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Biomedical subjects

M Peat

Publications and source records attributed to M Peat.

At least 19 recordsLinked to original sources
PubMed2000

Audit of bloodborne virus infections in injecting drug users in general practice.

Two hundred and ninety patients attending a single general practice in Edinburgh were known to have used illegal drugs, 145 of whom were identified as past or present injectors. Data on bloodborne virus infections and immunisation against hepatitis B virus (HBV) were gathered during 1998, attempts were made to improve the level of testing for bloodborne viruses and immunisation against HBV, and follow up was carried out between October 1999 and February 2000. One hundred and fifteen patients were studied in detail. Evidence of previous HBV infection was found in 31 of 71 tested in 1998 (44%) and 40 of 99 tested at follow up (40%). In 1998 54 out of the 75 tested for hepatitis C antibodies (72%) were positive compared with 73 out of 108 (68%) at follow up. Twenty-six of the 80 tested for HIV antibodies were positive in 1998 (33%) and 26 of 105 at follow up (25%). Large numbers of injecting drug users in our study were found to be not immune to hepatitis B and required immunisation. An abbreviated protocol for immunisation was devised, including post vaccination checks and boosting as necessary. Hepatitis C testing was requested after counselling in most cases, resulting in important and positive interventions. Prevention opportunities for all three bloodborne viruses were identified.

Blood-Borne Pathogens↗
PubMed1997

Attitudes and access: advancing the rights of people with disabilities.

Barriers to movement and communication in the physical environment prevent people with disabilities from enjoying the same rights, privileges and opportunities as other members of society. The guidelines presented by Drs. Karen E. Jones and Itamar E. Tamari in this issue (page 647) remind us that access to physicians' offices is one area in which improvement is greatly needed. But, as Jones and Tamari acknowledge, accessibility involves more than the removal of physical barriers. The greatest obstacles faced by disabled people are often attitudinal ones. Programs that place responsibility for rehabilitation and integration within the community can foster a better understanding of the issues. Family physicians and other professionals must work with communities to change the attitudes, beliefs and behaviours of policy-makers and the public. Until significant progress is made on this front, problems of access that serve to marginalize people with disabilities will persist.

Architectural Accessibility↗
PubMed1995

Inter-rater reliability of a paediatric outcome measure in Nepal.

The Hospital and Rehabilitation Centre for Disabled Children (HRDC) in Nepal identified the need to evaluate their in-hospital and community programmes. An instrument was developed to provide information regarding the functional level of the children treated by the HRDC as well as to provide information regarding care-givers' attitudes towards disability. Inter-rater reliability of the measure was tested in three regions of Nepal with 49 children. Six HRDC field workers travelled in pairs to the childrens' homes and alternated in roles as test administrator and observer. Correlations between the scores documented by the administrator and observer were used to estimate inter-rater reliability. Inter-rater reliability coefficients, calculated using a weighted kappa statistic, varied from 0.60 to 1.0. We conclude that the instrument demonstrated an acceptable level of inter-rater reliability in the field setting. Future studies to measure construct and concurrent validity, test-retest reliability and responsiveness of the instrument are recommended as well as testing the instrument in different cultures.

Activities of Daily Living↗
PubMed1993

Functional anatomy of the shoulder complex.

Recent research findings are incorporated in this review of the functional anatomy of the shoulder complex. The scapulothoracic mechanism is described, including a review of scapular motion and the structure and function of the sternoclavicular and acromioclavicular joints. New information regarding the resting position of the scapula on the thorax and the effect of aging and spinal posture on position has been presented. In the second part of the paper, the anatomy of the glenohumeral joint is reviewed, with emphasis on the articular, periarticular, and muscular mechanisms responsible for stability of this articulation. The article concludes with a discussion of the integrated function of the scapulothoracic and glenohumeral articulations in upper extremity elevation.

Acromioclavicular Joint↗
PubMed1989

Short-term methotrexate administration by low-dose infusion--does it influence clearance of psoriasis?

Twenty-four patients between them received 86 low-dose methotrexate infusions (given over 36 or 48 h) delivered by a Graseby syringe pump in addition to conventional topical therapy during hospital admission for treatment of severe psoriasis (either erythrodermic or severe widespread plaque-type). The average length of hospital stay, usually the time taken to achieve complete clearance, and the average relapse time in the group of patients overall showed no differences from a control group of 25 patients (matched for age and sex) having a similar severity of psoriasis treated without methotrexate. However, separation of the patients into three sub-groups (erythrodermic, severe and 'unstable' widespread plaque-type, and severe and 'stable' widespread plaque-type disease) revealed that erythrodermic patients, as expected, cleared significantly quicker when receiving methotrexate although severe and 'unstable' widespread plaque-type patients had their clearance times possibly prolonged by short-term methotrexate administration. Although methotrexate is commonly used for long-term management of patients with severe psoriasis, short-term methotrexate administered in this manner cannot necessarily be recommended for severe widespread plaque-type disease. Measurement of methotrexate levels in a further 24 patients with severe psoriasis receiving 47 low-dose infusions revealed relatively constant and predictable methotrexate concentrations. Acute side-effects of methotrexate given by the infusion method were minor and uncommon, the infusion being well tolerated by patients. However, the low-dose infusion technique did not, apparently, offer any advantage over conventional methotrexate administration.

Adult↗
PubMed1986

Functional anatomy of the shoulder complex.

The shoulder complex, together with other joint and muscle mechanisms of the upper limb, primarily is concerned with the ability to place and control the position of the hand in the visual work space in front of the body. The shoulder mechanism provides the upper limb with a range of motion exceeding that of any other joint mechanism. The placement of the hand is determined by four components of the shoulder complex: the glenohumeral, acromioclavicular, and sternoclavicular joints and the scapulothoracic gliding mechanism. The clavicular joints permit the scapula to move against the chest wall during movements of the arm, allowing the glenoid fossa to follow the head of the humerus, and thus contribute significantly to total arm movement. The functional interrelationships between the glenohumeral, scapulothoracic, and clavicular joint mechanisms are critical in providing a full, functional ROM. Any pathological condition of any one of these mechanisms will disturb upper limb function. The ligamentous and periarticular structures of the shoulder complex combine in maintaining the joint relationships, withstanding the forces applied to the joint surfaces, and stabilizing the dependent limb.

Acromioclavicular Joint↗
PubMed1986

Below-knee amputation: a comparison of the effect of the SACH foot and single axis foot on electromyographic patterns during locomotion.

The purpose of this investigation was to measure the effect of two terminal prosthetic components, the SACH foot and the single axis foot, on the locomotion patterns of unilateral below-knee amputees. The ten subjects who participated in the study were evaluated on two occasions, once following prescription of a PTB prosthesis and one terminal device and once following its replacement with the second device. The two devices were allocated alternately at the time of prosthetic prescription to ensure that five of the subjects used the SACH foot initially and five used the single axis foot. The electromyographic activity of the vastus lateralis and medial hamstrings was recorded bilaterally during gait using Beckman surface electrodes. The EMG signals were full wave rectified and low pass filtered to obtain the linear envelope. Pressure sensitive foot-switches were used to correlate the EMG signals with components of the gait cycle. The pattern of quadriceps and hamstring muscle activity of the contralateral limb was similar to that reported for normal individuals and was unaffected by changing the terminal device on the prosthetic limb. The pattern of quadriceps and hamstring activity of the prosthetic limb differed from that of the contralateral limb and was influenced by the change in terminal device. With both devices the muscles were active for a greater percentage of the stance phase when compared to the contralateral limb. With the SACH foot attachment there appeared to be more contraction of the quadriceps and hamstrings during the mid stance phase of gait.

Adult↗
PubMed1986

The effects of immobilization on the ultrastructure and mechanical properties of the medial collateral ligament of rats.

Rat medial collateral ligaments from one group of animals were tensile tested following immobilization. Ligaments from a second group of animals were examined using transmission electron microscopy to determine collagen fibril cross-sectional area and density. Immobilized and contralateral control ligaments were compared to determine the effect of immobilization on these parameters. There was a significant decrease in the linear stress, maximum stress, and stiffness of immobilized ligaments. There was no significant difference in the strain values reported. There was a significant decrease in the proportion of smaller, cross-sectional area fibrils (0-10,000 nm2) following immobilization. There was also a significant increase in the proportion of larger (30,000-40,000 nm2 and 40,000-50,000 nm2) fibrils following immobilization. This finding was attributed to a decreased synthesis and decreased degradation of collagen during immobilization; post-immobilization, the density of collagen fibrils in the ligament decreased. There may be a relationship between ultrastructural and mechanical alterations following immobilization. Significant clinical implications are apparent in the altered mechanical properties following immobilization.

Animals↗
PubMed1983

The normal peak of electromyographic activity of the quadriceps femoris muscle in the stair cycle.

The quadriceps femoris muscles of 18 subjects with no history of knee joint pathology were analysed climbing stairs. Temporal data was obtained from bilateral contact closing footswitches. Knee joint data was measured using a specially constructed flexible linkage-bar electrogonimeter. Electromyographic activity was obtained from bipolar Beckman surface electrodes placed on four components of the quadriceps femoris, vastus medialis oblique, vastus medialis longus, vastus lateralis and rectus femoris. Results showed that within the stair cycle, stance occupied 60% and swing 40%. Cadence values were greater during descending than ascending stairs. Joint angle data demonstrated 2 changes in direction of the angular motion of the knee joint in both ascending and descending. Electromyographic analysis identified a peak of EMG activity for each component of the quadriceps femoris in both ascending and descending stairs. Results identified the location of peak EMG activity at specific knee joint angles. The quadriceps components also demonstrated a regular sequence of recruitment. EMG amplitude levels obtained were higher in ascending than descending stairs. The results have clinical implications in the design of lower extremity prostheses and in the application of functional electrical stimulation.

Adult↗
PubMed1981

Influence of resistance, speed of movement, and forearm position on recruitment of the elbow flexors.

In this experiment, it was found that the maximum recruitment of the elbow flexors, with the exception of Pronator Teres, was greater with the forearm in the supinated position. Increases in the resistance and the speed of movement placed greater demands on all muscles. This was reflected by the increased EMG levels. These findings have clinical implications in the rehabilitation of the elbow flexors following musculo-skeletal or neurological pathology. It is suggested that a program of strengthening of the elbow flexors should include activities in the supinated position. This position places the greatest demand on the major elbow flexors. Additional demands can be made by alteration in the resistance and speed of movement.

Adolescent↗
PubMed1976

Electromyographic temporal analysis of gait: normal human locomotion.

The telemetered electromyographic (EMG) activity of pretibial muscles (tibialis anterior), triceps surae (lateral gastrocnemius), medial hamstring group and quadriceps (vastus lateralis) of 20 normal subjects was examined during locomotion. The ages of the subjects ranged from 8 to 72 years (mean, 37 years). A microswitch shoe was used to correlate the EMG activity with eight specific components of the gait cycle. Tibialis anterior showed two peaks of activity, the first at the swing-stance transition, the second at the stance-swing transition. Gastrocnemius showed a single peak of activity recorded during push-off. The medial hamstring showed its greatest activity during deceleration in the swing phase. Vastus lateralis demonstrated peak activity at the transition from swing to stance. The mean cadence was 106 steps per minute. Swing phase occupied 39.6% and stance phase 60.4% of the gait cycle.

Adolescent↗
PubMed1976

Electromyographic temporal analysis of gait: hemiplegic locomotion.

The telemetered electromyographic (EMG) activity of quadriceps, hamstrings, triceps surae and pretibial muscles on the affected side of 20 adult hemiplegic subjects was examined during locomotion. The subjects ranged in age from 29 to 68 years (mean, 52.1). Duration of the lesions ranged from 1 month to 8 years: in 11 subjects the duration of the lesions ranged from 1 to 9 months (mean, 4.9 months), and in the remaining 9 subjects from 1 to 8 years (mean, 4 years 2 months). Shoes with five microswitches, two in the heel and three in the sole, were used to correlate the EMG activity with eight specific components of the gait cycle. The results of the study showed a loss of the phasic pattern associated with normal locomotion. The hemiplegic subjects showed the greatest activity in the period of midstance. Expressed as a percentage of the total cycle, the mean stance time of the paretic lower limb was 67% and the mean swing time was 33%. The unaffected lower limb showed a stance phase of 80% and a swing phase of 20%.

Adult↗
PubMedDate not supplied

Electromyography in voluntary posterior instability of the shoulder.

Electromyographic (EMG) activity of selected shoulder girdle muscles was analyzed during voluntary posterior subluxation of the glenohumeral joint in four subjects. Although there was a great deal of variation in the muscle activation patterns during subluxation, subjects either pushed the humeral head backwards with the anterior muscles (deltoid, biceps) or pulled the humeral head backwards with the infraspinatus and/or posterior deltoid. In all cases, inhibition of the scapular rotators and winging of the scapula accompanied this maneuver. The method used in this study is presented as an objective technique for quantifying EMG activity during subluxation and relocation phases of shoulder instability.

Adolescent↗
PubMedDate not supplied

Measurement systems in physical therapy.

Many physical therapists lack an understanding of the prociples and applications of objective measurement methods in the clinical environment. This paper presents a working definition of the parameters of motor performance (analyzed in terms of outcome or process) as well as an explanation of measurement systems, particularly those related to measurements of position and motion (goniometers and photography), force (dynamometers and force gauges), and muscle activity (electromyography).

Documentation↗