Biomedical subjects

R J Abboud

Publications and source records attributed to R J Abboud.

6 recordsLinked to original sources

PubMed2007

The inadequate effect of automobile seating on foot posture and callus development.

Driver posture is an important factor to be considered in the ergonomics design process of automobiles. Most decisions during automobile design and manufacture are informed by studying the intricate biomechanical components of human musculoskeletal systems to ensure maximum comfort, safety and well-being during driving. A case study is presented that confirms inappropriate foot position as a causative factor for the development of abnormal lateral/plantar heel callosities when driving a 4 x 4-style vehicle. The driver's foot position was influenced by the seat geometry of the vehicle. Cessation of driving the 4 x 4-style vehicle and driving of an alternative automobile while on holiday for a period of 4 weeks resolved the condition. On return to the 4 x 4-style vehicle, however, the abnormal callus patterns redeveloped while using the same footwear and no change in any other parameters. It is therefore suggested that seat and consequent foot position is an important ergonomic factor that should be addressed in the future design of automobile seating.

Adult↗

PubMed2006

The Pedar in-shoe system: repeatability and normal pressure values.

The Pedar system is one of the most commonly used systems for in-shoe pressure measurement. Good repeatability is necessary to ensure the consistency of measurements on which clinical judgements are based. In addition, there is a need to establish a range of normal in-shoe pressure values, which will help to identify abnormalities. The aim of this study was to assess the repeatability of the Pedar system and determine the pressure values in normal subjects. Fifty-three subjects, 17 females (32%) and 36 males (68%), were recruited and measurements were performed twice with an average gap of 12 days (range 1-32 days) using only one brand of standardised running shoes (Donnay International). Peak pressure (PP), contact area (CA), contact time (CT), pressure-time integral (PTI), force-time integral (FTI) and instant of peak pressure (IPP) were calculated. The coefficient of repeatability (CR), expressed as a percentage of the mean, was no greater than 15.3% for all 122 parameters considered. The highest PP areas were under the great toe, with mean (S.D.) equal to 280.4 (83.0) kPa and heel 264.3 (44.1) kPa, followed by the first 248 (70.1) kPa, second 246.5 (48.3) kPa, and third 224.7 (50.4) kPa metatarsal heads. The CA was highest under the heel at 41.54 cm(2). The CT of the metatarsals was 77% to 87% of the total CT while that of the hallux was 75%. The PTI and FTI were highest under the heel. We concluded that the Pedar system was repeatable. The normal pressure values identified can therefore be used to provide a reference range in clinical practice using this specific type of footwear.

Adult↗

PubMed2005

Prescribing a website.

AIM: To assess the value of directing the attention of patients to sources of medical information on the internet. DESIGN: Prospective qualitative study in an orthopaedic outpatient clinic. PARTICIPANTS: 253 patients agreed to complete electronic questionnaires before and after reviewing information relevant to their conditions on the internet. Patients were allocated randomly into two groups; one group was given indications of general sites and the other recommended specific non-commercial sites. Completed questionnaires were received from 44 patients. RESULTS: 95% of the patients found the internet information easy to understand and 84% said that it was helpful for coping. 86% of the patients were satisfied that their current treatment was appropriate in the light of what they had learned from the internet. Ten patients out of the 36 who expressed a view thought that the internet information contradicted that provided by the doctor. Despite these results most patients still said that the doctor represented the best source of patient education. CONCLUSIONS: Increasing numbers of patients are familiar with the internet. Most of our patients felt that the internet was, on balance, helpful in providing information. The main difficulties with the internet are the sheer volume of information, the potential for misleading and the danger of misunderstanding. We feel that there is a real place for the specific prescription of an internet site by a clinician who has personally reviewed it to a patient thought to be able to benefit from it.

Humans↗

PubMed2004

Patients and the Internet: a demographic study of a cohort of orthopaedic out-patients.

The Internet is a rich source of medical information but relatively few studies have evaluated its use by patients who seek medical information. The purpose of this study is to assess the demographics of Internet access and attitudes towards the Internet in a cohort of orthopaedic out-patients. Four hundred and three patients attending the orthopaedic outpatient fracture clinic completed a questionnaire consisting of six divisions including personal information, facility to access the Internet and their attitudes towards the information retrieved. Fifty per cent of the patients accessed the Internet, either from home or office and the maximum usage being in the younger age group. Twenty-nine per cent of the patients were aware of the medical information available through the Internet. 19% patients would like to have a consultation through the Internet, the maximum being in the middle-aged group. 70% of those patients who accessed the medical information reported that the Internet information was different than that obtained at consultation with the doctor at the out-patient clinic. This study reveals that the Internet use by patients is still limited. If an increased percentage of medical conditions is to be addressed through the Internet, involving patient information, on-line consultations, prescriptions and referrals, then a substantial amount of patient education and training is required

Access to Information↗

PubMed2000

Lower limb muscle dysfunction may contribute to foot ulceration in diabetic patients.

OBJECTIVES: To investigate the relationship between in-shoe plantar foot pressure and the co-ordinated activity of five lower limb muscles of diabetic patients, who are known to have a higher risk of foot morbidity. DESIGN: A portable six channel electromyographic system has been designed, developed and synchronised in real time with a 16 channel piezoelectric transducer in-shoe pressure measuring device, Gaitscan. BACKGROUND: So far, no one has tried to establish a relationship between in-shoe foot pressure distribution and muscle activity of the lower limb in diabetes. The measurement of phasic muscle activity has been related to foot pressure and compared to a control group of normal volunteers. METHODS: Twenty nine diabetic subjects and 22 healthy non-diabetic volunteers have been studied by recording electromyography of lower leg muscles and in-shoe foot pressure measurements simultaneously. RESULTS: In diabetic subjects, the period of contact pressure was greater than in normal control subjects (P<0.003). The initial forefoot time to contact with the ground was shorter in diabetics when compared to controls, indicating a faster forefoot contact. Of the dorsiflexor muscles, the Anterior Tibialis, normally contracting eccentrically at heel strike, was subject to a measurable delay in the initiation of contraction, of mean difference of 180 ms (P<0.001), in diabetic subjects when compared to the normal controls. CONCLUSIONS: The late firing of Tibialis Anterior means that its normal modulating role in lowering the foot to the ground after heel strike through eccentric contraction is disturbed. The result is that the foot reaches the foot flat stage in a less ordered manner, subjecting it to high plantar pressures. RELEVANCE: The results obtained may assist in planning realignment procedures of the foot and help prevent development of ulcers on the sole of the foot in high risk diabetic subjects.

Adult↗

PubMed1981

The sleep apnea syndrome.

Four patients with sleep apnea syndrome were seen at the Vancouver General Hospital within the last three years and are discussed in this paper. The history of recognition of the syndrome, the types of apnea, and method of evaluation using polysomnographic techniques are reviewed, and methods of treatment are outlined.

Adenoidectomy↗