Biomedical subjects

D M Grinnell

Publications and source records attributed to D M Grinnell.

2 recordsLinked to original sources

PubMed1993

A radiological measure of shoulder subluxation in hemiplegia: its reliability and validity.

This study describes the reliability and validity of a new radiological method to measure shoulder subluxation that is based on taking a single x-ray of the affected shoulder in the plane of the scapula. A digitizer and a computer are used to quantify the measurements directly from the x-ray. One single radiological view of the shoulder taken in a standardized position provides four measures of subluxation including a measure of vertical subluxation, horizontal subluxation, a normalized distance sensitive to both vertical and horizontal subluxation, and an angular measure. A total of 72 volunteers with cerebrovascular accidents participated in the study. Thirty-six subjects had a clinical shoulder subluxation and 36 had no clinical subluxation. The construct validity analysis showed significant differences (p < .001) between the mean scores for subluxed and nonsubluxed groups on all four measures of subluxation. The concurrent validity of the x-ray measures in relation to external clinical measures (finger's breadth, measures in centimeters with calipers or a plexiglass jig) was moderate. Three measures were found to be reliable and valid whereas the fourth, a measure of horizontal subluxation has lower reliability. However, it does have clinical significance. The clinical and research implications of this study are presented.

Aged↗

PubMed1990

Electromyographic versus rhythmic positional biofeedback in computerized gait retraining with stroke patients.

This research provides a preliminary investigation of the relative efficacy of electromyographic (EMG) versus a novel biofeedback (BFB) approach to improve ankle control and functional gait in stroke patients. A computerized system was designed to provide audiovisual feedback of either muscle activity or ankle position during dorsiflexion and plantar flexion. The novel approach also included rhythmic pacing to emphasize the rapid timing of ankle motion necessary to switch from stance to swing during walking. Thirty-seven subjects were randomly assigned to one of the following groups: (1) no-treatment control, (2) EMG BFB, and (3) rhythmic positional BFB. Blind evaluations of ankle performance, gait, and perceived exertion were performed at regular intervals. Analyses of covariance revealed that subjects receiving rhythmic positional BFB significantly increased their walking speeds relative to other groups at posttest (p = .02) and at three-month follow-up (p = .035), without any increase in subjectively reported energy cost. The ability of positional BFB to emphasize the timing events during walking provided optimistic results for carry-over into gait functioning. The degree of sensorimotor recovery and time since onset of stroke were considered important factors in determining outcomes.

Adult↗