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Biomedical subjects

J K Stanghelle

Publications and source records attributed to J K Stanghelle.

At least 19 recordsLinked to original sources
PubMed1997

Long-term prevalence of impairments and disabilities after multiple trauma.

The prevalence of impairments and disabilities in activities of daily living (ADL), nonwork activities, and work were registered in a consecutive series (n = 69) of subjects with severe injuries. At follow-up 3 years after trauma, residual impairments prevailed in 80%. Only a few (6%) were ADL-dependent. Seventy-six percent had lost at least one nonwork activity, while vocational disability caused by the trauma occurred in 19%. Cognitive impairment was significantly associated with vocational disability, while physical impairment and pain were significantly associated with nonwork disability. Other parameters that influenced vocational disability negatively were age and blue-collar employment status. Although overall changes in social network quantity and quality were small, significantly more subjects with cognitive impairment or vocational disability experienced a decline in the quality and quantity of their social network after trauma. Furthermore, 25% of the subjects reported an increase in feelings of loneliness after trauma. We recommend the design of individualized, multidisciplinary rehabilitation plans before discharge from departments of surgery.

Abbreviated Injury Scale↗
PubMed1995

[Acupuncture therapy in stroke during the subacute phase. A randomized controlled trial].

The aim of this study was to investigate whether acupuncture treatment, if given to stroke patients in subacute phase in addition to rehabilitation would influence motor function, activity of daily living (ADL) and quality of life. After obtaining informed consent, 45 patients (median age 57 years) were randomised into a control group (n = 21) and an acupuncture group (n = 24). Median time from onset of stroke to inclusion in the study was 40 days. The inclusion criterion was hemiparesis following a first-ever stroke. When included and six weeks later all patients were evaluated by three measurement systems: the Motor Assessment Scale for stroke patients, Sunnaas Index of ADL and Nottingham Health Profile. All patients underwent individually adapted rehabilitation therapy. The patients in the treatment group were given classical acupuncture three to four times a week for six weeks, each session lasting 20-30 minutes. Both groups improved significantly in motor function and ADL. However, improvement was significantly greater among the acupuncture group than among the controls. Only the acupuncture group rated a significantly improved quality of life. Our results indicate that acupuncture gives an additive therapeutic benefit when given to stroke patients during their rehabilitation programme in the subacute phase.

Activities of Daily Living↗
PubMed1995

[Bladder problems after traumatic spinal cord injuries].

Patients with a recent traumatic spinal cord lesion admitted consecutively to Sunnaas Rehabilitation Hospital during the five-year period from 1987 to 1991 were included in a study of bladder function, including results of urodynamic investigation and urological complications, both during primary rehabilitation and on average five years (two to nine years) after injury. Indication for urodynamic investigation was found in 125 out of 170 patients. The study shows that micturition is a major problem after spinal cord injury, and that the follow-up programme after the rehabilitation period should be improved. General practitioners should be aware of these problems. Close cooperation between the rehabilitation department and the primary health service is needed to avoid renal and urinary complications in these patients.

Adolescent↗
PubMed1995

[Cystometry in neurogenic bladder disorders. Methodologic problems and assessment of risk of renal complications].

Patients with neurogenic bladder dysfunction may have an elevated detrusor pressure during the filling or emptying phase, which may result in upper urinary tract dysfunction. Cystometric examination is important in order to evaluate the risk of such complications and the effect of therapeutic intervention. If compliance is low, the cystometric filling rate has to be slow in order to obtain a physiologically representative pressure. In the case of detrusor hyperreflexia, intraindividual variation makes it necessary to perform repeated filling of the bladder in order to get representative values for the amplitude and duration of the detrusor contraction. The clinical significance of these methodological problems is discussed.

Humans↗
PubMed1995

[Videofluoroscopy in the examination of swallowing disorders. A useful method for evaluation of rehabilitation].

This article presents a protocol for videofluoroscopy based upon the literature and on four years of practical experience in a rehabilitation hospital from evaluation and treatment of dysphagia in patients with cerebral vascular and/or traumatic head injury. The protocol includes a description of clinical evaluation, necessary equipment and personnel. It also describes the types of food and liquids used, the positioning of the patient, the compensatory and therapeutic techniques which may be tested during the study, and the evaluation and reporting of results. During rehabilitation, patients with swallowing disorders can receive specific and practical advice on food intake, based on the results of videofluoroscopy.

Brain Injuries↗
PubMed1995

Pain and life quality within 2 years of spinal cord injury.

The prevalence and classification of pain were investigated in 46 patients admitted consecutively with traumatic spinal cord injury to a rehabilitation hospital. All were studied within 2 years of trauma. Forty-six percent experienced pain of moderate-to-severe intensity. The patients with pain were classified into five categories: diffuse pain, segmental pain, root pain, visceral pain and non-neurogenic pain. Most patients experienced more than one type of pain. Pain appeared more intense in the evening than in the morning or at noon. Older age (median 40 years vs 24 years) was related to increased prevalence of pain. Significantly more patients with pain (70%) than without pain (24%) had a case-score on the 20-item version of the General Health Questionnaire, indicating psychological distress and reduced quality of life. The present study indicates that pain causes emotional distress in addition to the distress associated with the spinal cord injury itself.

Adolescent↗
PubMed1995

Residual urine following intermittent catheterisation in patients with spinal cord injuries.

Residual urine following catheterisation was studied using ultrasonography (Ultramark II Scientific Medical System) in 12 patients with spinal cord injury, for an average of 4 months (range 3-7 months) after the time of injury. All of the patients were examined on three occasions. Urinary tract infections were also registered, and the functional type of the urinary bladder was identified by a cystometric examination. Ultrasonography showed residual urine volumes after 25 of a total of 36 catheterisations (70%). In seven of these catheterisations the residual urine volume exceeded 50 ml, and in two patients was more than 100 ml. None of the patients had a residual urinary volume of more than 50 ml after all three catheterisations, but in all but two patients, some residual urine volume was found after at least one of the catheterisations. Low and non-significant correlations were found between residual volume and frequency of urinary tract infections. It is possible that even small residual urine volumes after catheterisations may predispose to urinary tract infections in these patients.

Adolescent↗
PubMed1994

[Neuromuscular disorders of the extremities after heroin-induced rhabdomyolysis].

We describe four patients with neuromuscular deficiencies after heroin-induced rhabdomyolysis. Such deficiencies have a good prognosis, but all our patients continued to have sequelae. In an emergency situation one should always consider fasciotomy for acute compartment syndromes. Two of our patients developed a Volkmann's ischemic contracture after acute compartment syndromes. The other two had deficiencies from compression neuropathies. We observed functional restitution over a period of one to two years. Physiotherapy and orthopaedic aids are important in the rehabilitation of these patients. However, the main problem is still their drug addiction.

Acute Disease↗
PubMed1993

[Infrared tympanic thermometry--worse than reported?].

A comparison of parallel measurements of body temperature with infrared tympanic thermometry (First Temp 2000A) in both ears and with rectal mercury thermometer were performed in 100 patients with stroke (n = 60) or spinal cord injury (n = 40). Agreement between the two methods of temperature determination was assessed by calculating limits of agreement within which 95% (+/- 2 SD) of the individual differences would fall. Ear temperature was on average 0.3 +/- 1.0 (2 SD) degrees C above rectal temperature (p < 0.01). The upper and lower limits of agreement between the two methods were -0.7 degrees C and +1.3 degrees C, respectively. Mean difference between ear temperature in right and left ear was 0.0 +/- 0.7 (2 SD) degrees C. According to these results tympanic membrane temperature measured with First Temp 2000A appears to give clinical significant erroneous readings, and should be used with caution.

Adolescent↗
PubMed1993

[Invasive or transcutaneous measurements of oxygen saturation and blood gases? An evaluation of pulse oximetry and transcutaneous measurement of PO2 and PCO2 during rest and exercise].

Arterial and transcutaneous measurements of the oxygen saturation (SO2), the partial pressure of oxygen (PO2) and the partial pressure of carbon dioxide (PCO2 were compared during rest before and after cycling, and during submaximal and maximal exercise, in 12 adult patients with cystic fibrosis. SO2 was measured non-invasively using two different pulse oximeters (Radiometer and Ohmeda, respectively) and PO2 and PCO2 were registered with a transcutaneous electrode (Radiometer). The coefficients of correlation between arterial and transcutaneous values were respectively 0.95 (Radiometer) and 0.85 (Ohmeda) for SO2, 0.77 for PO2, and 0.75 for PCO2. On average the differences between arterial and transcutaneous values were small, but varied by 3-4% (2SD) for SO2, 2.0 kPa for PO2 and 1.0 kPa for PCO2. Our results indicate that pulse oximetry is a reasonably good way of detecting severe arterial hypoxemia during work, whereas the transcutaneous measurements of PO2 and PCO2 show such large variations that this method cannot be recommended for clinical use.

Adult↗
PubMed1993

[Residual urine after intermittent catheterization in patients with spinal cord injuries].

Residual urine following catheterization was studied using ultrasonography (Ultramark II Scientific Medical System) in 12 patients with spinal cord injury, for an average of four months (range 3-7 months) after time of injury. All patients were examined three times. Urinary tract infections were also registered, and the functional type of the urinary bladder was identified by cystometric examination. Ultrasonography showed residual urine volumes after 25 of a total of 36 catheterizations (70%). In seven of these catheterizations the residual urine volume exceeded 50 ml, and in two cases was more than 100 ml. None of the patients had a residual urinary volume of more than 50 ml after all three catheterizations, but in all but two patients, some residual urine volume was found after at least one of the catheterizations. Low and non-significant correlations were found between residual volume and frequency of urinary tract infections. It is possible that even small residual urine volumes after catheterization may predispose for urinary tract infections in these patients.

Adolescent↗
PubMed1993

Pulmonary function and symptom-limited exercise stress testing in subjects with late sequelae of poliomyelitis.

Sixty-eight subjects, consecutively admitted to our rehabilitation hospital with a presumptive postpolio syndrome, were examined by pulmonary function and symptom-limited exercise stress testing. The purpose of this investigation was to study how many of these subjects could be classified as suffering from cardiorespiratory deconditioning. The subjects had moderately reduced lung function of restrictive type, and none of the subjects had forced expiratory volume for one second (FEV1) below 30% of predicted value, indicating that hypoventilation would probably not occur. A pronounced reduction in maximal oxygen uptake (max VO2) was seen, especially in women. The maximal heart rate (max HR) values were above 70% of predicted values in all but one subject, indicating that the subjects might benefit from endurance training. Fifteen subjects had a suspected pulmonary limitation due to the exercise, with the ratio ventilation/maximal voluntary ventilation (V/MVV) above 70%. However, max HR in these subjects did not differ from that in the subjects with the ratio V/MVV below 70%. Thirteen other subjects had a ratio V/MVV < 70% but did not achieve respiratory quotient (R) > 1.0 and/or capillary lactate concentration > 4 mmol/l during exercise, indicating that muscular factors limited the exercise. These results indicate that cardiorespiratory deconditioning was considerable in most of our subjects with postpolio syndrome.

Adult↗
PubMed1993

Lung volumes in tetraplegic patients according to cervical spinal cord injury level.

Fifty-six tetraplegic patients with motor complete lesions (Frankel A and B) underwent spirometric measurements more than 6 months after injury. The results were evaluated according to the level of transection of the cervical cord. A pronounced restrictive respiratory dysfunction was demonstrated in all patients. The expiratory reserve volume (ERV) was zero or markedly reduced in patients at all lesion levels. Systematic increases in both ERV and vital capacity (VC) were found with lower lesion level. The inspiratory capacity (IC) was reduced at all injury levels, but there were no systematic differences in IC between injury levels C4-C8. The total lung capacity (TLC) was reduced and the ratio residual volume/total lung capacity (RV/TLC) was increased in patients at all injury levels. The lung function of patients tested > 12 months after injury was not significantly different from the function in those tested 6-12 months after injury. A respiratory rehabilitation programme for tetraplegic patients should take into account the fact that the respiratory function, especially the forced expiration, is dependent upon injury level.

Adolescent↗
PubMed1992

[Rehabilitation of patients with brain stem damage].

We describe seven patients with serious brain stem damage who were admitted to Sunnaas Rehabilitation Hospital over a period of two years (1989-91). Our patients had quadriplegia and anarthria with some or completely preserved cognitive function. They experienced varying degrees of restitution, but all remained severely impaired. Important areas for rehabilitation include communication, alimentation, mobility, emotional reactions, medical complications and daily living arrangements. Severely impaired patients can enhance their quality of life by use of technical devices. Minimal motor function is necessary to control a switch, but preserved cognitive function is essential.

Adult↗
PubMed1991

[42 patients with post-polio syndrome. A retrospective study from Sunnaas hospital].

We describe a retrospective study of 42 patients admitted to Sunnaas Rehabilitation Hospital with suspect postpolio syndrome over a period of two years. The patients were 32 females and 10 males aged 28-74 years (mean 54 years). 29 were married or cohabitant, 31 had children, and 20 were in paid employment. The mean age at onset of polio was 12 years, with an average interval of 36 years between onset of polio and onset of new problems. The mean duration of new health problems was seven years. The most common such problems were pain in muscles and joints, general fatigue and new weakness of the muscles. 28 of the patients needed personal assistance to carry out everyday activities. 33 had braces, crutches or wheelchair for ambulation. Lung function was moderately reduced and physical working capacity was severely reduced. Physiotherapy, ergotherapy and technical aids were provided for 38 of the patients, 16 received assistance to organizing social support or help at home, 13 were helped to make practical changes in their homes, and eight were provided with a wheelchair. According to this study, most patients with the postpolio syndrome need interdisciplinary evaluation and management in a rehabilitation hospital.

Adult↗