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Biomedical subjects

N J Zimny

Publications and source records attributed to N J Zimny.

7 recordsLinked to original sources
PubMed2000

Effects of ultrasound and stretch on knee ligament extensibility.

STUDY DESIGN: Randomized, double-blind pre-test and post-test with repeated measures. OBJECTIVE: To determine whether heating with continuous wattage ultrasound (CWUS) augmented the effects of stretching on ligament extensibility in nonimpaired human subjects. BACKGROUND: Heating with CWUS, combined with static stretching, is often used to treat ligament "tightness," but "heat and stretch" has not been studied well in vivo. METHODS AND MEASURES: Twenty-one nonimpaired women subjects (aged 31.5 +/- 11.0 years) underwent serial measurements of knee joint displacement (valgus and varus) on a Genucom arthrometer before and after valgus stretch (10 ft-lb x 2.5 minutes). Subjects received either simultaneous CWUS (3 MHz, 1.25 W/cm2) or sham CWUS applied over the medial collateral ligament. Five trials (2 before, 3 after treatment) were conducted with the right knee positioned in 20 degrees of flexion. Subjects received the alternate treatment 28 days later. For each subject, all testing was performed by the same investigator. RESULTS: Repeated measures ANOVA revealed that stretching, combined with sham CWUS, increased mean valgus displacement from 8.95 degrees (+/-1.72 degrees) to 10.00 degrees (+/-2.10 degrees). Stretching, combined with CWUS, increased mean valgus displacement from 9.24 degrees (+/-2.36 degrees) to 10.48 degrees (+/-2.54 degrees). This was a 13.4% change from the control condition. CONCLUSION: Heating with CWUS did not augment the effects of stretching. "Heat and stretch" with CWUS may not be more effective than stretching alone for increasing the extensibility of dense connective tissue.

Adolescent↗
PubMed1998

Clinical reasoning in the evaluation and management of undiagnosed chronic hip pain in a young adult.

This case report describes the clinical reasoning used to manage chronic left hip pain in a 21-year-old woman who was recreationally active. The patient had a history of possible congenital hip dysplasia (CHD) and known recurrent lateral (external) patellar subluxations on the left side. She complained of experiencing hip pain when walking, sitting, playing soccer, and doing "step aerobics." Hip range of motion (ROM), muscle force, and joint stability problems were assessed. Abnormal movement patterns were observed during gait and step aerobics. Intervention was based on the working hypothesis that periarticular stiffness and muscle weakness from earlier trauma were superimposed on joint instability from CHD. Following intervention, the patient's hip ROM and muscle force improved concurrently with reduction of hip pain, increased ability to participate in recreational activities, and improvement in the movement pattern during step aerobics. An eclectic approach to analysis of the problem was used, combining data unique to the patient with knowledge of CHD and concepts proposed by Cyriax, Maitland, Sahrmann, and others. The clinical reasoning used to establish a basis for treatment and its limitations are discussed.

Adult↗
PubMed1993

Development of a computer-assisted method for the collection, organization, and use of patient health history information in physical therapy.

Screening a patient's general health prior to instituting physical therapy management is generally acknowledged as important. However, neither the specific content nor the optimal method of performing this part of patient examination has received much attention. One method that uses a computerized information management system to assemble relevant clinical literature and to guide the collection, organization, and use of patient health history data in clinical decision-making is described. The philosophy and rationale for performance of general health screenings by physical therapists, justification for the use of computers in the screening process, and the development and application of one type of computer-assisted health history screening system for physical therapy are presented.

Decision Making, Computer-Assisted↗
PubMed1992

Making information accessible and useful to practicing clinicians. Problem-knowledge coupling.

Assessments of health care technology will lead to improvements in patient services only if this information is actually used by clinicians. Traditional methods of planning treatment that rely solely on memory limit the clinician's access to and use of the full available body of knowledge in the field. An alternative approach using a computer-assisted methodology is presented as a way to overcome traditional limitations and promote the development and diffusion of knowledge.

Ambulatory Care↗
PubMed1989

Problem-knowledge coupling: a tool for physical therapy clinical practice.

The purposes of this article are 1) to summarize the development, function, and philosophy of the Problem-Knowledge Coupler (PKC), a computerized tool that is designed to aid the clinical decision-making process in medical practice, and 2) to speculate on the value this system has in meeting clinical practice, needs and addressing professional practice issues in physical therapy. The evolution of the PKC system from its origins in the problem-oriented system of medical care is described, and the philosophy of problem-knowledge coupling is contrasted to the basic philosophy of traditional clinical medical practice and never computerized expert decision-support systems. We suggest that problem-knowledge coupling could be a useful tool in physical therapy because it improves the collection and synthesis of patient information and uses the unique nature of individual patient problems coupled with the clinical literature as the bases for clinical practice decisions.

Decision Making, Computer-Assisted↗
PubMed1989

The problem-oriented system, problem-knowledge coupling, and clinical decision making.

The information tool to aid us in making the clinical decisions discussed in this presentation is called the PKC. Our goal with patients should be to couple the knowledge of the unique patient to the knowledge in the literature and get the best possible match. This approach requires combinatorial versus probabilistic thinking. In the real world, ideal matches are not found. Therefore, it is critical to exhaust the patient's uniqueness first and only then use probabilities to settle further uncertainties. It is an error to teach people how to deal with uncertainty instead of teaching them to clean up a great deal of the uncertainty first. Patients must be involved in this endeavor. In essence, they have a PhD in their own uniqueness, and it is this uniqueness that is very powerful in solving complex problems. This method of patient evaluation and management cannot be used with the unaided mind. It requires new and powerful information tools like the PKC. All information that is relevant to a problem should be included in the coupler. It should encompass differing points of view, and the rationale should be made explicit to clinician and patient alike. When complete, the coupler should represent an interdisciplinary compilation of questions and tests that are expected to be collected every time in the clinic for the type of problem the coupler represents. This method will provide a basis for quality control because the contents of the coupler now have defined what we expect to occur in every patient encounter.(ABSTRACT TRUNCATED AT 250 WORDS)

Artificial Intelligence↗