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Biomedical subjects

G K Montgomery

Publications and source records attributed to G K Montgomery.

11 recordsLinked to original sources
PubMed1995

A multi-factor account of disability after brain injury: implications for neuropsychological counselling.

Persons with brain injuries demonstrate an inconsistency in functioning over time and circumstances that requires a consideration of factors in addition to the size and location of the acquired brain lesions. A multi-factor account is presented in which neuropsychological disability on any occasion is attributed to some combination of neuropsychological deficits plus one or more of four personal factors (negative thinking, tension-arousal, fatigue, physical symptoms) and three situational factors (demands for complex attention, demands for rapid processing, external distractions). Citing pertinent research the paper discusses the development of, and possible mechanisms of influence by, these seven factors. It then broadly prescribes clinical interventions that might assist clients to reduce their adverse effects. It is suggested that the scope of brain injury rehabilitation be extended to include training clients to identify and manage non-organic conditions that may combine with direct brain injury effects to compromise productive work, complicate social relationships, or render the affected person less able to cope with stress.

Activities of Daily Living↗
PubMed1990

Compliance, reliability, and validity of self-monitoring for physical disturbances of Parkinson's disease. The Parkinson's Symptom Diary.

Previous clinical research in Parkinson's disease has recognized the value of self-monitoring procedures in which patients observe and record the frequency and severity of their own symptoms as these occur within the patient's social and work environment. We discuss issues of methodology and report a study of compliance, test-retest reliability, and validity with a new self-monitoring instrument, the Parkinson's Symptom Diary. Two recordings of frequency (loss of balance, hesitation-freezing) and two ratings of severity (tremor, difficulty walking) were made four times daily for one week by patients (N = 73) who were without apparent loss of cognitive or memory functions. A total of 91% of the diaries received (97% of requested) met strict compliance criteria so that independent sampling over days could be assumed. Test-retest stability over one month was demonstrated for each score (all Spearman rho greater than .85) in a representative subsample of 28 patients. Criterion validity was demonstrated for each score by an expected pattern of correlations with independently obtained observer ratings of the same or related indices of disease, and by comparison with Hoehn and Yahr disability stages. By its simplicity, this self-assessment device can be an invaluable complement to traditional methods of clinical and laboratory assessment in the care and evaluation of Parkinson patients.

Activities of Daily Living↗
PubMed1987

Factor analysis of Parkinson's impairment. An evaluation of the final common pathway.

The question of how pathophysiologic mechanisms may combine to yield significant performance impairment in Parkinson's disease was studied by factor analysis of the covariation among behavioral deficits observed during simulated daily living activities. Eighty-four patients with idiopathic Parkinson's disease were videotape-recorded while performing a sequence of nine common tasks of daily living in a standardized format. Acceptable observer reliability was achieved for ten clinical signs that were factor-analyzed to suggest three dimensions of motor performance: ambulation, tremor, and animation. The findings are discussed with respect to traditional concepts of Parkinson's disease and the possible interplay between primary disease mechanisms.

Aged↗
PubMed1987

Intravenous thyrotropin-releasing hormone in patients with amyotrophic lateral sclerosis. Dose-response and randomized concurrent placebo-controlled pilot studies.

Focal, small-to-moderate and transient improvement occurred in the muscle strength and function of patients with ALS who received TRH in dose-response and screening studies. In a small pilot study of 12 patients, 3 months administration of TRH at 10 mg per kg on alternate days resulted in localized increased strength of jaw muscles as well as significant improvement in lower extremity function. Aerobic exercise capacity was particularly improved in patients with ALS following administration of TRH. Autonomic effects of TRH on heart rate, respiration, and blood pressure were not serious and attenuated slightly over the course of the study.

Amyotrophic Lateral Sclerosis↗
PubMed1987

Neuropsychological perspectives in amyotrophic lateral sclerosis.

Three aspects of neuropsychological functioning in patients with ALS are examined. Contrary to previous research, a new psychometric study of psychological adjustment suggested significant depression-distress in this population and related psychological disturbance differentially to signs of upper versus lower motor neuron involvement and to respiratory failure. An association between ALS and impaired neuropsychological functioning is discussed through an examination of the clinical and pathologic literatures. ALS appears to be a multisystem degenerative disease with a variety of expressions that may frequently include loss of cognitive-behavioral competency with progressive involvement of the prefrontal cortex and, in a few instances, profound dementia. Finally, the article describes an analysis of trends in psychological adjustment and in the perception of physical capability over the course of a pilot clinical trial.

Adaptation, Psychological↗
PubMed1985

Qualitative assessment of Parkinson's disease: study of reliability and data reduction with an abbreviated Columbia Scale.

Research in Parkinson's disease has given little attention to the reliability of subjective-qualitative assessment, or to the empirical aggregation of physical signs to supraordinate indexes of motor disturbance. We illustrate methods for examining observer reliability and discuss the importance of reliability to the interpretation of results. Observers rated patients (n = 70) for physical signs (selected Columbia Scale scores), disability stages, and abnormal involuntary movements. Observer agreement was achieved for Columbia scores and disability stages (range of Spearman rho = 0.67-0.95), but not for dyskinesias or dystonic postures. A factor analysis of Columbia scores revealed two indexes of motor disturbance: motor deficiency and tremor.

Aged↗
PubMed1984

Versatility in computer automation for biofeedback: the behavioral assessment and rehabilitative training system (BARTS).

User versatility in a system for computer-automated biofeedback training is the degree to which the assessment and training parameters may be altered by the user's employing English language or other simple code, that is, without altering the system's applications software. The Behavioral Assessment and Rehabilitative Training System (BARTS) includes a design and control program that allows for the specification of assessment and training protocols by persons who are entirely lacking in computer programming skills. This paper describes the logic for data acquisition and training that is incorporated in the BARTS, describes the parameters that must be specified in constituting unique assessment or training protocols, and illustrates the system's application in a research-oriented biofeedback clinic.

Biofeedback, Psychology↗