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R Teasell

Publications and source records attributed to R Teasell.

8 recordsLinked to original sources
PubMed2000

Perspectives on posttraumatic fibromyalgia: a random survey of Canadian general practitioners, orthopedists, physiatrists, and rheumatologists.

OBJECTIVE: To determine which factors physicians consider important in patients with chronic generalized posttraumatic pain. METHODS: Using physician membership directories, random samples of 287 Canadian general practitioners, 160 orthopedists, 160 physiatrists, and 160 rheumatologists were surveyed. Each subject was mailed a case scenario describing a 45-year-old woman who sustained a whiplash injury and subsequently developed chronic, generalized pain, fatigue, sleep difficulties, and diffuse muscle tenderness. Respondents were asked whether they agreed with a diagnosis of fibromyalgia (FM), and what factors they considered to be important in the development of chronic, generalized posttraumatic pain. RESULTS: More-recent medical school graduates were more likely to agree with the FM diagnosis. Orthopedists (28.8%) were least likely to agree, while rheumatologists (83.0%) were most likely to agree. On multivariate analysis, 5 factors predicted agreement or disagreement with the diagnosis of FM: (1) number of FM cases diagnosed by the respondent per week (p < 0.0001); (2) patient's sex (p < 0.0001); (3) force of initial impact (p = 0.003); (4) patient's pre-collision psychiatric history (p = 0.03); and (5) severity of initial injuries (p = 0.03). The force of initial impact and the patient's pre-collision psychiatric history were both negatively correlated with agreement in diagnosis. Patient related factors (personality, emotional stress, pre-collision physical, mental health) were considered more important than trauma related factors in the development of chronic, widespread pain. CONCLUSION: Future studies of the association between trauma and FM should identify potential cases outside of specialty clinics, and baseline assessments should include some measurement of personality, stress, and pre-collision physical and mental health.

Adult↗
PubMed1995

Clinical applicability and test-retest reliability of an external perturbation test of balance in stroke subjects.

We address the test-retest reliability and clinical applicability of an adapted external perturbation balance assessment, ie, the Postural Stress Test (PST). Repeated-measures were designed to assess the clinical features of a component of balance disorder in stroke. Twenty ambulatory stroke patients and 20 age-, gender-, height-, and weight-matched healthy control subjects participated in this study. Stroke patients were tested (using the adapted PST) on 4 separate days; matched control subjects were tested on one occasion. With the subject standing, backward perturbation forces were applied at the level of the center of gravity. Postural reactions to the test were scored in real-time and from videotape, from two different viewing angles, ie, 45 degrees and 90 degrees to the saggital plane. Scores (out of a maximal of 81) were ascertained using a 10-point subjective-observational scale. None of the control subjects fell during testing; four of the hemiplegic subjects fell. Subjects were protected from potential injury by a custom-designed safety harness system. For the hemiplegic subjects, intraclass correlation coefficients (ICCs), calculated as the reliability of any one occasion, ranged from 0.71 to 0.77, whereas those calculated as the reliability of the mean of the first two occasions ranged from 0.83 to 0.93. Although scores on the fourth occasion were significantly greater than those on the third occasion, both being significantly greater than those on the first and second test occasions (p < .05), differences were less than 5 points on the 81-point scale.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1993

Complications of immobilization and bed rest. Part 1: Musculoskeletal and cardiovascular complications.

Prolonged bed rest and immobilization inevitably lead to complications. Such complications are much easier to prevent than to treat. Musculoskeletal complications include loss of muscle strength and endurance, contractures and soft tissue changes, disuse osteoporosis, and degenerative joint disease. Cardiovascular complications include an increased heart rate, decreased cardiac reserve, orthostatic hypotension, and venous thromboembolism.

Bed Rest↗
PubMed1993

Complications of immobilization and bed rest. Part 2: Other complications.

Prolonged immobilization affects almost every organ system. Respiratory complications include decreased ventilation, atelectasis, and pneumonia. Decreased basal metabolic rate, increased diuresis, natriuresis, and nitrogen and calcium depletion affect metabolism. Genitourinary problems include renal stones and more frequent urinary tract infections. Glucose intolerance, anorexia, constipation, and pressure sores might develop. Central nervous system changes could affect balance and coordination and lead to increasing dependence on caregivers.

Bed Rest↗
PubMed1993

Catastrophic reaction after stroke. A case study.

The catastrophic reaction is a rare affective disorder following left hemispheric strokes. It is characterized by a disruptive emotional outburst involving anxiety, agitation and aggressive behavior. A case is presented that appears to underscore the intense frustration that these individuals experience when they cannot adequately express themselves through language. The catastrophic reaction behavior proved to be unremitting and failed to respond to withdrawal of the patient from threatening or difficult therapies, use of medications or attempts at behavioral modification. The catastrophic reaction appears to be a specific consequence of the intense frustration and perceived loss associated with an expressive aphasia. This may help explain the reportedly higher incidence of depression in left frontal strokes.

Aged↗