Biomedical subjects

M J Strube

Publications and source records attributed to M J Strube.

At least 19 recordsLinked to original sources

PubMed1998

Hypnotic susceptibility order effects in waking analgesia.

This study reexamined Spanos, Hodgins, Stam, and Gwynn's (1984) contention that susceptibility testing order effects generated a relationship between waking analgesia pain reduction and level of hypnotic responsiveness. Undergraduate volunteers with no previous hypnosis experience were randomly assigned to two groups. Group 1 (n = 69) first received a cold pressor pain protocol, and then was administered the Standford Hypnotic Susceptibility Scale, Form C (SHSS:C). Group 2 (n = 69) was administered the SHSS:C prior to the cold pressor pain protocol. Our findings do not support Spanos, Hodgins et al.'s contention that susceptibility testing order effects generate the often reported relationship between waking analgesia and level of hypnotic responsiveness. We found significant partial correlation coefficients between the SHSS:C and nonhypnotic pain reduction regardless of order of susceptibility testing. Implications regarding the adequacy of design-generated expectancies to explain hypnotic analgesia phenomena were examined.

Adult↗

PubMed1998

The influence of experience with a set of simulated patients on diagnosis of simulated patients not previously diagnosed.

BACKGROUND AND PURPOSE: Diagnoses, to be useful, should be accurate. The purpose of this study using fictitious patients and student judges was to test the theory that diagnostic errors would occur when students saw simulated patients who were similar to previously seen simulated patients. SUBJECTS: Sixty physical therapist (PT) students and 60 non-physical therapist (NPT) students were studied. Subjects were assigned randomly to one of three groups. METHODS: Instructions to the three groups differed in terms of rules provided for diagnoses and instructions to remember the patients. Students first diagnosed the same eight fictitious patients five times. The students then diagnosed eight new patients with similar characteristics interspersed with the original eight patients. Half of the new patients had a diagnosis different from that of the most similar old patient. RESULTS: Students who were given a rule for diagnosis made fewer errors than students who were not given a rule. Students in the PT group took longer but made fewer errors on the critical opposite-diagnosis new cases than did students in the NPT group. CONCLUSION AND DISCUSSION: The results do not provide support for the theory that diagnostic errors would occur when students saw patients who were similar to previously seen patients. Students in the PT group appeared to emphasize accuracy at the expense of speed in making their diagnoses. Given the nature of the simulated patient information and the mode of presentation used in the experiment, however, the conclusion that therapists in actual practice do not make errors because of the similarity between new and previously seen patients is not yet warranted.

Adult↗

PubMed1998

Personal, interpersonal, and organizational influences on student satisfaction with clinical education.

BACKGROUND AND PURPOSE: Understanding the factors that contribute to student satisfaction may lead to improved education in physical therapy. This study tested the extent to which variables in the personal, interpersonal, and organizational domains influence satisfaction with clinical experiences. SUBJECTS: Physical therapist students (N = 113) in 2 phases of their clinical experiences at one private school participated. METHODS: A nonexperimental design tested 3 models for predicting overall satisfaction. Students completed 3 surveys and weekly logs during 8-week-long clinical experiences. RESULTS: The survey return rate was 96%. Overall satisfaction with the clinical experience was predicted by life satisfaction, gender, off-site events, on-site events, interaction between negative events and gender, instructor teaching skills, interaction between education phase and gender, variety, and use of selected orientation methods. CONCLUSION AND DISCUSSION: Overall satisfaction is predicted by variables in all 3 domains. Overall satisfaction was best explained by factors in the interpersonal domain and student gender. Causal research is needed to confirm whether satisfaction can be improved and whether the results apply to other students at other schools. The relationships among satisfaction, performance, later job satisfaction, and career commitment need to be explored further.

Adult↗

PubMed1997

Therapeutic footwear: enhanced function in people with diabetes and transmetatarsal amputation.

OBJECTIVE: Patients with diabetes mellitus (DM) and a transmetatarsal amputation (TMA) have considerable deficits in function compared with age-matched controls. The purpose of this study was to determine if therapeutic footwear could improve the functional mobility of patients with DM and TMA. STUDY DESIGN: Repeated-measures design. SETTING: Academic medical center. PATIENTS: Thirty subjects (10 women, 20 men) with DM and a TMA, with a mean age of 61.7 +/- 4.0 yrs. INTERVENTIONS: Six types of footwear evaluating the following components: length of shoe (full-length or short shoe), a rigid rocker-bottom sole, and an ankle-foot-orthosis. OUTCOME MEASURES: Physical Performance Test (PPT), functional reach, and walking speed. Measurements in each footwear condition occurred after a 1-month adjustment period. RESULTS: Patients wearing full-length custom-made shoes with a total-contact insert, a rigid rocker-bottom sole or a short shoe with a rigid rocker-bottom sole (with or without an ankle-foot-orthosis) had similar and significantly higher scores in the PPT and faster walking speed than when wearing regular shoes with a toe filler (p < .05). The short shoe and the ankle-foot-orthosis, however, generated many patient complaints about cosmesis and restriction at the ankle, respectively. There were no differences in any of the measures of functional reach. CONCLUSION: Although there are individual exceptions, we recommend the full-length shoe, total-contact insert, and a rigid rocker-bottom sole for most patients with DM and a TMA.

Activities of Daily Living↗

PubMed1997

Functional limitations in patients with diabetes and transmetatarsal amputations.

BACKGROUND AND PURPOSE: Reports in the surgical and rehabilitation literature suggest that patients with transmetatarsal amputations (TMAs) function well with regular shoes and a toe filler. Functional limitations, however, have not been documented in this population. The purpose of this study was to compare the function of patients with diabetes mellitus (DM) and TMA with that of age- and gender-matched control subjects. SUBJECTS: Thirty subjects (15 subjects with DM and TMAs and 15 control subjects), with a mean age of 62.3 years (SD = 9.2, range = 43-83), were studied. METHODS: Function was measured using the Functional Reach Test (FRT), the Physical Performance Test (PPT), walking speed for 15.2 m (50 ft), and the Sickness Impact Profile (SIP). Subjects in the TMA-DM group wore standard shoes with a toe filler. RESULTS: The TMA-DM group scored lower (mean +/- standard deviation) than did the control group on all tests (FRT: 19.1 +/- 8.6 vs 31.5 +/- 9.1 cm [7.5 +/- 3.4 vs 12.4 +/- 3.6 in]; PPT: 18.7 +/- 4.8 vs 24.1 +/- 2.2 points [28 points possible]; walking speed: 51.5 +/- 13.2 vs 75.6 +/- 9.3 m/min; SIP: 17.0 +/- 12.7 vs 3.7 +/- 4.7). CONCLUSION AND DISCUSSION: Persons with DM and TMAs have considerable functional limitations. Research is needed to determine whether therapeutic footwear or other forms of rehabilitation can improve their function.

Activities of Daily Living↗

PubMed1997

Therapeutic footwear can reduce plantar pressures in patients with diabetes and transmetatarsal amputation.

OBJECTIVE: To compare how footwear (full-length shoe or short shoe), a total contact insert, a rigid rocker-bottom (RRB) sole, and an ankle-foot orthosis (AFO) affect peak plantar pressure (PPP) on the distal residuum and contralateral extremity of patients with diabetes and transmetatarsal amputation (TMA). RESEARCH DESIGN AND METHODS: Thirty patients with diabetes and TMA participated (mean age 62 +/- 4 years). In-shoe plantar pressures during walking were measured in six types of footwear. Each measurement occurred after a 1-month adjustment period. Repeated measure analysis of variance (ANOVA) was used to compare treatments. RESULTS: All five types of therapeutic footwear reduced plantar pressures compared with regular shoes with a toe-filler (P < 0.05). A full-length shoe, total contact insert, and RRB sole resulted in lower pressures on the distal residuum (222 vs. 284 kPa) and forefoot of the contralateral extremity (197 vs. 239 kPa), compared with a regular shoe and toe-filler. Footwear with an AFO showed reduced PPP on the residuum, but most patients complained of reduced ankle motion during walking. A short shoe reduced pressures on the residuum, but not on the contralateral extremity, and many patients had complaints regarding cosmesis of the shoe. CONCLUSIONS: The full-length shoe, total contact insert, and an RRB sole provided the best pressure reduction for the residuum and contralateral foot, with the optimal compromise for cosmetic acceptance and function.

Adult↗

PubMed1996

Multiple susceptibility testing: is it helpful?

This study explored whether or not the use of combined group and individually administered susceptibility tests improve the predictive power over the use of a singly administered test. Two hundred and eighty undergraduates were assigned to one of five groups: Group 1 received the HGSHS: A and then the SHSS:C; Group 2 the CIS and SHSS:C; Group 3 the HGSHS: A and the SHCS:A; Group 4 received the CIS and the SHCS:A; and Group 5 was tested on the SHSS:C alone. After the susceptibility screening the subjects were hypnotized and tested on four types of target hypnotic behaviors. From the RSPSHS:I&II the following four factors were chosen (1) cognitive distortion, (2) positive hallucination, (3) negative hallucination, (4) dreams and regression. The items were matched on difficulty level. The data were subjected to a series of stepwise multiple regression and logistic regression analyses. The results confirmed previous research; i.e., (1) The SHSS:C is the best single measure, (2) the SHCS:A is a poor substitute for the SHSS:C; (3) the HGSHS:A is not adequate substitute for SHSS:C; (4) the CIS is weak in predictive power compared to the HGSHS:A; (5) Only for a weak measure such as SHCS:A does combined testing produce an advantage; (6) There appear to be no warm-up effects for SHSS:C when preceded by HGSHS:A.

Adolescent↗

PubMed1996

Durability of posthypnotic suggestions: type of suggestion and difficulty level.

This study investigated the impact of Difficulty Level and Type of Suggestion upon the durability of posthypnotic suggestion over an 8-week period. Seventy-eight highly susceptible subjects selected by both the Harvard Group Scale of Hypnotic Susceptibility: Form A (HGSHS:A) and Stanford Hypnotic Scale of Susceptibility: Form C (SHSS:C) were assigned to six groups (two levels of Difficulty x three Types of Suggestion). S's were tested for posthypnotic suggestion at 1, 3, 6, and 8 weeks. A 2 x 3 x 4 (Difficulty x Suggestion x Time) factorial ANOVA was conducted, with Time treated as a repeated-measure. The outcome variable at each time was either pass or fail for relevant suggestion. We found a significant Time effect, a significant Difficulty effect, and a significant Time x Difficulty interaction. Fewer subjects passed the difficult suggestions than passed the easy suggestions; fewer passed suggestions at a latter time; and the decay in pass rate was more pronounced for the easy suggestion condition, due largely to the higher initial pass rate. Type of Suggestion was not significant, nor were any of the other interactions. Clinical implications were discussed.

Adult↗

PubMed1995

Differential effects of hypnotic suggestion on multiple dimensions of pain.

Within the framework of multidimensional pain assessment, this study extended an earlier finding that hypnotic analgesia and relaxation suggestions have differential effects on pain reduction by evaluating these strategies in subjects undergoing a cold pressor protocol. Thirty-two highly susceptible subjects were randomly assigned to an analgesia or a relaxation suggestion treatment group. Six pain reports were taken at 10-sec intervals for each experimental condition. The baseline measures served as covariates. A 2 x 2 x 2 x 6 repeated-measures analysis of covariance (ANCOVA) revealed a significant group (analgesia, relaxation) by pain dimension (intensity, unpleasantness), by condition (suggestion alone, hypnotic induction plus suggestion) interaction. Analysis of the simple-simple main effects, holding both group and condition constant, revealed that application of hypnotic analgesia reduced report of pain intensity significantly more than report of pain unpleasantness. Conversely, hypnotic relaxation reduced pain unpleasantness more than intensity. The clinical implications of the study are discussed.

Female↗

PubMed1995

Hypnotic analgesia, expectancy effects, and choice of design: a reexamination.

Previous research by Stam and Spanos suggests that if waking analgesia is followed by hypnotic analgesia, subjects refrain from maximally responding during the waking trial so they report less pain under hypnosis (i.e., a "holdback effect"). This hypothesis was re-examined using more stringent controls. Thirty-six highly susceptible subjects chosen by a combination of the Harvard Group Scale of Hypnotic Susceptibility, Form A and the Stanford Hypnotic Susceptibility Scale, Form C were randomly assigned to one of three treatment groups (waking analgesia followed by hypnotic analgesia, waking analgesia followed by waking analgesia, or hypnotic analgesia followed by waking analgesia). Each group received three 60-second immersions of cold pressor pain stimulation (baseline, Immersion 1, Immersion 2) and rated pain using a magnitude estimation and a category rating scale. The obtained results failed to support the hypotheses of a holdback effect or a "reverse-order holdback effect." Properties of within-subjects and between-subjects designs were considered in explaining the superiority of hypnotic analgesia over waking analgesia typically found in within-subjects models.

Adult↗

PubMed1995

Relationship of plantar-flexor peak torque and dorsiflexion range of motion to kinetic variables during walking.

BACKGROUND AND PURPOSE: Limited ankle plantar-flexor moments and power during walking have been documented in several patient populations and are believed to contribute to gait deviations. The primary purpose of this study was to determine the relationship of plantar-flexor peak torque (PFPT) and dorsiflexion range of motion (ROM) to peak ankle moments and power during walking in a group of subjects without diabetes mellitus (DM) and in a group of subjects with DM and associated peripheral neuropathies. SUBJECTS: Nineteen subjects, 9 with DM and associated peripheral neuropathies (mean age = 58 years, SD = 14, range = 35-75 years) and 10 without DM (mean age = 57 years, SD = 11, range = 37-68 years), were evaluated. METHODS: The following data were collected on all subjects: PFPT, dorsiflexion ROM, and ankle moments and power during walking (using a two-dimensional link-segment model). Hierarchical multiple regression was used for data analysis. RESULTS: Plantar-flexor peak torque made substantial contributions to the ankle moment (40%) and ankle plantar-flexor power (53%) during walking. There also was a high correlation between PFPT and dorsiflexion ROM (r = .78) and between dorsiflexion ROM and ankle power (r = .72). CONCLUSION AND DISCUSSION: Plantar-flexor peak torque and dorsiflexion ROM are interrelated and appear to be important factors that contribute to ankle plantar-flexor moments and power during walking. This finding suggests that increasing PFPT and dorsiflexion ROM may help decrease gait deviations such as decreased step length and walking speed. When increasing PFPT is not possible, the natural occurrence of limited dorsiflexion ROM may help to maximize ankle moments during walking. Further research is needed to test whether these proposed treatment strategies can have a clinically useful effect. [Mueller MJ, Minor SD, Schaaf JA, et al. Relationship of plantar-flexor peak torque and dorsiflexion range of motion to kinetic variables during walking.

Adult↗

PubMed1994

Differences in the gait characteristics of patients with diabetes and peripheral neuropathy compared with age-matched controls.

BACKGROUND AND PURPOSE: Patients with diabetes and peripheral neuropathy have a high incidence of injuries while walking. Biomechanical analysis of their walking may lead to treatments to reduce these injuries. The purpose of this study was to compare (1) the gait characteristics, (2) the plantar-flexor peak torques, and (3) the ankle range of motion of subjects with diabetes mellitus (DM) and peripheral neuropathy with those of age-matched controls. SUBJECTS: Twenty subjects, 10 with DM and a history of peripheral neuropathy (DM group) (mean age = 58 years, SD = 15, range = 35-75) and 10 subjects without diabetes (NODM group) (mean age = 57 years, SD = 11, range = 37-68), were evaluated. METHODS: The following data were collected on all subjects: ankle joint mobility, plantar-flexor peak torque (ankle strength), kinematics of the trunk and lower extremity during normal walking, and ground reaction forces. Moments and power at the ankle, knee, and hip during walking were calculated using a two-dimensional link-segment model. RESULTS: The DM group subjects showed less ankle mobility, ankle moment, ankle power, velocity, and stride length during walking than the NODM group subjects. A significant decrease in ankle strength and mobility appeared to be the primary factor contributing to the altered walking patterns of the DM group. CONCLUSION AND DISCUSSION: The DM group subjects appeared to pull their legs forward using hip flexor muscles (hip strategy) rather than pushing the legs forward using plantar-flexor muscles (ankle strategy), as seen in the NODM group subjects. Implications for treatment are presented to attempt to reduce the number of injuries during walking in patients with DM and peripheral neuropathy.

Adult↗

PubMed1992

A study of discomfort with electrical stimulation.

The primary purpose of this study was to investigate the influence of personality variables and contractile forces on magnitude estimates of pain unpleasantness and pain intensity during varying levels of neuromuscular electrical stimulation (NMES). Thirty volunteers, according to their scores on a preferred coping-style questionnaire, were assigned to one of two groups, one designated "monitors" (information seekers) and the other designated "blunters" (information avoiders). All subjects were administered varying levels of two types of NMES, one causing both afferent stimulation and muscle contraction and one causing only afferent stimulation. Subjects judged the intensity and unpleasantness of each current type using magnitude estimation. Data were analyzed using a 2 x 2 x 2 x 3 (coping style x current type x pain descriptor x current level) analysis of variance. The results indicated that the rate of increase of magnitude estimates for unpleasantness and pain intensity that corresponded to increases in current were dependent on (1) the preferred coping style of the subject, (2) whether the stimulus caused a muscle contraction, and (3) whether the subject was judging the intensity or the unpleasantness of the applied stimulus. Behavioral styles appear to affect how subjects characterize the discomfort associated with NMES, and involuntary muscle contractions contribute to the discomfort felt from NMES. These results suggest that interventions tailored to a preferred coping style may increase a subject's level of tolerance to NMES and thus provide a more beneficial treatment.

Adaptation, Psychological↗

PubMed1991

Small sample failure of random assignment: a further examination.

The purpose of random assignment is to produce equivalence on nuisance variables across experimental groups, even when the nuisance variables are unmeasured or of uncertain number. The effectiveness of random assignment, however, depends on sample size; as sample size increases, the likelihood of equivalence also increases. This article demonstrates that, although nonequivalence on a nuisance variable may be quite likely for small samples, the probability is quite low that nonequivalence will produce erroneous inferences. In fact, the probability of an erroneous inference in the absence of a true treatment effect is generally no greater than the nominal Type I error rate. Accordingly, it is unlikely that small samples have biased inferences drawn from past psychotherapy outcome research. However, small samples cause other problems that argue against their routine use.

Follow-Up Studies↗

PubMed1991

Durability of "posthypnotic suggestions" as a function of type of suggestion and trance depth.

3 types of "posthypnotic suggestion," based upon factor analytic studies, were administered to high hypnotizable Ss (reals) and to low hypnotizable Ss instructed to simulate hypnosis (simulators) (N = 12 high and 6 low hypnotizable Ss per suggestion). The "posthypnotic suggestions" consisted of instructions given to Ss following a hypnotic induction that, when the posthypnotic cue was later given, they would re-enter the hypnotic state and perform a certain task at that time. Ss were then tested 6 times for durability of "posthypnotic response" during an 8-week period. Responses to the "suggestions" were rated by research assistants (objective scores) and by Ss themselves (subjective scores). There was a significant Trials x Type of "Suggestion" interaction for both types of scores for the reals but not for the simulators, indicating different rates of decline with time for the different "suggestions" for the hypnotic Ss. Depth of reported hypnotic trance during the assessment sessions was found to be strongly related to performance of the "posthypnotic suggestion" for both real and simulating Ss.

Adolescent↗

PubMed1991

Reliability of isokinetic measurements of trunk muscle performance.

The purpose of this investigation was to assess the reliability of isokinetic trunk muscle performance. Sixty-one volunteers participated (29 men, 32 women; age range, 20-60 years). All subjects were without low-back symptoms at the time of testing. All testing was performed with the subject initially standing, using speeds of 60, 120, and 180 degrees per second. Ten repetitions of flexion and extension were performed reciprocally at each speed, with a 3-minute rest period between speeds. Test-retest intervals were 1 and 3 weeks from the initial test. Peak torque-to-body-weight ratios, extension-to-flexion ratios, and average work per repetition were calculated for each speed for flexion and extension. Data were analyzed with analysis of variance, intraclass correlation coefficients, and Pearson correlation coefficients. Intraclass correlation coefficient values ranged from .74 to .88 for measurements derived from peak torque, and from .88-.93 for measurements derived from work (with the exception of .69 for men at 180 degrees/sec). Standard error of measurements ranged from 8 to 32 ft-lb, with a tendency to increase with increasing speeds. It was concluded that, when using this protocol, isokinetic measurements of muscle function offer the clinician sensitive and reliable measurements of trunk muscle performance and that incorporating increased practice with women and longer rest periods with men may further decrease error associated with these isokinetic trunk strength measurements.

Adult↗

PubMed1989

Cardiovascular correlates of type A behavior components during social interaction.

This study examined the cardiovascular (CV) correlates of the primary Type A behavior components during social interactions. Brief dialogues were created to role-play (RP) stereotypic Type A and Type B ways of responding to three common social situations designed to elicit hostility (H), time-urgency (T), and competition (C). Situations and dialogues were validated by independent raters. Thirty undergraduate students were identified as Type A and 30 as Type B, with 15 males and 15 females in each group. Subjects were provided scripts for each of the six experimental RPs and rehearsed them prior to the CV assessment. Measures of systolic and diastolic blood pressure (SBP, DBP) and heart-rate (HR) were obtained during an adaptation period and during each RP. Analyses of the "A" (i.e. H, T, C) versus "B" (i.e. non-H, non-T, non-C) RPs indicated that DBP (p less than 0.03) and HR (p less than 0.002) were higher during the H as compared with non-H RP. Significantly higher SBP was observed in the T as compared with the non-T RP (p less than 0.04). No CV differences were observed in the comparison of the C and non-C RPs. Analyses comparing the three "Type A" RPs revealed higher SBP during H and T RPs, as compared with the C RP (p less than 0.003). Effects of subject Type (i.e. A/B) were not obtained in any analysis. These findings indicate that hostile and time-urgent social interactions are associated with significant increases in CV arousal which are independent of overall Type status.

Adult↗

PubMed1989

Electrical stimulation of quadriceps femoris in an elite weight lifter: a single subject experiment.

The response to treatment of high intensity neuromuscular electrical stimulation (NMES) to both quadriceps femoris muscles as an adjunct to ongoing weight training was evaluated using a single subject experimental design. For an elite weight lifter weekly maximal measurements of snatch (S), clean and jerk (CJ), and front squat (SQ) were obtained over 4 months during which the subject weight trained daily for 3 h. The 1st month, baseline data were collected. After baseline measurements, a 1-month period of high-intensity NMES was added to the subject's weight training. NMES was then withdrawn for 1 month and administered once more for 2 weeks. Three quadriceps femoris muscle biopsies were taken, two during the initial baseline period and one just before the end of the first stimulation period. The results showed a significant and clear relationship between performance gains and NMES administration and withdrawal. Steep gains for S, CJ, and SQ were seen after 2 weeks of stimulation, with front squat showing a 20-kg increase within the 1st week of both stimulation periods. Muscle biopsy showed an increased type I fiber area, decreased type IIa and IIb fiber area, and an increase of type II fibers after NMES. The results of this study support the use of high-dose NMES as an adjunct to weight training in elite lifters.

Adult↗