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Biomedical subjects

Mathew H M Lee

Publications and source records attributed to Mathew H M Lee.

5 recordsLinked to original sources

Rehabilitation outcomes in the older adult.

Numerous studies support the use of rehabilitative interventions in the older adult. Given the many fiscal challenges in health care today, it is of utmost importance that funding for rehabilitation result in fruitful outcomes. Specific rehabilitative interventions have been found to be very effective in the elderly and can be demonstrated through numerous studies. Outcomes for conditions including stroke, traumatic brain injury, spinal cord injury, amputation, hip fracture, and joint replacement are discussed. There is great need for ongoing research to determine optimal rehabilitative interventions in the elderly.

Activities of Daily Living↗

Delivery of rehabilitation services to people aging with a disability.

The disabled elderly population continues to grow. Systems of care for the disabled elderly are vast, ranging from inpatient facilities to outpatient programs and home programs. Recent advances in technology allow us to reach patients in their homes through telemedicine. Support services within the community are growing, and case managers are becoming more necessary as it becomes more difficult to navigate the health care system. As providers of rehabilitative services, we must help our patients find the most appropriate setting to receive care. As the focus continues to shift from inpatient to outpatient care and to home services, we must approach health care in a dynamic fashion and with flexibility. We must be advocates for our patients and their caretakers. Significant research questions remain, and health care policy requires development. As the population ages and the disabled elderly population become a focus of fiscal experts, we must look to provide the most cost-effective yet functionally productive health care. We may shift from focusing on functional performance in a therapy gym or inpatient rehabilitation unit to functional performance at home. We must focus on IADL and QOL indicators and must strive to find ways to provide efficient, cost-effective care. Medicaid, Medicare, and third-party insurers offer various options. The VHA offers additional benefit to those who are eligible. Advocacy groups such as the American Association of Retired Persons struggle to meet its members' needs and concerns while generating income to provide education and other resources. We must work to promote the strengths of the elderly population by addressing preventive strategies while maintaining functional independence.

Aged↗

Pain perception decrement produced through repeated stimulation.

Pain responses (pain detection and pain discomfort) to electrical dental stimulation were studied in 16 normal subjects. The repetition of the dental stimuli induced a significant and long-lasting (60 min) decrease in pain sensitivity at both sensory levels (after 60 min of repetitive stimulation, 79% increase in pain detection, P less than 0.0001, 45% increase in pain discomfort, P less than 0.0004). The sensory response decrement through repeated elicitation was not influenced by naloxone administration (1.2 mg i.m.). This study clearly demonstrates the induction of pain sensory decrease through repetitive stimulation which differs from peripheral sensory receptor adaptation, from the inhibitory gating mechanism or from diffuse inhibitory controls activation; its unresponsiveness to naloxone suggests that this phenomenon is not opioid-dependent. A technique has been standardized which will enable the systematic study of pain decrease under sustained nociceptive stimulation in chronic pain patients.

Double-Blind Method↗

Sympathetic vasomotor changes induced by manual and electrical acupuncture of the Hoku point visualized by thermography.

Considerable evidence implicates sympathetic neural activity in acupuncture analgesia. However, the exact nature of these effects has not been specified in detail, and many experimental findings are contradictory. This study evaluated in normal conditions the specific sympathetic effects of both manual and electrical acupuncture applied to the same hand (Hoku) point. Thermographic measures of superficial skin temperature were used to assess sympathetic vasomotor tone in the face, hand and foot of 19 normal subjects. Baseline assessment, manual acupuncture and electrical acupuncture were performed in 3 separate sessions in a well controlled, 23 degrees C environment. Superficial skin temperature decreased slowly in the control condition. Both manual and electrical acupuncture produced a generalized long-lasting warming effect, indicating reduced sympathetic activity (sympatholytic effect). In addition, electrical acupuncture induced a localized short-term cooling effect, indicating a transient segmental increase in sympathetic activity (sympathomimetic effect).

Acupuncture Therapy↗