Biomedical subjects

Elsie Culham

Publications and source records attributed to Elsie Culham.

4 recordsLinked to original sources

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

Control of lead and trail limbs during obstacle crossing following stroke.

BACKGROUND AND PURPOSE: Obstacle crossing is compromised following stroke. The purpose of this study was to quantify modifications during obstacle clearance following stroke. SUBJECTS: Twelve subjects with stroke and 12 subjects without stroke participated in the study. METHODS: Kinematic variables were measured while participants crossed a 4-cm-high obstacle. Subjects with stroke walked at a self-selected speed; subjects without stroke walked at a comparable speed and at a self-selected speed. RESULTS: Several modifications were observed following stroke with both groups walking at self-selected speeds. The affected lead limb was positioned closer to the obstacle before crossing. Affected trail-limb clearance over the obstacle was reduced. Both affected and unaffected lead and trail limbs landed closer to the obstacle after clearance. Swing time was increased in the affected lead limb after obstacle clearance. Fewer modifications were detected at matched walking speed; the trail limb still landed closer to the obstacle. DISCUSSION AND CONCLUSION: Modifications during obstacle crossing following stroke may be partly related to walking speed. The findings raise issues of safety because people with stroke demonstrated reduced clearance of a 4-cm obstacle and limb placement closer to the obstacle after clearance.

Aged↗

PubMed2003

Radiographic measures in subjects who are asymptomatic and subjects with patellofemoral pain syndrome.

Lateral tilt and displacement of the patella are considered characteristic features of patellofemoral pain syndrome. It has been suggested that abnormal patellar tilt and displacement are detected best with the knee near full extension, which requires computed tomography or magnetic resonance imaging. The objective of the current study was to determine whether alignment abnormalities could be detected in subjects with patellofemoral pain syndrome from axial radiographs obtained at 35 degrees knee flexion using a new, standardized radiographic technique. Thirty-three subjects with patellofemoral pain syndrome and 33 matched control subjects were recruited from a military population. Lateral and axial (unloaded and with quadriceps contraction) radiographs were taken using the Patellofemoral QUESTOR Precision Radiograph system. Measures of patellar tilt and displacement, and anatomic measures (sulcus angle, patellar facet angle, patella alta) were obtained from the radiographs. No significant differences in patellar tilt or displacement were detected between the groups (paired t tests) in either the unloaded or loaded (quadriceps contracted) condition, suggesting that these measures, obtained at this knee angle are not useful diagnostic or outcome measures in patellofemoral pain syndrome. Patellar angle, sulcus angle, and patellar height also did not differ between groups suggesting that these are not etiologic factors in patellofemoral pain syndrome.

Adult↗

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↗