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Biomedical subjects

J Wim Brandsma

Publications and source records attributed to J Wim Brandsma.

3 recordsLinked to original sources

26th Kellersberger Memorial Lecture. Lessons from leprosy rehabilitation for general rehabilitation.

Leprosy is primarily a disease of skin and peripheral nerves. Because of nerve function impairment, leprosy patients may develop primary nerve related impairments such as, loss of sensation and weakness or paralysis. These primary impairments may lead to secondary impairments such as ulceration and contractures. Many other diseases and disorders present with similar impairments as seen in leprosy e.g. diabetes and peripheral nerve injuries. Nerve function assessment and ulcer prevention and treatment are areas that have been researched in leprosy but these research findings are not yet commonly known and adopted in diseases and disorders that 'relate' to leprosy. Rehabilitation is a relatively new field in medicine and not (well) developed in many developing countries. Rehabilitation requires an integrated approach from different disciplines and professionals. As for other medical specialty fields, rehabilitation demands evidence based practice.

Activities of Daily Living↗

WHO disability grading: operational definitions.

The WHO disability grading has been in use for many years. Its main use has been as an indicator for early case detection/reporting. More recently, the WHO grading has also been used as a change indicator of impairments for patients while on treatment. In such instances, the individual scores for eyes hand, and feet are added to obtain the so-called EHF sum score. A major drawback in the use of the grading system has been the lack of operational definitions of the descriptions for the grades. This may result in data and results of comparisons of data across programs and countries being flawed. The paper discusses the WHO grading in the light of its dual use: as an indicator for early case detection and as an indicator for change in impairments. The paper presents operational definitions for the grading options.

Disability Evaluation↗

Reliability of thumb web measurements.

Two new methods of thumb web space measurement, the intermetacarpal distance (IMD) and the derived intermetacarpal angle (DIMA), were proposed and compared with a conventional method for interrater reliability. Forty subjects (22 normal hands, 18 impaired hands) were measured. Reliability of the measurement was estimated using the intraclass correlation coefficient (ICC) and the Bland and Altman method of 95% limits of agreement. Overall, the IMD method showed an ICC of 0.88 with 95% limits of agreement of -6.9 to 5.6 mm (approximately +/-6.2 mm). Similarly, for the DIMA method, the ICC was 0.47 with 95% limits of agreement of -11.9 to 5.1 degrees (approximately +/-8.5 degrees ). The IMD method appears more reliable than the conventional method, which had an ICC of 0.26 and 95% limits of agreement of -17.5 to 9.2 degrees (approximately +/-13.3 degrees ). The IMD method is recommended as a reliable method of measuring the thumb web space.

Adolescent↗