Biomedical subjects

Robert R Conatser

Publications and source records attributed to Robert R Conatser.

3 recordsLinked to original sources

PubMed2006

Effect of counterstrain on stretch reflexes, hoffmann reflexes, and clinical outcomes in subjects with plantar fasciitis.

CONTEXT: Previous research indicates that osteopathic manipulative treatment based on counterstrain produces a decrease in the stretch reflex of the calf muscles in subjects with Achilles tendinitis. OBJECTIVES: To study the effects of counterstrain on stretch reflex activity and clinical outcomes in subjects with plantar fasciitis. METHODS: In a single-blind, randomized controlled trial of crossover design, the effects of counterstrain were compared with those of placebo in adult subjects (N=20) with plantar fasciitis. The subjects were led to believe that both the counterstrain and placebo were therapeutic modalities whose effects were being compared. Ten subjects (50%) were assigned to receive 3 weeks of counterstrain treatment during phase 1 of the trial, while the other 10 subjects were given placebo capsules. After a 2- to 4-week washout period, phase 2 of the trial began with the interventions reversed. Clinical outcomes were assessed with daily questionnaires. Stretch reflex and H-reflex (Hoffmann reflex) in the calf muscles were assessed twice during each laboratory visit, before and after treatment in the counterstrain phase. RESULTS: No significant changes in the electrically recorded reflexes of the calf muscles were observed in response to treatment. However, changes in the mechanical characteristics of the twitches resulting from the electrical responses were observed. Peak force and time to reach peak force both increased (P< or =.05) in the posttreatment measurements, with the increase being significantly more pronounced in the counterstrain phase (P< .05). A comparison of pretreatment and posttreatment symptom severity demonstrated significant relief of symptoms that was most pronounced immediately following treatment and lasted for 48 hours. CONCLUSIONS: Clinical improvement occurs in subjects with plantar fasciitis in response to counterstrain treatment. The clinical response is accompanied by mechanical, but not electrical, changes in the reflex responses of the calf muscles. The causative relation between the mechanical changes and the clinical responses remains to be explored.

Adult↗

PubMed2003

Characteristics of physicians disciplined by the State Medical Board of Ohio.

Although physicians have been disciplined for a variety of offenses by state medical boards across the United States, limited information is available about the characteristics of these physicians. To assess the characteristics of, offenses committed by, and resulting disciplinary actions taken against a consecutive series of disciplined physicians in the state of Ohio, the authors conducted a case-control study of all 308 physicians publicly disciplined by the State Medical Board of Ohio (SMBO) from January 1997 to June 1999. Subjects were matched with two groups of control physicians--one matched by location only, and the second matched for location, gender, practice type, and self-designated specialty. The main outcomes measured were disciplinary actions, offenses leading to state medical board actions, and the characteristics of disciplined physicians. Of 340 physicians disciplined during these 30 months (approximately 0.37% per year), 308 committed 477 offenses requiring 409 actions by the SMBO. The most common offenses were impairment due to alcohol and/or drug use (21%), inappropriate prescribing or drug possession (14%), previous state actions (15%), negligence or incompetence (7%), and drug-related charges (7%). Although offenders were significantly less likely to be women (P < .05; odds ratio [OR], 0.46; 95% confidence interval [CI], 0.28-0.75), the authors found no difference in the severity of disciplinary action taken against offenders by gender (OR, 1.23; 95% CI, 0.54-2.82) or by type of medical training, ie, between osteopathic physicians and allopathic physicians (OR, 0.70; 95% CI, 0.39-1.26). Compared with controls matched for location, gender, practice type, and self-designated specialty, offenders were significantly less likely to be board certified (OR, 0.65; CI, 0.46-0.92) and significantly more likely to have been in practice 20 or fewer years (OR, 1.51; 95% CI, 1.08-2.13). Disciplinary actions in Ohio were more frequent, more severe, and more often in response to impairment due to alcohol and/or drug use and previous state actions than previously reported. No difference in the severity of disciplinary action was noted between men and women or between osteopathic and allopathic physicians.

Adult↗

PubMed1997

The relationship between elbow flexor volume and angular stiffness at the elbow.

OBJECTIVE: The purpose of this experiment was to determine if a correlation exists between the volume of the elbow flexors and angular stiffness at the elbow, and to determine the contribution of the biceps brachii and the brachialis muscles to angular stiffness. DESIGN: This study is a descriptive, correlational study and presents a graphical model of the passive properties of muscle. BACKGROUND: The correlation between arm volume and angular stiffness has been shown, but the measurement of arm volume was not specific to the structures being strained. Pre-positioning a bi-articular muscle by stretching over one joint decreases the range of motion at the other joint and may affect the stiffness. METHODS: Angular stiffness at the elbow of 14 female and 15 male volunteers was measured, and the volume of the elbow flexors was calculated from compounded ultrasound imaging. Initial biceps length was set by pre-positioning the shoulder in two different positions. RESULTS: A significant linear relationship was observed between the slope of phase 1 of the stiffness curve and volume of the elbow flexors in both horizontal flexion (r = 0.92) and horizontal extension (r = 0.79) of the shoulder. Phase 2 of the stiffness curve showed no linear relationship to muscle volume in either shoulder position (flexion, r = 0.22; extension r = 0.33). The slopes of phases 1 and 2 were significantly greater with the shoulder in horizontal extension than in horizontal flexion. CONCLUSION: The volume of the elbow flexor muscles is a good predictor of angular stiffness in phase 1 of the curve. A model of the additive contribution of the biceps and brachialis muscles is presented to account for the increased stiffness in the shoulder extended position. RELEVANCE: Recognition of the correlation between muscle volume and stiffness, coupled with understanding that pre-positioning a bi-articular muscle may affect muscle stiffness may aid the clinician in accurately assessing muscle stiffness in patients with connective tissue disorders, neurological dysfunction and contractures.

Journal Article↗