Biomedical subjects

N D Cobble

Publications and source records attributed to N D Cobble.

5 recordsLinked to original sources

PubMed1992

Baclofen effect on quadriceps strength in multiple sclerosis.

Weakness has been reported by patients as one side effect of baclofen. We evaluated torque production as a measure of contractile strength in 30 subjects with clinically definite multiple sclerosis. Participants, with minimal to moderate spasticity, were titrated onto baclofen by 5mg increments every other day for seven days and maintained at 20mg for one week. Using a KinCom isokinetic unit set at 60 degrees per second, subjects performed maximal concentric quadriceps contractions; three consecutive trials were recorded. Results indicated no significant difference in maximum torque production between sessions. Although torque values remained unchanged, the angle at which peak torque production occurred moved closer to normal values. Subjective reports of weakness do not appear related to physiologic properties of contraction, but may be a subjective interpretation that less stiffness is weakness because of less resistance to muscle contraction.

Activities of Daily Living↗

PubMed1991

Evaluation of treatment protocols on minimal to moderate spasticity in multiple sclerosis.

Thirty men and women diagnosed with definite multiple sclerosis (MS) were treated for ten weeks in a blinded, cross-over study. Patients with minimal to moderate spasticity were randomized to one of three sequences to evaluate the effects on MS-related spasticity of baclofen alone, stretching regimen with placebo, placebo alone, and stretching regimen with baclofen. The Cybex II isokinetic unit, timed gait, Ashworth scale, and subject's assessment of function were objective and subjective measures used to evaluate changes in hypertonicity. There was significant correlation between the Cybex and Ashworth as methods of measuring spasticity. Overall, treatment with baclofen alone significantly improved moderate quadriceps spasticity as measured by Cybex flexion scores. A trend, indicative of enhancing the beneficial effects of baclofen, was noted when stretching exercises were added to the treatment.

Adult↗

PubMed1991

Rehabilitation in brain disorders. 2. Clinical manifestations and medical issues.

This self-directed learning module highlights advances in clinical manifestations of brain disorders. It is part of the chapter on rehabilitation in brain disorders for the Self-Directed Medical Knowledge Program Study Guide for practitioners and trainees in physical medicine and rehabilitation. This chapter is composed of four articles, and each builds on principles established in the others. This article covers medical complications, neurobehavioral aspects, and cognitive deficits seen in patients with brain disorders, specifically seizures, hydrocephalus, heterotopic ossification, and cardiovascular/pulmonary, neuroendocrine, gastrointestinal, genitourinary, communication, motoric, and visual/spatial/sensory disorders. Advances that are covered in this section are neuroendocrine complications, seizure prophylaxis, and coma treatment. The learner is directed to articles 1, 3, and 4 in this chapter for supporting information.

Brain Diseases↗

PubMed1991

Rehabilitation in brain disorders. 3. Intervention strategies.

This self-directed learning module highlights advances in the principles of management of brain disorders. It is part of the chapter on rehabilitation in brain disorders for the Self-Directed Medical Knowledge Program Study Guide for practitioners and trainees in physical medicine and rehabilitation. The chapter is composed of four articles, and each builds on principles established in the others. This article covers rehabilitation philosophy, management of cognitive remediation, and behavioral management, with attention to communication disorders, social factors, vocational/educational/avocational issues, treatment of motor deficits, dysphagia, sensory dysfunction, sexual dysfunction, and substance abuse. Advances that are covered in this section include pharmacologic and rehabilitative interventions for acute, chronic, and progressive brain injuries and diseases. The learner is directed to articles 1, 2, and 4 in this chapter for supporting information.

Brain Diseases↗

PubMed1991

Rehabilitation in brain disorders. 4. Specific disorders.

This self-directed learning module highlights important aspects of medical rehabilitation of patients with brain disorders. The specific disorders reviewed in this module are traumatic brain injury, stroke, multiple sclerosis, Parkinson's disease, and other degenerative disorders. This module is a section of the chapter on rehabilitation of brain disorders for the Self-Directed Medical Knowledge Program Study Guide for practitioners and trainees in physical medicine and rehabilitation. The chapter is composed of four articles, and each builds on principles established in the others. Emphasis is given in this section on key elements of current medical practice, including epidemiology, pathophysiology, prognosis, and outcome. Neurologic assessment and management is highlighted for coma, amnesia, cranial nerve and late intracranial complications, postacute management, and postconcussive syndromes. The learner is directed to articles 1, 2, and 3 in this chapter for supporting information.

Brain Diseases↗