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Biomedical subjects

G Aufdemkampe

Publications and source records attributed to G Aufdemkampe.

10 recordsLinked to original sources
PubMed2006

Contracture preventive positioning of the hemiplegic arm in subacute stroke patients: a pilot randomized controlled trial.

OBJECTIVE: To investigate the effectiveness of a contracture preventive positioning procedure for the hemiplegic arm in subacute stroke patients in addition to conventional physio- and occupational therapy. DESIGN: A single-blind pilot randomized controlled trial. SETTING: Inpatient neurological units from three rehabilitation centres in the Netherlands. SUBJECTS: Nineteen subacute stroke patients (minus two drop-outs) with a severe motor deficit of the arm. INTERVENTIONS: All subjects underwent conventional rehabilitation care. Nine subjects additionally received a positioning procedure for two 30-min sessions a day, five days a week, for five weeks. MAIN MEASURES: Passive range of motion of five arm movements using a hydrogoniometer and resistance to passive movement at the elbow using the Ashworth Scale. Secondary outcome measures were pain at the end range of passive motions, the arm section of the Fugl-Meyer Assessment and Barthel Index scores for ADL-independence. Outcome measures were taken after five weeks and additional measurements after 10 weeks by two assessors blinded to group allocation. RESULTS: Comparison of the experimental (n = 9) with the control subjects (n = 8) after five weeks showed that additional positioning significantly slowed down development of shoulder abduction contracture (P = 0.042, -5.3 degrees versus -23 degrees). No other differences were found between the groups. CONCLUSIONS: Applying a contracture preventive positioning procedure for the hemiplegic arm slowed down the development of shoulder abduction contracture. Positioning did not show significant additional value on other outcome measures. Since the sample size was small, results of this study need future verification.

Adult↗
PubMed2002

Orthotic devices for treating patellofemoral pain syndrome.

BACKGROUND: Patellofemoral pain syndrome is a frequently reported condition in active adults. A wide variety of conservative treatment strategies have been described. As yet, no optimal strategy has been identified. Application of orthotic devices e.g. knee braces, knee straps, forms of taping of the knee, active training devices, knee sleeves and in-shoe orthotics to support the foot have been advocated to treat this condition. OBJECTIVES: To assess the effectiveness of foot and knee orthotics for treatment of patellofemoral pain syndrome. SEARCH STRATEGY: We searched the Cochrane Musculoskeletal Injuries Group specialised register (December 2001), the Cochrane Controlled Trials register (Issue 2, 2000), MEDLINE (January 1966 to March 2000; EMBASE (January 1988 to March 2000); CINAHL (January 1982 to March 2000) and PEDro (up to March 2000). Relevant orthotic companies were contacted. SELECTION CRITERIA: All randomised and quasi-randomised trials comparing the effectiveness of knee or foot orthotics for treatment of patellofemoral pain syndrome were selected. Trials describing the use of orthotic devices in conjunction with operative treatment were excluded. DATA COLLECTION AND ANALYSIS: Three reviewers independently assessed methodological quality of the identified trials by use of a modified version of the Cochrane Musculoskeletal Injuries Group assessment tool, consisting 11 items. Two reviewers extracted data without blinding. Trialists were contacted to obtain missing data. MAIN RESULTS: Five trials involving 362 participants were included in this review. Five other trials await possible inclusion if further information can be obtained and one awaits further assessment. Due to clinical heterogeneity, we refrained from statistical pooling and conducted analysis by grading the strength of scientific evidence. The level of obtained research-based evidence was graded as limited as all trials were of low methodological quality. This limited research-based evidence showed the Protonics orthosis at six week follow-up was significantly more effective for decrease in pain (weighted mean difference (WMD) between groups 3.2; 95% confidence interval (CI) 2.8 to 3.6), functional improvement on the Kujala score (WMD 45.6; 95% CI 43.4 to 47.7) and change in patellofemoral congruence angle (WMD 17.2; 95% CI 14.1 to 20.3) when compared to no treatment. A comprehensive programme including tape application was significantly superior to a monitored exercise programme without tape application for decrease in worst pain (WMD 1.6; 95% CI 0.4 to 2.8) and usual pain (WMD 1.2; 95% CI 0.2 to 2.1), and clinical change and functional improvement questionnaire scores (WMD 10, 95% CI 2.07 to 17.93) at four weeks follow-up. The trials reported statistically significant differences in patient satisfaction after applied therapy (WMD 3.3; 95% CI 0.5 to 6.1) in favour of the McConnell regimen compared with the Coumans bandage at six weeks follow-up. REVIEWER'S CONCLUSIONS: The evidence from randomised controlled trials is currently too limited to draw definitive conclusions about the use of knee and foot orthotics for the treatment of patellofemoral pain. Future high quality trials in this field are warranted.

Arthralgia↗
PubMed2001

Effect of a physical therapeutic intervention for balance problems in the elderly: a single-blind, randomized, controlled multicentre trial.

OBJECTIVE: To establish the effect of a short, individualized exercise programme on balance dysfunction in the elderly. DESIGN: A single-blind, randomized, controlled, multicentre trial. SETTING: Physical and recreational therapy departments from two rehabilitation centres. PARTICIPANTS: Ninety-four subjects of >75 years with functional balance problems living independently or in a residential care facility. Seventy-seven subjects completed the intervention period and four-week follow-up. At a one-year follow-up 49 subjects were evaluated on balance functioning. INTERVENTIONS: Twelve sessions of an individualized balance training programme (experimental group) or 12 sessions of an individualized extra attention programme (control group) given in 4-6 weeks. MAIN OUTCOME MEASURES: Berg Balance Scale and the Dynamic Gait Index to establish balance functioning, a visual analogue scale to establish fear of falling in daily life and the Hospital Anxiety Depression Scale to verify feelings of anxiety and depression. RESULTS: Subjects in the experimental group improved significantly more on the Berg Balance Scale and the Dynamic Gait Index than those in the control group (p f 0.001, p f 0.001, respectively). However the effect disappeared at a one-year follow-up on the Berg Balance Scale. No prognostic factors could be identified to determine who would benefit most from the individualized exercise programme. Results on the other response variables revealed no effect of the intervention. CONCLUSION: A short individualized exercise programme can improve functional balance in people aged 75 years and older. This improvement was maintained at least for one month but had worn off by one year.

Activities of Daily Living↗
PubMed1999

Intraexaminer and interexaminer reliability of the Gillet test.

OBJECTIVES: The purpose of this study was to determine the intraexaminer and interexaminer reliability of the Gillet test. STUDY DESIGN: In a test-retest study the incidence of asymmetric or symmetric sacroiliac joint motion was investigated with the Gillet test. METHODS: Forty-one male subjects volunteered for this study (mean age, 23 +/- 2.24 years). Thirty-eight subjects were examined in the first test procedure, and at least 4 days later 37 subjects were examined again. The subjects were subdivided into symptomatic and asymptomatic groups on the basis of certain criteria. RESULTS: To obtain the intraexaminer and interexaminer reliability values, Cohen's kappa, the percentage agreement, bias-adjusted kappa, and prevalence-adjusted bias-adjusted kappa were used. The mean Cohen's kappa did not exceed the value of 0.081. Only the percentage agreement of the symptomatic group did exceed the minimum level of 80%. When kappa was positive, the prevalence-adjusted bias-adjusted kappa was markedly higher than kappa; when kappa was negative, the prevalence-adjusted bias-adjusted kappa was only slightly higher than kappa. Only small differences were found between kappa and bias-adjusted kappa. CONCLUSION: The Gillet test, as performed in this study, does not appear to be reliable.

Adult↗
PubMed1999

The QA pressure measurement system: an accuracy and reliability study.

OBJECTIVE: The main purpose of this study was to determine the accuracy and reliability of the Queen Alexandra Pressure Measurement System (QA PMS). Furthermore, we examined whether there were significant differences in measured pressures of the buttock area during sitting between normal subjects and spinal cord injured (SCI) patients. DESIGN: Accuracy (calibration) and reliability (test-retest) study. SETTING: The spinal cord unit of Tertiary Care Centre 'De Hoogstraat' in Utrecht, The Netherlands. PATIENTS: A convenience sample of 16 SCI patients and 15 normal subjects. MAIN OUTCOME MEASURES: The accuracy was determined by using the Standard Error of the Mean (SEM, in mmHg). The Technical Error of Measurement (TEM, in mmHg) was calculated as measure for differences between two paired measurements. The reliability was determined by using an Intraclass Correlation Coefficient (ICC). Significant differences in measured pressures between both groups (P<0.05) were determined by using an unpaired (two sample) t-test. RESULTS: Accuracy (calibration): mean SEM=0.30 (+/-0.1) mmHg, indicating a high level of accuracy. Differences between two paired measurements: mean TEM calibration= 1.87 (+/-0.76) mmHg; mean TEM normal subjects=4.76 (+/-1.78) mmHg; mean TEM SCI patients=6.34 (+/-2.19) mmHg. Reliability: mean ICC(3,1) calibration=0.85 (95% CI=0.74 0.95); mean ICC(2.1) normal subjects=0.92 (95% CI=0.90 0.94); mean ICC(2.1) SCI patients=0.90 (95% CI=0.88 0.92). The normal subjects had significantly higher mean pressures (P=0.028) than the SCI patients (mean pressures 31.0 vs 28.5 mmHg), whilst the SCI patients had significantly higher peak-pressures (P=0.0000) than the normal subjects (mean peak-pressures: 134.1 vs 75.7 mmHg). CONCLUSIONS: The QA Pressure Measurement System has sufficient accuracy and good reliability as a measurement procedure. There are significant differences between the measured pressures of both groups: the significantly higher peak pressures of the SCI patients seem to be the most important.

Buttocks↗
PubMed1998

Sensibility testing in patients with a lumbosacral radicular syndrome.

OBJECTIVE: To examine whether there is a significant difference in gnostic sensibility between affected and unaffected legs of patients suffering from lumbosacral radicular syndrome (LRS) resulting from a disc herniation and to determine the validity of the sensibility test for detecting a disc herniation. DESIGN: Observer blind study of sensibility testing. SETTING: Four general hospitals (neurology department) and one practice of physical and manual therapy. SUBJECTS: Fifty-one patients with radicular pain in the lumbosacral nerve roots for at least 4 wk and/or neurological deficits. METHODS: The gnostic sensibility of 51 patients with a unilateral LRS was tested using Semmes-Weinstein monofilaments for the L4, L5 and S1 dermatomes. RESULTS: Gnostic hypoesthetic impairments in the L4, L5 and S1 dermatomes were found in 84.6% of the 43 patients in which the presence of disc herniation was confirmed by CT. There was significant difference in gnostic sensibility between the affected and unaffected legs in the L4, L5, and S1 dermatomes for disc herniation at the L4-L5 level and for the L5 and S1 dermatomes for a disc herniation at the L5-S1 level. There was no significant difference in gnostic sensibility in the L4 dermatome for a disc herniation at the L5-S1 level. CONCLUSION: The gnostic sensibility of the affected leg is hypoesthetic compared with the unaffected leg. The specificity of the sensibility test using monofilaments is acceptable, but the sensitivity is not. The monofilament test is a useful and practical tool for excluding the presence of a disc herniation at dermatomes L4, L5 and S1 and disc herniations at the L4-L5, L5-S1 level.

Adult↗
PubMed1998

Reliability of manual skinfold tests in a healthy male population.

OBJECTIVE: To assess the intra- and interexaminer agreement of a manual skinfold thickness test and a manual skinfold compliance test. The relation between the weekly routine of the examiners and the intraexaminer reliability was also assessed for both tests. DESIGN: This is a reliability study of a common palpatory procedure to assess skinfold thickness and skinfold compliance. Twelve healthy subjects were palpated twice in two sessions by 12 examiners. SETTING: The study was conducted at the Polytechnic of Utrecht (the Netherlands), Faculty of Health Care, Department of Physiotherapy. SUBJECTS: Healthy male subjects recruited from students of the Polytechnic of Utrecht (the Netherlands), Department of Physiotherapy. RESULTS: The intraexaminer agreement Intraclass Correlation Coefficient [ICC(3.1)] was .25 for skinfold thickness and .28 for skinfold compliance. The interexaminer agreement [ICC(2,1)] ranged from .01 to .24. The Pearson correlation coefficient between the examiners age and routine vs. intraexaminer agreement ranged from -.41 to .23 (nonsignificant). CONCLUSIONS: The intra- and interexaminer agreement of the manual skinfold test produced poor-to-fair reliability. The correlation between the examiners' weekly routine and the intraexaminer reliability ranged from low negative to little (if any). This study shows a lack of reliability of palpatory tests for skinfold thickness and skinfold compliance. This outcome agrees with results of previous studies found in the literature.

Adult↗
PubMed1997

Assessing anterior cruciate ligament injuries: the association and differential value of questionnaires, clinical tests, and functional tests.

It is important to examine the package of questionnaires and clinical and functional tests as used in anterior cruciate ligament (ACL)-injured patients in order to gain insight on the patient's present status. Nine measuring systems in three categories were examined: four questionnaires, three clinical tests, and two functional tests. Differences between sports activity rating system, factor occupational rating system scale, and Tegner scores pre- and post-injury and the differences between the affected and unaffected knee in the clinical and functional tests were calculated using the Wilcoxon test for paired observations. These differences proved to be significant (p < 0.05). The association between the various tests was also examined. None of the associations satisfied the preset standards. Based on these low levels of association, it does not seem possible to reduce the package of tests to one questionnaire, one clinical test, and one functional test as all questionnaires and tests seem to be related to different aspects of the injured ACL. Based upon these results, the total package should be used to gain insight in both impairment and disability level in patients with an injured ACL.

Activities of Daily Living↗
PubMed1993

Negative affect, pain and disability in osteoarthritis patients: the mediating role of muscle weakness.

Negative affect has been shown to be associated with high levels of pain and disability in osteoarthritis (OA) patients. As an explanation of this association, it was hypothesized that muscle weakness is a mediating factor between negative affect, pain and disability. Accordingly, negative affect enhances the patient's tendency to avoid pain-related activities; a low activity level induces muscle weakness, instability of joints and thus pain and disability. This theory leads to the prediction that the association between negative affect, pain and disability is most pronounced in patients with weak muscles. The prediction was tested in a study on patients with OA of the hip and/or knee. Regarding disability (but not pain), the prediction was confirmed. This study indicates that muscle weakness is a mediating factor between negative affect and disability in OA-patients.

Adaptation, Psychological↗