosing spondylitis. This followup study reports on 22 control patients who received the previously withheld treatment and 24 experimental patients who received followup treatment as needed. METHODS: The primary outcome measure was spinal mobility measured by fingertip-to-floor distance using a portable measuring device specially designed and validated for this study. RESULTS: Following treatment, fingertip-to-floor distance did not change in control patients (P2 = 0.145). Between 4 and 8 months, fingertip-to-floor distance did not change in experimental patients (P2 = 0.143); however, initial improvement achieved was maintained. The experimental group at 4 months was better than the control group at 8 months (P2 = 0.038). CONCLUSION: The home physiotherapy treatment program must be delivered as rigorously as it was in the initial trial to be effective. The benefit from this treatment program can be maintained with very little intervention.

Follow-Up Studies↗
PubMed1993

Measuring abdominal muscle weakness in patients with low back pain and matched controls: a comparison of 3 devices.

OBJECTIVE: To compare 3 hand held devices used to measure isometric abdominal muscle strength: the adapted sphygmomanometer, the vigorometer and the Penny & Giles myometer. METHODS: Subjects were men, aged 22 to 43 years. Fifteen had a history of low back pain and 18 age matched controls had no low back pain. The test position was a half sit-up at 45 degrees, knees at 90 degrees, feet secured. The single observer applied pressure with one of the devices downwards, just below the sternal notch, while the patient maintained that position. Order of methods was random, controlled by a series of 3 x 3 Latin squares. The vigorometer and myometer were calibrated to mm Hg. Even numbered subjects were tested twice; odd numbered subjects had their measurements timed. RESULTS: One subject was unable to complete the study. Subjects with low back pain had abdominal muscle strength 38.8 mmHg lower than healthy controls [F(1,62) = 72.84, P2 < 0.01]. Order of measurements was similar [F(2,62) = 1.19, P2 = 0.31]; instruments differed [F(2,62) = 27.94, P2 < 0.01]. Duplicate readings were similar (minimum P2 > 0.10); all 3 devices detected significant differences between the 2 groups (P2 < 0.01); mean measurement time was 19 s and time to measure with each device was similar (P2 = 0.70). CONCLUSION: All 3 instruments performed equally well. Since the sphygomanometer is available at about 1/5 the cost of the vigorometer and 1/12 the cost of the myometer, it is the preferred instrument.

Abdominal Muscles↗
PubMed1993

Interpretation and power of a pooled index.

OBJECTIVE: To describe, illustrate, provide statistical rationale and give clinical examples of the concept of a pooled index. METHODS: No explicit design. Randomized control trials of patients diagnosed with rheumatoid arthritis from Rheumatic disease clinics, tertiary care hospitals and communities are used as examples to illustrate the pooled index technique. Interventions in rheumatic disease unit inpatient and outpatient care, occupational therapy and physiotherapy provided by Arthritis Society Therapists in the community were compared. Variables included active joint count, morning stiffness in min, mean of right and left grip strength in mm Hg, erythrocyte sedimentation rate in mm/h, a functional change score, and a pooled index. RESULTS: The pooled index in each study detected a clinically important effect while individual measures were generally not able to declare the effect statistically significant. CONCLUSIONS: The pooled index is a more powerful clinical outcome than any individual measure provided it is computed from at least 2 relevant clinical outcome measures that have low correlation with each other.

Arthritis, Rheumatoid↗
PubMed1992

Observer variation in an audit of charts of patients with rheumatoid arthritis.

Arthritis Society physiotherapists (PTs) in Ontario adopted Problem Oriented Records (POR) to monitor patient care; goals were to encourage patient specific treatment plans and standardized records. After nine months in practice, the POR system was evaluated by an audit on charts of patients with Rheumatoid Arthritis. Audit teams of two PTs were created within each of five geographic areas. Auditors attended an audit instruction workshop. Two charts, selected randomly from the discharged patients of each of 38 therapists, were independently scored on 56 items by an audit team. The extent of agreement within the auditor team (observer variation) was measured, and adequacy scores computed for each chart. Adequate reliability of the audit instrument was established before examination of adequacy scores and making inferences about quality of care. The auditor agreement measures (kappa) varied from 0.13 to 0.97, mean = 0.74 and SD = 0.16; these estimates were indicative of adequate reliability of the audit form, although agreement scores were different amongst the five areas (P2 less than .01). POR adequacy scores varied from 10.0 to 93.1, mean = 64.5 and SD = 16.9. There were no differences in adequacy scores amongst the five areas (P2 = .61). To reduce observer variation, increased pre-audit emphasis is needed on auditor guidelines and training for items relating to assessment findings, problem identification, and treatment planning.

Analysis of Variance↗
PubMed1991

Effects of occupational therapy home service on patients with rheumatoid arthritis.

Because there is little information about the efficacy of home occupational therapy, we decided to assess the effects of a home service on patients with rheumatoid arthritis. 105 patients aged 18-70 years, on stable medical therapy, were randomised to receive a 6-week comprehensive programme of occupational therapy (experimental group, 53 patients) or to receive no such treatment (control group, 52). At 6 weeks, control patients received the experimental regimen, and experimental patients were continued on treatment as needed up to 12 weeks. Outcomes were measured at baseline, 6, and 12 weeks with a global functional capacity score (functional score). At 6 weeks the functional score for the experimental group was significantly higher than that for the control group (mean difference = 8.1, 95% Cl 1.7 to 15.8, p = 0.012). Control patients at 12 weeks showed a similar improvement to experimental patients at 6 weeks, and between 6 and 12 weeks the experimental patients were stable. Occupational therapy leads to a statistically significant and clinically important improvement in function in patients with rheumatoid arthritis.

Activities of Daily Living↗
PubMed1990

An evaluation of four different measures of abdominal muscle strength: patient, order and instrument variation.

We compared 4 measures of abdominal muscle strength in 24 male subjects aged 20-52 years, 12 without low back pain (LBP) and 12 with LBP. The manometer to knee and manometer to sternum methods involved 2 positions of testing abdominal muscle strength using the adapter sphygmomanometer, a 3rd method was a scheme of graduated sit-ups, and the 4th had the sphygmomanometer bladder replaced by a disposable plastic tube and the subject blowing into the manometer. Order of methods was controlled with knee 4 x 4 latin squares. Analysis of variance showed that order of measurement was not significant [F (3,60) = 0.24, P2 = 0.725], but methods were different [F (3,60) = 86.80, P2 less than 0.01], and subjects without LBP had higher abdominal muscle strength than subjects with LBP [F (1.60) = 89.29, P2 less than 0.001]. The manometer to knee and manometer to sternum methods were equally sensitive and more sensitive than the graduated sit-up and blow into manometer methods. The manometer to sternum method was best as it was not painful and exercised the abdominals well.

Abdominal Muscles↗
PubMed1990

The effects of comprehensive home physiotherapy and supervision on patients with ankylosing spondylitis--a randomized controlled trial.

Fifty-three patients with ankylosing spondylitis (AS) were randomly allocated; 26 experimental patients received physiotherapy and disease education, 27 control patients received neither. The primary treatment outcome was change in spinal mobility measured at 4 months by fingertip-to-floor distance. Experimental patients had more improvement in fingertip-to-floor distance (p2 less than 0.004) and in function (p2 less than 0.001) than control patients. Physiotherapy with disease education is effective in the treatment of patients with AS.

Adolescent↗
PubMed1989

Cost-effectiveness of inpatient and intensive outpatient treatment of rheumatoid arthritis. A randomized, controlled trial.

Women with active rheumatoid arthritis who were judged to be in need of hospitalization were assigned at random to receive inpatient therapy (n = 35) or intensive outpatient therapy (n = 36). All relevant costs of treatment were measured. At 19 weeks, clinical outcomes, as summarized in a pooled index, were significantly better in the inpatient group (pooled index units: inpatient 0.72, outpatient 0.25; F[1,69] = 10.9, P = 0.002). Inpatient therapy produced a sustained three-fold increase in efficacy, at a 2.5-fold increase in cost to society.

Adolescent↗
PubMed1988

Postdysenteric reactive arthritis. A clinical and immunogenetic study following an outbreak of salmonellosis.

Following an outbreak of foodborne gastroenteritis caused by Salmonella typhimurium, questionnaires were sent to affected individuals and then to the family physicians of any who experienced extra-enteric complications. Of 260 individuals infected with S typhimurium for whom adequate data were obtained, 19 patients developed joint disease (7.3%). All were men; the mean age +/- SD was 39.3 +/- 1.6 years. Among the 16 patients for whom this information was available, the interval from the onset of diarrhea to the onset of joint pain was less than 7 days in 7, 8-21 days in 2, and greater than 21 days in 7. There was a significantly longer duration of diarrhea in those patients with joint disease (mean +/- SEM 15.2 +/- 2.6 days) than in those without complications (10.0 +/- 1.1 days) (P less than 0.01). The joint disease was monarticular in 3 patients and polyarticular in 16. The joints most commonly affected were the elbow (47%), wrist (47%), knee (42%), low back (32%), and shoulder (32%). Six of the 19 patients had at least 1 extraarticular feature: ocular (5 patients), mucosal (1 patient), urethral (2 patients), or cutaneous (1 patient). Of these 19 patients, 11 were located and agreed to HLA typing. Four were positive for HLA-B27, 6 were HLA-B7 positive, and 1 had HLA-Bw60. Of the 4 B27 positive patients, 3 were DR1 positive; of the 6 B7 positive patients, 5 were DR2 positive.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

The total assessment of rheumatoid polyarthritis--evaluation of a training program for physiotherapists and occupational therapists.

We evaluated a training program for physiotherapists and occupational therapists in the total assessment of patients with rheumatoid polyarthritis. Close agreement was seen between the active joint counts of the rheumatologists and 36 therapists (p2 = 0.23). In the 7 quality variables for bedside case workups, a statistically significant learning effect was seen over the 6 week period (p2 = less than 0.005). In the 10 quality variables for the case presentations at Week 6, judged at the graduate medical trainee level, mean global scores achieved were 72.5%. Therapists reported a high level of satisfaction with all components of the program.

Arthritis, Rheumatoid↗
PubMed1986

Patient, observer and instrument variation in the measurement of strength of shoulder abductor muscles in patients with rheumatoid arthritis using a modified sphygmomanometer.

We describe the use of a modified sphygmomanometer to measure the strength of shoulder abductor muscles. Using a 5 x 5 Greco-Latin square design we compared the measurements of 5 physical therapists taken on 5 patients with rheumatoid arthritis with 2 cuff adaptations. The design variables explained 96.4% of the pressure readings, with patients accounting for 76.6%. There was no significant variation due to order of testing, cuff preparations or observers. The method is simple, portable, inexpensive, comfortable and safe to use. It can also be applied to 26 different muscle groups.

Adult↗
PubMed1985

Epidemiology of musculoskeletal disorders (complaints) and related disability in Canada.

Data on musculoskeletal disorders (complaints), collected as part of the Canada Health Survey were analyzed. Sixteen percent of those sampled reported having arthritis, rheumatism or back, limb or joint disorders with a greater prevalence among females and in the older population. In 21% this was associated with limitation of activity with an average of 11 disability days/person/year. Serious back disorders were reported in 4.4% of the population. While the majority of health consultations (53%) were with a physician, a substantial number (34%) were with chiropractors.

Adolescent↗