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Biomedical subjects

L S Halstead

Publications and source records attributed to L S Halstead.

46 records · Page 3Linked to original sources
PubMed1976

Longitudinal unobtrusive measurements in rehabilitation.

Most evaluation techniques in rehabilitation emphasize descriptions of patient capability during brief time intervals under relatively standardized conditions. This paper outlines a conceptual approach which emphasizes the importance of evaluating how patients actually perform under everyday circumstances during extended periods of time. The underlying strategy embodied in this approach consists of the following elements: (1) continuous monitoring of discrete activities over extended periods of time (hours to months); (2) data collection wherever the patient goes allowing nontest behavior patterns to be studied; and (3) unobtrusive, noninvasive, and ethically acceptable monitoring to minimize observer bias. Although numerous techniques can be used to obtain these kinds of measurements, recent advances in biomedical engineering make a technological approach both inexpensive and feasible for selected activities. In addition, unobtrusive instrumentation can help generate objective, quantitative information concerning actual patient behavior which provides a previously unavailable data base for evaluating individual patient progress, assessing program effectiveness and developing more relevant outcome measures. Two examples of studies which utilize longitudinal unobtrusive measurements are described and preliminary results are presented.

Activities of Daily Living↗
PubMed1976

Human sexuality: an interdisciplinary program for health care professionals and the physically disabled.

The central feature of a program in human sexuality for health care professionals and persons with physical disabilities developed at the Texas Institute for Rehabilitation and Research (TIRR) is a 2 1/2-day Sexual Attitude Reassessment (SAR) Workshop. Although the content of this Workshop has many features in common with ones used elsewhere, its organization, financing, and development are relatively unique. Based in a small, specialty hospital in the South, it is a low-budget, largely self-supporting program run by an extradepartmental, multidisciplinary staff. Evaluations of 12 workshops involving over 500 disabled and ablebodied participants are compared with similar data reported in the literature along with information (before and after the workshop) concerning the participants' attitudes, behavior, and satisfaction regarding various sexual activities. There were programmatic, institutional, and community problems unique to developing this program, but it has unusual potential for personal and staff development, intrainstitutional team building and broader community service.

Attitude of Health Personnel↗
PubMed1976

Team care in chronic illness: a critical review of the literature of the past 25 years.

Accumulated literature over the past 25 years about the team approach to chronic disease can be divided into three broad categories: (1) the opinion base which reflects statements of belief and faith, (2) the descriptive base which contains details and personal testimony of programs using team concepts and (3) the study base which includes serious research efforts to investigate the effectiveness of team care in various settings. An analysis of the articles in the last category provides a useful insight into the problems and possibilities associated with this neglected area of health care research. The populations studied include patients with heart disease, hypertension, stroke, hip fracture, rheumatoid arthritis, diabetes and groups referred for comprehensive rehabilitation. The majority of the studies demonstrated improved outcomes in one or more areas for patients receiving coordinated team care when compared with control groups. Although these studies serve as a useful guide, the extent to which the findings can be generalized is open to serious question. In the absence of additional research, team care will remain as it is today, largely a matter of faith and the subject of many platitudes. An outline is proposed of the major methodological features which should be considered in the planning and/or evaluation of future studies in this area.

Chronic Disease↗
PubMed1975

Bone metabolism in quadriplegia: dissociation between calciuria and hydroxyprolinuria.

Relationships between duration of paralysis, recumbency, muscular activity, and urinary loss of calcium (Cau), phosphorus (Pu), and hydroxyproline (OHPu) were studied daily in 32 traumatic quadriplegic patients during comprehensive rehabilitation and randomly in those readmitted for treatment. Within days after onset, quadriplegic patients had increases in Pu, then OHPu, and finally, Cau. Patients actively engaged in rehabilitation exercises showed a steady fall in OHPu, whereas CAU remained high for up to 18 months. Patients paralyzed for over 18 months (late) had low Cau, Pu and OHPu; but if the patients were kept in bed, OHPu increased rapidly. Patients with early quadriplegia have an increased bone remodeling, suggesting that the excess OHPu and Cau are derived from resorbed bone. Patients with late quadriplegia have little bone remodeling, therefore the excess OHPu occurring during recumbency may be derived from the resorption of new collagen produced during the removal of weight bearing without further change in muscular activity. Resorbed new collagen is excreted in part as large, OHP-containing polypeptides; these were found in the urine of quadriplegic patients, and therefore were present in blood and may play a role in initiating ectopic bone and renal calculi. The presence of OHP in 11 bladder calculi from quadriplegic patients tends to support this hypothesis. These studies indicate that muscular activity and weight bearing influence the bone metabolism of quadriplegic patients and suggest that the presence in body fluids of increased catabolic products from bone may have a role in bone-related complications.

Adolescent↗
PubMedDate not supplied

Nonparalytic polio and postpolio syndrome.

We describe four cases of postpolio syndrome with typical histories, physical examination results, and electrodiagnostic evidence of extensive anterior horn cell disease, as well as the putative pathophysiology of postpolio syndrome in persons with histories of nonparalytic polio and the diagnostic implications for individuals older than 40 yr of age who are experiencing unexplained new weakness, fatigue, and muscle or joint pain. Although the diagnosis of postpolio syndrome traditionally has required a remote history of paralytic polio, many persons such as the ones described here with typical symptoms of postpolio syndrome have no clear history of paralytic disease and are being misdiagnosed. With this in mind, we believe that the diagnostic criteria for postpolio syndrome should be modified to include the following: a history of remote paralytic polio or findings on history, physical examination results, and laboratory studies compatible with poliovirus damage of the central nervous system earlier in life.

Adult↗