Biomedical subjects

Brenda Brouwer

Publications and source records attributed to Brenda Brouwer.

6 recordsLinked to original sources

PubMed2007

Are deficiencies in manual tracking associated with upper extremity cumulative trauma disorders?

OBJECTIVES: To examine the reliability of manual tracking performance and its association with impairment and disability in individuals symptomatic of an upper extremity cumulative trauma disorder (CTD). METHODS: Volunteer and physician referred subjects (100 control, 140 CTD) tracked a target cursor moving quasi-randomly using a hand-held stylus interfaced with a digitizing tablet. Impairment was physician-rated and the Disability of the Arm, Shoulder and Hand questionnaire measured disability. Subsamples of 25 subjects per group were tested on three occasions. RESULTS: Reliability of tracking performance was excellent (ICC > or = 0.88) and sensitivity was 81%. Performance was superior in controls (p < 0.001) and deteriorated as a function of impairment level (p < 0.001). Tracking and impairment rating explained 65% of the disability score. CONCLUSIONS: Tracking performance may be an important outcome for monitoring change over time and the impact of a CTD on function in everyday activities.

Adolescent↗

PubMed2006

A randomized controlled trial of supervised versus unsupervised exercise programs for ambulatory stroke survivors.

BACKGROUND AND PURPOSE: Little is known about the relative efficacy of supervised versus unsupervised community exercise programs for stroke survivors. This study compared the effectiveness of a 10-week supervised strengthening and conditioning program (supervised) with a 1-week supervised instruction program followed by a 9-week unsupervised home program (unsupervised) and evaluated retention of changes at 6 months and 1 year after program completion. METHODS: Seventy-two subjects retained at baseline (27 women, 45 men; mean+/-SD age, 64.6+/-11.8 years) were randomly allocated to receive the supervised or unsupervised program. The primary outcome was walking speed over 6 minutes, and secondary outcome measures were Human Activity Profile, Medical Outcome Study 36-Item Short-Form survey (SF-36), Physiological Cost Index, and lower extremity muscle strength. RESULTS: The 6-minute walking speed increased significantly in both groups and remained significantly improved by 1 year. The Human Activity Profile demonstrated an increasing trend only in the supervised group that was significant by 1 year. The SF-36 Physical Component summary score increased significantly in the supervised group and remained improved by 1 year; the unsupervised group showed significant improvement at 1 year. Women made greater gains in supervised programs, but men made greater gains in unsupervised programs. CONCLUSIONS: Supervised exercise programs and unsupervised programs after initial supervised instruction were both associated with physical benefits that were retained for 1 year, although supervised programs showed trends to greater improvements in self-reported gains. Gender differences require further research.

Activities of Daily Living↗

PubMed2005

Gender-related differences in physical performance among seniors.

This study examined gender differences in balance, gait, and muscle performance in seniors and identified gender-specific factors contributing to physical performance. Forty (20 men, 20 women) healthy, community-dwelling seniors (74.5 +/- 5.3 years) participated. Limits of stability, gait speed, lower limb flexor and extensor isokinetic concentric peak torques, self-reported activity level, and balance confidence were measured. No gender differences were detected in gait speed, limits of stability when normalized to height, activity level, or balance confidence (p = .188). Women were weaker than men (p = .007), even after controlling for weight and body-mass index, suggesting that other gender-related factors contribute to strength. Gender accounted for 18-46% of the variance in strength and served as a modifier of the relationship between activity level and strength in some muscle groups. The primary factors relating to gender-specific strength was activity level in men and body weight in women.

Aged↗

PubMedDate not supplied

Balance, muscle strength, and fear of falling in older adults.

This study examined balance ability, lower-extremity muscle strength, fear of falling and their inter-relationships in 40 community-dwelling older adults (>65 years). Subjects who self-identified either as being fearful of falling or not (no concern) were screened to exclude those with known risk factors for falling. Limits of stability, maximal isometric strength, gait speed, and fear of falling were contrasted between groups (27 control subjects, 13 fearful subjects). Those fearful of falling demonstrated smaller center of pressure (COP) excursions in anterior, left, and right directions (p<.0001) and used a smaller percentage of their base of support during maximal weight shifting in combined anterior-posterior and right-left directions (p<.001) compared to the control group. Strength did not differ between groups, but was associated with the ability to shift the COP in the anterior-posterior direction (p<.05). Fear of falling also related to weight shifting ability (p<.017). Seniors fearful of falling demonstrated limitations in balance ability and balance confidence that could not be explained by muscle weakness.

Aged↗

PubMedDate not supplied

Physical function and health status among seniors with and without a fear of falling.

BACKGROUND: Fear of falling (FF) is pervasive among older people and is an independent risk factor for decreased mobility and loss of quality of life. Although it is a serious health concern, little is known about the severity of the physical and health-related deficits in high-functioning fearful seniors. OBJECTIVE: This study examined the physical correlates of FF in community-dwelling seniors in relation to their non-fearful counterparts and also explored the relevance of recent fall history. SUBJECTS: Twenty-five volunteers who stated that they had curtailed their activities due to a FF and who reported themselves to be healthy participated. Non-fearful, age- and gender-matched subjects were also recruited and served as a comparison group. METHODS: This cross-sectional study had participants come to the laboratory on one occasion for about 1.5 h. Limits of balance stability, walking speed, and lower limb muscle strength were measured in random order. In addition, the SF-36, the Activities-specific Balance Confidence (ABC) scale and the Human Activity Profile questionnaires were completed to provide measures of heath status, FF and activity levels, respectively. RESULTS: Subjects with a FF had lower ABC scores (69.8 +/- 10.2) than controls (90.2 +/- 7.9; p < 0.001), and although they reported activity curtailment, the groups presented similar activity profiles (p > 0.05). Balance ability was not compromised in seniors with a FF, although their walking speed was slower than that of control subjects (p < 0.004). Lower limb weakness was significant in the FF group, which also reported low physical health. Perceived physical health, activity and hip flexor torque in combination accounted for almost 62% of the variance in ABC scores. Secondary analysis of the data from the FF group revealed a tendency for those who had fallen in the past year to restrict their limits of stability compared to those who had not fallen; though generally the effect sizes were small to moderate. CONCLUSIONS: The marked deficits in strength and health status found among seniors living independently in the community, who are in good health, but report being fearful of falling underscores the seriousness of FF as a potential health risk factor in the well elderly.

Accidental Falls↗

PubMedDate not supplied

Effectiveness of muscle vibration in modulating corticospinal excitability.

This study explored the effect of vibration of the forearm extensors on motor cortical excitability and the influence of stimulus duration. Sixteen healthy volunteers between 23 and 42 years old participated in one or two studies. We applied 15 or 30 min of 100 Hz, 0.5 mm-amplitude vibration to the extensor carpi radialis longus (ECRL) muscle. Cortical excitability was measured as the magnitude of the motor-evoked potentials (MEPs), and the size of the representation area associated with ECRL and flexor carpi ulnaris muscles was determined with the use of transcranial magnetic stimulation. A 33% increase in MEP size and enlarged area of cortical excitability was detected 5 min after 15 min of vibration in the ECRL only. No changes were associated with 30 min of vibration in either muscle. These findings indicate that the facilitatory effects of vibration in healthy subjects depend on stimulus duration and provide impetus for testing the extent to which short-duration vibration augments corticospinal excitability to improve muscle function in people with central motor disorders.

Adult↗