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Biomedical subjects

P Hardcastle

Publications and source records attributed to P Hardcastle.

14 recordsLinked to original sources
PubMed1994

The effects of warming by active and passive means on the subsequent responses to cold water immersion.

Two experiments were undertaken to investigate the effects of warming the body upon the responses during a subsequent cold water immersion (CWI). In both experiments the subjects, wearing swimming costumes, undertook two 45-min CWIs in water at 15 degrees C. In experiment 1, 12 subjects exercised on a cycle ergometer until their rectal temperatures (Tre) rose by an average of 0.73 degree C. They were then immediately immersed in the cold water. Before their other CWI they rested seated on a cycle ergometer (control condition). In experiment 2, 16 different subjects were immersed in a hot bath (40 degrees C) until their Tre rose by an average of 0.9 degrees; they were then immediately immersed in the cold water. Before their other CWI they were immersed in thermoneutral water (35 degrees C; control condition). Heart rate in both experiments and respiratory frequency in experiment 1 were significantly (P < 0.05) higher during the first 30 s of CWI following active warming. In experiment 1, the rate of fall of Tre during the final 15 min of CWI was significantly (P < 0.01) faster when CWI followed active warming (2.46 degrees C.h-1) compared with the control condition (1.68 degrees C.h-1). However, this rate was observed when absolute Tre was still above that seen in the control CWIs. It is possible, therefore, that if longer CWIs had been undertaken, the two temperature curves may have converged and thereafter fallen at similar rates; this was the case with the aural temperature (Tau) seen in experiment 1 and the Tau and Tre in experiment 2. It is concluded that pre-warming is neither beneficial nor detrimental to survival prospects during a subsequent CWI.

Adult↗
PubMed1994

Comparison of magnetic resonance imaging and computed tomographic discography in the assessment of lumbar disc degeneration.

Eighteen patients with chronic low back pain were studied with magnetic resonance imaging (MRI) and computed tomographic (CT) discography. Each study was classified as being normal, showing early disc degenerative changes including annular tear, showing established disc degeneration or disc herniation. There was comparable information in over 90% of the MRI studies when compared to CT discography, without reliance on pain provocation or carrying out an invasive procedure. The axial and sagittal T1 weighted images were used to exclude other causes of pain, such as foraminal stenosis and disc herniation. The mid-sagittal T2 weighted image used in this study was considered to be, in part, responsible for the underestimation of disc degeneration because it did not allow visualization of the lateral aspects of the discs.

Humans↗
PubMed1992

A physical approach to the rehabilitation of patients disabled by chronic low back pain.

OBJECTIVE: To report the outcome of a multidisciplinary physically based program to treat sufferers of chronic low back pain who had not responded to previous treatment. DESIGN: Prospective intervention study. SETTING: The treatment program was conducted at the private practice of Brian C Edwards and Associates Rehabilitation Centre. PATIENTS: A total of 54 patients participated in the treatment program. All patients were medically referred. No specific exclusion criteria were used; however, all were not working and had not responded to previous treatment. INTERVENTION: The rehabilitation program consisted of mobilising physiotherapy, isokinetic testing, physical reconditioning, work hardening and psychological testing. This was carried out for seven hours a day, five days a week for four weeks. RESULTS: Of the 54 patients taking part in this trial 30 (55%) were successfully rehabilitated (returned to work) and remained so at a follow-up session one year later. CONCLUSION: While selection criteria for successful rehabilitation have not been established, the results do indicate that such physical rehabilitation programs have an important part to play in the rehabilitation of sufferers of chronic low back pain.

Adult↗
PubMed1992

Spinal abnormalities in young fast bowlers.

The action of fast bowling in the game of cricket is known to cause injuries to the lumbar spine. We studied a group of 16- to 18-year-old fast bowlers, selected for special training in Western Australia. All 24 had MR scans of the spine, 22 had radiographs and CT scans; in 20 the bowling technique was analysed biomechanically. There was a high incidence of back pain and this was always associated with a radiological abnormality. Pars interarticularis defects were diagnosed in 54% and intervertebral disc degeneration in 63%. Bowling actions which involved counter-rotation were associated with a higher incidence of both injuries.

Adolescent↗
PubMed1992

Lower spinal mobility and external immobilization in the normal and pathologic condition.

The study presented here used lateral flexion and extension roentgenograms to determine lumbosacral motion in healthy persons and in patients with spondylolisthesis. The lumbosacral corset, Jewett extension brace, and plastic thoracolumbosacral orthosis (TLSO) were then placed and repeat roentgenograms were done to see if effective immobilization could be obtained. Although individual variation existed, there appeared to be no significant difference in lower lumbar motion between the two groups studied, and the orthotics acted in a similar fashion on both the volunteers and the patients. The lumbosacral corset was unable to immobilize the L3-S1 levels. There was a statistically significant decrease in the average lateral disk space motion at L3-4 and L4-5 with the use of the Jewett brace and the TLSO (P less than .01); however, the motion was never completely eliminated. No brace could adequately immobilize the L5-S1 level, and some people demonstrated increased motion at this level while wearing the orthotics.

Adolescent↗
PubMed1991

Lumbar pain in fast bowlers.

Lumbar pain is common among cricket's fast bowlers, leading to premature retirement. The cause of a high incidence of back problems lies in the repetitive spinal movements necessary in the art of fast bowling. This combines repetitive lateral flexion, thoraco-dorsal rotation, spinal flexion and compression. The causes are basically too much bowling by young players with relatively immature pars interarticularis, poor physical fitness and a poor bowling action.

Athletic Injuries↗
PubMed1987

Long-term results of conservative and operative management in complete paraplegics with spinal cord injuries between T10 and L2 with respect to function.

This study analyzed 87 athletes attending the Para Olympic Games at Stoke Mandeville in 1984. All athletes had had complete neurologic lesions between the levels of T10 adn L2. Clinical details were obtained from each athlete. Assessment then consisted of measurement of spinal movement in the sagittal plane using spondylometers and movement in the rotation plane using a rotameter. Body trunk strength was measured with the athletes in their own wheelchairs using a myometer. This gave a recording of kilograms of force. Trunk balance was assessed on both a static and a dynamic basis. The age, sex, follow-up period, and body weight for both spinal fusion and conservatively treated groups were similar. There was little difference in the incidence of pain between those treated by conservative and operative methods. There was statistically significant difference in the range of sagittal plane and rotation movement. There was no difference in flexor trunk power measured with the myometer between the two groups, but when extensor power was measured it was found to be 25% less in the spinal fusion group. There was no difference between the two groups when tested for static and dynamic trunk balance. Two other athletes who had had spinal fusions extending from the upper thoracic region to the sacrum showed unusually poor trunk stability. Overall, this study demonstrates that spinal fusion, particularly over multiple segments in complete paraplegics, has a deleterious effect not only on spinal movement but also on body trunk strength.

Adolescent↗
PubMed1986

Hereditary bone dysplasia with malignant change. Report of three families.

In this paper three families are reported with members who had hereditary bone dysplasia that was originally described by Arnold in one family. We provide further information about that family and suggest that the diagnosis of the malignant change should be changed from fibrosarcoma to malignant fibrous histiocytoma. A thorough search of the literature has failed to reveal any conditions, either hereditary or acquired, that are similar. The major feature of the dysplasia is diaphyseal medullary stenosis of bone with overlying cortical-bone thickening, and the propensity to malignant transformation and fractures with minimum trauma is emphasized. The tumors in seven, and possibly eight, of the nine patients in whom a malignant lesion developed were originally classified as fibrosarcoma and proved to be markedly aggressive. The hereditary pattern appears to be autosomal dominant. The clinical manifestations of a malignant lesion occur generally in the second to the fifth decades of life.

Adolescent↗
PubMed1985

Near-total laryngectomy with myo-mucosal valved neoglottis.

The entire larynx is usually sacrificed in the process of surgical treatment of T3 glottic carcinoma, trans-glottic carcinoma and pyriform sinus carcinoma, with consequent loss of speech. Most of the uninvolved, cancer-free part of the larynx is discarded for no good reason. According to the surgical principles of oncology, a tumour should be removed with clear margins, but this does not necessarily mean that the whole organ has to be extirpated. In a recently applied surgical procedure, the small tumour-free part of the larynx is fashioned into an innervated myo-mucosal valved shunt joining trachea and pharynx. This neoglottis allows expiration into the pharynx in speech production but it also contracts during swallowing to avoid aspiration. The first four consecutive cases in which this procedure has been carried out with complete success are presented.

Carcinoma, Squamous Cell↗
PubMed1985

The significance of the Trendelenburg test.

Trendelenburg's test of function of the hip joint was first reported before radiology was available. At least four methods of performing it have since been described in the literature. We examined 50 normal subjects and 103 people with disorders affecting either the spine or the hip, in order to determine the different responses that occurred when they were asked to stand on one leg. This has enabled us to define a standard method of performing the Trendelenburg test, and to interpret the test as a method of assessing hip abductor function. The major pitfalls that result in misinterpretation, or false-positive responses, are pain, lack of cooperation from the patient, and impingement between the rib cage and the iliac crest. False-negative responses result from the patient using muscles above and below the pelvis, and from leaning beyond the hip on the standing side.

Adolescent↗
PubMed1984

Acute rupture of the lateral ligament of the ankle. To suture or not to suture?

One hundred patients with acute ruptures of the lateral ligaments of the ankle were randomly allocated either to conservative treatment in a plaster cast or to operative repair. With the aid of stress tenography, the extent of the injury was established. There were 30 patients with isolated anterior talofibular ruptures and 20 with additional calcaneofibular ligament ruptures in each treatment group. Operative repair was associated with a higher incidence of complications in the first weeks, and slightly delayed the patients' return to work. At an independent two-year review there was no evidence that operative repair offered improved symptomatic or functional benefit.

Adolescent↗