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Biomedical subjects

R D Wigley

Publications and source records attributed to R D Wigley.

At least 19 recordsLinked to original sources
PubMed1992

Arthritis community education by leather puppet (wayang kulit) shadow play in rural Indonesia (Java).

As part of the WHO/International League Against Rheumatism (ILAR) sponsored community organized programme for the control of rheumatic disease (COPCORD), an arthritis community education programme (ACE) was undertaken utilizing the traditional form of entertainment in a rural area in Central Java-the wayang. The point prevalence rate of musculoskeletal complaints was estimated in 4683 men & women aged 15 years and over by house-to-house interviews. From 1105 respondents recording recent musculoskeletal pain, 844 were randomly selected and half the latter attended a puppet shadow play (wayang) incorporating the ACE. The other half, matched for age, sex and educational level who did not see the play, served as controls. A questionnaire containing biphasic choices of correct or incorrect ways of performing activities of daily living (ADL) to minimize musculoskeletal problems was administered to the whole group before, 1 month and 6 months after the wayang. Increased knowledge of correct ways of performing ADL (correct ADL) in the intervention group compared with the control group at 1 and 6 months after wayang was significant (P less than 0.05). Comprehension of correct ADL following the wayang could be demonstrated even in subjects who were illiterate and those who had attended primary school only. Retention of knowledge at the 6 month assessment declined more markedly in the illiterate group. ACE by wayang was shown to be feasible and effective in transferring knowledge on ADL to people with musculoskeletal problems in the sample population in Java. This effect could be shown even in the poorly educated section of the community.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Epidemiology of rheumatic diseases in rural and urban populations in Indonesia: a World Health Organisation International League Against Rheumatism COPCORD study, stage I, phase 2.

To determine the incidence of musculoskeletal pain, disabilities, and help seeking behaviour, a questionnaire was administered to a rural population of 2184 men and 2499 women and an urban population of 481 men and 590 women aged over 15 years by house to house interviews with completion rates of 95.2% (rural) and 97.1% (urban). The incidences of pain in the joints, back, or neck were 23.6% (rural) and 31.3% (urban). The incidence of disability due to an inability to walk, lift, carry, and dress was 2.8% (rural) and 0.9% (urban). The percentage of the population with pain who had to stop work owing to disability was 75% (rural) and 78% (urban). Official health care facilities were used by 62% (rural) and 71% (urban) of the population. Traditional health care was used by 87% (rural) and 89% (urban). The high percentage of subjects unable to work was due to a predominance of manual labour occupations (rural, 90%, urban, 80%). The age and sex specific incidence of rheumatic diseases in these populations were similar to other developing and developed countries. The primary rheumatology service was inadequate due to the low priority given by the health service to non-communicable diseases and inadequate rheumatology teaching of the primary health care doctors during undergraduate training. Musculoskeletal pain is a major public health problem in Indonesia and is still not fully appreciated.

Adolescent↗
PubMed1992

The epidemiology of gout and hyperuricemia in a rural population of Java.

The prevalence of gout and hyperuricemia was investigated by a survey of a total population of 4683 rural adults. The successful response rate was 95.2%. Of the respondents 85.3% of the individuals were examined. The prevalence of gout and hyperuricemia in men was 1.7 and 24.3%, respectively. The male to female ratio was 34:1 for gout and 2:1 for hyperuricemia. The observed higher prevalence of gout and hyperuricemia in this male Malayo-Polynesian population compared with Caucasian data, in spite of a lower life expectancy and subsistence economy, suggests that genetic and racial predisposition are key causative factors.

Adolescent↗
PubMed1990

Rehabilitation in chronic back pain: employment status after four years.

Of 129 chronic back pain patients treated consecutively at the Palmerston North hospital rehabilitation unit in 1982-3, 102 responded to a questionnaire in 1987. The 27 nonresponders had had pain for a shorter time and were considered to have a better prognosis. Of the 102 responders, 31 no longer had back pain; 51 (six women) were employed full or part time and 17 (two women) were looking for work. Two men had reversed roles and 17 had retired. Women who no longer had a job outside the home classed themselves as housewives rather than as retired or unemployed. This study provides data for future planning but without controls, confident conclusions cannot be drawn on the efficacy of the rehabilitation programme. There is a need for further controlled studies.

Adolescent↗
PubMed1987

Rheumatic complaints in Tokelau. I. Migrants resident in New Zealand. The Tokelau Island migrant study.

The three Tokelau atolls are 8 degrees south of the equator. In 1966 the islands were involved in a severe hurricane which drew attention to overcrowding and led to resettlement of more than half the population in New Zealand. One thousand three hundred and eighty one migrants over 15 years old were examined in New Zealand in 1980 and 1981 for rheumatic complaints as part of a continuing assessment. Clinical criteria for osteoarthritis (COA), including crepitus in any joint and in the knee, showed an increase in prevalence with age and weight in both sexes. Partial correlation coefficient analysis showed an association of the number of affected joints or the severity of knee COA (COAK) with both age and weight. Stepwise regression showed that age was the best predictor of both COA and COAK scores. Weight had predictive value only for COAK and only in women. Using the tracking method, previous high and/or increasing weight was related to COAK observed at this assessment. Heberden nodes increased with age and were more prevalent in women but were not associated with weight. Low back, dorsal and neck pain showed no association with age or sex. Low back pain was associated with weight. Joint pain following injury occurred in 15.4% of men. Gout, more common in men, was the only frequent inflammatory arthritis found. Two definite cases of rheumatoid arthritis (RA) were identified and four had criteria 1 and 2 for the New York criteria.

Adolescent↗
PubMed1987

Rheumatic complaints in Tokelau. II. A comparison of migrants in New Zealand and non-migrants. The Tokelau Island migrant study.

The migration of 1381 Tokelauans 15 years and over to New Zealand leaving 811 in Tokelau, provided a unique opportunity to test centuries of speculation on the impact of environment on rheumatic disease. There was no change in all rheumatic complaints. The migrant men had more gout, joint pain following injury, and neck pain. The migrant women had more dorsal back pain. There was no change in the prevalence of clinically defined osteoarthritis (COA) despite positive associations with weight and higher weights in the migrants. Rheumatoid arthritis was infrequent in both populations. Low back pain was common but was not more common in migrants, though compensation payments are readily available in New Zealand and are not in the Islands.

Adolescent↗
PubMed1985

Double-blind evaluation of piroxicam and naproxen following missed dosage in patients with inflammatory arthritis.

We conducted two separate double-blind withdrawal studies in parallel; one involved 20 patients taking piroxicam 20 mg daily, and the other involved 20 patients taking naproxen 750 mg daily. After 48 hour withdrawal of active medication, the naproxen group showed significant deterioration in eight of the 14 parameters measured and the piroxicam group in one of the 14 parameters measured. The deterioration in the naproxen group was significantly greater than that in the piroxicam group in five of the 14 parameters measured. These findings are consistent with the long half-life of piroxicam and suggest that non-compliance leading to omission of piroxicam for two days is of less clinical importance than omission of naproxen for two days.

Adult↗
PubMed1985

Rheumatic pain in a Philippine village. A WHO-ILAR COPCORD Study.

In initiating a community oriented programme for the control of rheumatic disease (COPCORD), 1685 people of all ages from a rural area in the Philippines were questioned by primary health care workers (PHW) for limb and spinal rheumatic pain and disability. The total complaint rate was 15.3% for men and 18.5% for women. For those 15 years and older the age adjusted rheumatic pain rates for pain present at the time of survey were 28.4% for the Philippines and 22.6% for Lawrence's UK population. The most common rheumatic pain sites in this community were knee, lumbar spine, neck and the trapezius muscle. The disability rate was 4.5% for those 15 years and older. One quarter of those with pain had received medical attention and the remainder, herbal treatment, massage, various faith and/or self-treatment methods.

Adolescent↗
PubMed1984

The analgesic effects of transcutaneous electrical nerve stimulation and placebo in chronic pain patients. A double-blind non-crossover comparison.

The analgesic effects of high frequency transcutaneous electrical nerve stimulation (TNS), "acupuncture-like" TNS and placebo TNS were evaluated in 33 patients with rheumatoid arthritis and chronic hand pain using a randomized, double-blind, non-crossover design. An oscilloscope was employed to monitor the stimulator output in the TNS treatment groups and to provide strong suggestion and a focus of attention in the placebo treatment group. The two forms of TNS were applied at the highest intensity that could be tolerated by patients. Assessments of resting pain, joint tenderness, grip strength and grip pain were made before and after treatment. The pain and joint tenderness measurements showed high frequency TNS, "acupuncture-like" TNS and placebo TNS to be equally effective in producing analgesia of similar degree and trend over time. The grip strength measurements showed no significant change. The results obtained with placebo are probably due to the suggestion and attention effects of the visual stimulus. The implications of these results in respect to pain control pathways are discussed. Although TNS given at high intensity was shown to be no better than placebo applied with strong suggestion, this does not preclude its use as a method of pain control in rheumatoid arthritis.

Acupuncture Therapy↗
PubMed1984

Proximal dissection of the olecranon bursa in rheumatoid arthritis.

A patient with rheumatoid arthritis and a distended olecranon bursa, which subsequently dissected subcutaneously in a proximal direction over the triceps muscle, is reported. Dissection of the olecranon bursa in a distal direction is not uncommon, but proximal dissection has not been reported.

Arthritis, Rheumatoid↗
PubMed1983

Transcutaneous electrical nerve stimulation in rheumatoid arthritis.

The therapeutic effect of once weekly transcutaneous electrical nerve stimulation in patients with rheumatoid arthritis was compared with placebo in a randomised, double-blind, non-crossover study lasting three weeks. Thirty-two patients with classic or definite rheumatoid arthritis and wrist involvement were evaluated. Transcutaneous electrical nerve stimulation was better than the placebo in relieving pain at rest and while gripping. In addition, grip strength, measured as power and work done, immediately improved following transcutaneous electrical nerve stimulation but returned almost to initial values between assessments. No significant improvement was shown for the placebo group.

Adult↗
PubMed1983

A simple pressure dolorimeter for the quantification of joint tenderness in inflammatory arthritis.

A simple pressure dolorimeter for the detection and quantification of joint tenderness is described and evaluated. The pressure dolorimeter was more sensitive than a modified Ritchie Index in measuring degree of joint tenderness and as sensitive in detecting tender joints. The interobserver error of the pressure dolorimeter was low, and in a drug withdrawal study, the pressure dolorimeter was able to detect change in joint tenderness whereas the conventional Ritchie Index was not. These results suggest that the pressure dolorimeter is a simple, reliable and sensitive instrument for measuring joint tenderness in patients with inflammatory joint disease. It is also inexpensive and readily available.

Arthritis, Rheumatoid↗