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Biomedical subjects

E Lindeman

Publications and source records attributed to E Lindeman.

25 records · Page 2Linked to original sources
PubMed1995

Strength training in patients with myotonic dystrophy and hereditary motor and sensory neuropathy: a randomized clinical trial.

A randomized clinical trial on the effects of strength training was performed in myotonic dystrophy (MyD) patients and patients with hereditary motor and sensory neuropathy (HMSN). Training and most measurement tools involved the proximal lower extremity muscles. The participants trained 3 times a week for 24 weeks with weights adapted to their force. Strength was evaluated by isokinetically measured knee torque. Fatiguability was assessed by the time an isometric contraction could be sustained. Functional performance was measured by timed motor performance and by questionnaires on functional performance. Serum myoglobin (Mb) levels were determined to detect changes in muscle fiber membrane permeability. The MyD group included 33 participants, and the HMSN group included 29 participants. Within each diagnostic group, patients were individually matched and subsequently randomized for treatment allocation. In the MyD patients, none of the measurement techniques showed any training effect. Neither were there signs of deterioration caused by the training. In the HMSN group, knee torques increased. Timed motor performance did not change, although the questionnaires showed an improvement on items related to upper-leg function. Mb levels did not change significantly as a result of the training. In conclusion, the MyD group showed neither positive nor negative effects of the training protocol, whereas the training produced a moderate increase in strength and leg-related functional performance in the HMSN group.

Activities of Daily Living↗
PubMed1995

Deterioration of motor function in myotonic dystrophy and hereditary motor and sensory neuropathy.

In order to obtain more information about the deterioration of motor function in patients with myotonic dystrophy and in patients with hereditary motor and sensory neuropathy, changes in strength and functionality were determined at one year intervals, over a follow-up period of 1 to 5 years. Twenty-five myotonic dystrophy patients and 16 hereditary motor and sensory neuropathy patients participated. Strength measurements were restricted to knee extension and flexion torques measured isokinetically on a dynamometer at two velocities (120 and 60 degrees/s). Functionality was measured as scaled time scores for rising from sitting, rising from supine, walking and stair climbing. Myotonic dystrophy patients showed a reduction of knee extension torques at 60 degrees/sec (mean decrease per year 5.7 Nm, or 9%) as well as a decrease in functionality. Hereditary motor and sensory neuropathy patients showed no statistically significant changes in torques or functionality. The correlation between isokinetically measured knee extension torques and functional scores was statistically significant in myotonic dystrophy but not in hereditary motor and sensory neuropathy. No correlation was found between changes in torques and changes in functional scores.

Adolescent↗
PubMed1994

Reduction of knee torques and leg-related functional abilities in hereditary motor and sensory neuropathy.

Our purpose was to evaluate a test battery for measuring progress and the effect of interventions in patients with hereditary motor and sensory neuropathy (HMSN types I and II). For this purpose differences in upper leg strength and functional abilities between patients and healthy persons were quantified. Twenty patients participated in the study. They were matched with healthy control subjects with respect to gender, age, body weight, and height. Because of the high reproducibility and sensitivity of the method, muscle strength was quantified as isokinetic and isometric knee torques on an isokinetic dynamometer. Isokinetic knee extension and flexion torques were recorded for three movement velocities (120, 60, and 30 degrees/sec). An extension endurance test was performed at 80% of maximum voluntary contraction. Time scored activities (for instance, stair climbing) that are mainly related to leg function were measured to determine functional abilities. The torques were lower (p < 0.009) and endurance was less (p = 0.03) for patients than for controls. Time scores were higher (p < 0.013) in patients. A strength reduction in the knee extensors and flexors and a decrease in functional abilities was found even in mildly affected patients. Torques and time scores were correlated, although correlation coefficients were rather low. Our results indicate that both types of test are useful for monitoring lower limb function in HMSN patients.

Adolescent↗
PubMedDate not supplied

A patient-specific approach for measuring functional status in low back pain.

BACKGROUND: Activities and their importance for daily living vary widely between patients. Patient-specific measurement of functional status means that the evaluation is focused on activities that an individual patient selected as main complaints. OBJECTIVE: To develop and to evaluate a patient-specific approach for measuring functional status in low back pain. STUDY DESIGN: A cohort of 150 patients was measured at baseline and 12 weeks later. METHODS: The feasibility of the patient-specific approach was evaluated in patients with nonspecific low back pain. We used effect size statistics to evaluate responsiveness in terms of sensitivity to change and specificity to change. RESULTS: The selection procedure for the main complaint was feasible but labor intensive. The patient-specific approach was able to detect changes in complaints that were highly relevant for the patients. The patient-specific approach appeared to be more sensitive to change but less specific to change compared with other instruments. CONCLUSIONS: On the basis of this study it would be valuable to apply the patient-specific approach in future studies, also with the aim of further evaluation. In the meantime a number of practical problems of the method need to be resolved.

Activities of Daily Living↗
PubMedDate not supplied

The efficacy of traction for lumbar back pain: design of a randomized clinical trial.

OBJECTIVE: To present the design of a trial on the efficacy of lumbar traction. DESIGN: Randomized clinical trial. PATIENTS: Patients with a minimum of 6 wk, nonspecific low back pain. INTERVENTION: High-dose, motorized, continuous traction with a force between 35% and 50% of the total body weight was compared with sham or low-dose traction with a force between 0 and 20% of body weight. The sham traction was given with a specially developed brace that becomes tighter in the back during traction. This is experienced by patients as if traction were exerted. OUTCOME MEASURES: Primary measures were the patient's global impression of the effect and the severity of three main complaints. Secondary effect measures were functional status, pain, range of motion, work absence and recurrences. The effect measures were rated before randomization and 4 wk, 12 wk and 6 months later. CONCLUSION: There have been a number of earlier trials on the efficacy of lumbar traction; they suffer, however, from severe methodological flaws. This trial aimed to avoid these shortcomings.

Analysis of Variance↗