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C Nepomuceno

Publications and source records attributed to C Nepomuceno.

12 recordsLinked to original sources
PubMed1987

Reliability and validity of the Disability Rating Scale and the Levels of Cognitive Functioning Scale in monitoring recovery from severe head injury.

The Disability Rating Scale (DRS) and the Levels of Cognitive Functioning Scale (LCFS) are both widely used to monitor recovery from head injury, despite the total lack of published research on the reliability and validity of the LCFS, and the fragmented and incomplete reports on these characteristics of the DRS. Forty head-injured inpatients were evaluated with the DRS and LCFS four times weekly throughout their rehabilitation hospitalization. The DRS and LCFS were compared in terms of how consistently ratings could be made by different raters, how stable those ratings were from day to day, their relative correlation with Stover Zeiger (S-Z) ratings collected concurrently at admission, and with S-Z, Glasgow Outcome Scale (GOS), and Expanded GOS (EGOS) ratings collected concurrently at discharge, and finally in the ability of admission DRS and LCFS scores to predict discharge ratings on the S-Z, GOS, and EGOS. Results suggest that both scales possess significant degrees of test-retest and interrater reliabilities, and of concurrent and predictive validities, but the DRS surpasses the LCFS in nearly every regard. These results offer psychometric justification favoring the use of the DRS for monitoring recovery from head injury.

Adult↗
PubMed1980

Psycho-social aspects of chronic pain in spinal cord injury.

The relationship between persistent pain in spinal cord injury and medical-descriptive, demographic, psychological and familial-social data was studied. Multiple linear regression and discriminant analysis were used to predict (1) presence or absence of pain; (2) severity of pain; (3) time post-injury onset of pain; (4) whether or not pain interfered with activities of daily living. The best combinations of predictor variables accounted for only 15 and 19% of the dependent measures pain vs. no-pain and onset of pain, respectively. The best combinations of predictor variables accounted for 43 and 44%, respectively of the dependent measures severity of pain and whether or not pain interfered with activities of daily living. Higher levels of subjective pain were associated with greater age, higher verbal intelligence, higher levels of anxiety and a more negative psycho-social situation. Persons who reported pain interfering with activities of daily living were more likely to be older, of higher intelligence, more depressed, clinically rated as experiencing greater levels of distress and immersed in a more negative psycho-social environment. The importance of psycho-social variables in the understanding of persistent spinal cord injury pain and the need for prospective studies along these lines are demonstrated.

Activities of Daily Living↗
PubMed1979

Pain in patients with spinal cord injury.

For this study of intractable pain after spinal cord injury (SCI), a questionnaire was developed, pilot-tested and mailed to 356 previously hospitalized SCI patients, 200 (56%) of whom returned the completed questionnaire. Of the respondents, 160 (80%) reported abnormal sensation and 96 (48%) called the discomfort painful. Abnormal sensations were first noted within 6 months of injury by 105 patients, from 7 months to 4 years after injury by 39, and longer than 4 years after injury or unknown by 16. Pain locations varied and were unrelated to the level of lesion. In 30% of those reporting abnormal sensation the location of pain remained stationary, whereas in 17% it changed over time. The intensity of pain was described as severe to extreme by 25%; 44% indicated that it interfered with daily activities. Increase of pain over time was noted by 41%. Activity, inactivity, weather change and overexertion were not frequently identified as aggravating circumstances. Rest and medication were cited as alleviating factors. Approximately 38% of those experiencing pain used medications but only 22% obtained consistent relief from their use. Patients with low level lesions were more willing to exchange a hypothetical chance of recovery and/or loss of reacquired physiologic functions for pain relief than were patients with higher lesions.

Activities of Daily Living↗
PubMed1977

Differential analyses of EMG findings in motor neuron lesions.

The principle in electromyography that positive sharp waves (PSW) and fibrillation potentials (FP) are pathognomonic of lower motor neuron (LMN) pathology is challenged by recent reports that the same potentials are observed in upper motor neuron (UMN) lesions. We have also observed positive sharp waves and fibrillation potentials in patients with UMN lesions, without conditions that involve the LMN. This study was undertaken to ascertain if there are differences in the potentials between the LMN and UMN lesions. Twenty-five UMN and 25 LMN patients were electromyographed. Manual and computer analyses were used to compare parameters from positive sharp wave and fibrillation potentials. Our findings indicate that there are interlesion differences in the mean frequency of occurrence ratio of PSW to FP and in some of the durational wave parameters.

Adult↗