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Biomedical subjects

L R Knuts

Publications and source records attributed to L R Knuts.

27 records · Page 2Linked to original sources
PubMed1986

Rehabilitation after surgery for lumbar disc herniation: results of a randomized clinical trial.

The aim of this prospective study was to examine the one-year postoperative results in patients operated on for lumbar disc herniation randomized in two groups: one with comprehensive rehabilitation and the other taken care of by normal care facilities. A total of 212 patients without any previous spinal operations comprised the final study group. The physiatrist, the surgeon, the social worker, and the psychologist performed the handicap evaluation according to the occupation handicap scales of the WHO. The handicap was evaluated for two phases: before the onset of acute sciatica leading to operation and one year after operation. No significant differences in handicap distribution between the intervention and normal care groups were seen. The postoperative handicap correlated highly significantly with preoperative handicap for both groups. More than half (57%) of all the patients returned to work within two months of the operation. The amount of sick leaves did not differ significantly between the intervention and normal care groups. A total of 15 persons (7%) retired during the postoperative year.

Absenteeism↗
PubMed1985

Validity of the 24-hour dietary recall.

The validity of the 24-hour recall was studied with a comparison of recalled and observed food and nutrient intake for 140 subjects, 84 males (60%) and 56 females (40%), 15 to 57 years old. The observation was carried out during 1 day by recording the amounts of foods selected by the subjects at four meals. The following day, 24-hour recalls were obtained. The results showed that some food items eaten were omitted in the recall, the extremes being 4% of times eaten for fish and 50% for cooked vegetables. In addition, some food items not actually eaten were added in the recall, the additions ranging from 2% of times recalled for bread to 29% for sugar. The difference between mean recalled and observed nutrient intake was between -6% and 11%, except for sucrose (-20%) and vitamin C (-16%). The product-moment correlation coefficient between observed and recalled nutrient intake was in the range of 0.58 to 0.74. Women achieved somewhat more accurate results than men, and the recall results in the 35 to 44 age group were the most valid. It was concluded that validity is unsatisfactory on the individual level and satisfactory on the group level.

Adolescent↗
PubMed1984

Invalidity pension after lumbar disc operation.

A total of 753 patients (328 women, 425 men) below 65 years of age and without previous pension living in the South-West of Finland, were operated on for the first time for lumbar disc herniation during the period 1975-1979. The frequency of a new invalidity pension was observed during a follow up period of two years. Of the 753 patients there were 100 new invalidity pensioners (13%) during one year and 133 (18%) during two years after the first operation. According to a statistical model for the impact of age and nature of work on invalidity pension the greatest risk of pensioning for women was associated with age, pensioning being more than five times higher in the age group 45-54 years than below 35 years. Moderate and heavy work by women constituted a minor risk factor, increasing the risk by less than two times compared with light work. In men the risk correlated clearly to both age and nature of work. Moderate and heavy work increased the risk nearly three times compared with light work. The frequency of pensions among 45-64 year old men was even 6-8 times higher, than the risk for men below 35 years. A second operation increased the risk on average two to three times. Cauda equina syndrome was not a risk factor for receiving an invalidity pension. The primary diagnosis for an invalidity pension was something other than lumbar disc herniation in 20%. Patients with unsatisfactory results after lumbar disc operations account for about 10% of all the new invalidity pensions due to some form of back disease in Finland.

Adult↗
PubMed1983

Effects of comprehensive rehabilitation on weight reduction in myocardial infarction patients.

The effect of a comprehensive rehabilitation programme, including diet therapy, was studied in overweight male myocardial infarction (MI) patients randomly assigned to a rehabilitation group (n = 69) and a control group (n = 64). The results show a mean weight decrease of 3.8 kg in the rehabilitation group and a mean weight increase of 1.1 kg in the control group (t = -5.78, p less than 0.001). The proportion of patients reducing their weight more than 5 kg was 33% in the rehabilitation group and 5% in the control group (chi 2 = 15.6, p less than 0.001). Patient characteristics which significantly affected the weight change by univariate analysis were age, level of overweight, smoking habits, employment situation and social problems. Multivariate analyses yielded a two-variable model with moderate explanatory power in the rehabilitation group. The model includes the variables Body Mass Index and cessation of smoking before MI.

Adult↗
PubMed1981

Agreement between dietary interviews.

The nutrient intake for 86 male myocardial infarction patients was calculated from data based on the interview methods studied both one and two years after infarction. The dietary history method resulted in systematically higher mean daily intakes than the other methods. The differences in mean intakes calculated from the recall methods were, in general, rather small. The agreement, measured by the intraclass correlation coefficient, varied from 0.42 to 0.69. The pattern of mean differences between methods was consistent one and two years after infarction.

Adult↗
PubMedDate not supplied

Clinical, social, and psychological factors and outcome in a 5-year follow-up study of 276 patients hospitalized because of suspected lumbar disc herniation.

The study consisted of 276 patients who were hospitalized between 1980 and 1982 because of suspected lumbar disc herniation. No randomization of treatment was used. On the basis of clinical indications 179 patients were operated on and 97 had further conservative treatment. Results of physical, social, and psychological examinations performed after 1 year were related to the 5-year outcome defined by occupation handicap of the WHO system. For operated patients, subjective working incapacity, sensory deficit of leg, tightness of hamstrings, age, and pain in lumbar extension predicted a poor outcome. Predictive factors for non-operated patients were increased occurrence of occupational hazards and co-morbidity.

Adult↗
PubMedDate not supplied

Psychological impairments, disabilities, and handicaps: a pilot study of psychological assessment of functioning in chronic pain patients.

This study addresses the psychological assessment of functioning in chronic pain patients. First, a model of functional assessment is proposed, which is based on the biopsychosocial view of chronic disease (Engel) and on the consequences of diseases (WHO). Second, a set of psychological criteria for impairments, disabilities, and handicaps, described by WHO as the consequences of diseases, are determined. Third, the psychological criteria selected are operationalized and the utility of the psychological assessment instruments tested in a clinical rehabilitation study. The results indicate that prediction of post-treatment functioning in the rehabilitation patient, by psychological procedures, may improve if the concept of functioning is determined as three sub-areas of impairments, disabilities, and handicaps.

Activities of Daily Living↗
PubMedDate not supplied

Lumbar spinal canal size of sciatica patients.

Seven measures at the three lowest lumbar interspaces were recorded from conventional radiographs of the lumbar spines of 160 consecutive patients with low back pain and sciatica admitted for myelography and possible surgery. Eighty-eight patients were operated upon for disc herniation, and of the conservatively-treated 72 patients, 18 had a pathologic and 54 a normal myelogram. The results were evaluated after one year using the occupational handicap scales of WHO. Correlations of radiographic measures to stature were moderate and to age small. After adjusting for stature and age, only the male interpedicular distances and the antero-posterior diameter of intervertebral foramen at L3 were greater than those of females. The males with a pathologic myelogram had smaller posterior disc height at L3 and a smaller interarticular distance at L3 and L4 than those with normal myelogram, likewise the midsagittal diameter at L3 and L4 in females. In all patients other measures besides posterior disc height were smaller than those for low back pain patients (p less than 0.001) or for cadavers (p less than 0.001). The only correlation between measures and clinical manifestations was between pedicular length at L3 and limited straight leg raising. Where the disc material had been extruded into the spinal canal, the interpedicular distance was significantly wider. Only anterior disc height at L3 revealed differences between good and poor outcome one year after surgery, as did the interarticular distance at S1 in patients with normal myelogram after conservative treatment.

Adolescent↗