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Biomedical subjects

S F Wainapel

Publications and source records attributed to S F Wainapel.

At least 19 recordsLinked to original sources
PubMed1989

Severe visual impairment on a rehabilitation unit: incidence and implications.

Eleven of the first 191 admissions (5.8%) to a rehabilitation inpatient unit met the criteria for legal blindness; two additional patients (1%) had severe visual impairment (visual acuity above 20/200 but less than 20/70 with corrective lenses). All but three of these patients were ambulatory with a walkerette or cane when discharged to their homes. The commonest causes of blindness were macular degeneration, cataract, glaucoma, and diabetic retinopathy. Despite being older (mean age 79.7 years compared to 70.4 years for all 191 admissions) and having visual impairment superimposed on their primary rehabilitation diagnosis, these patients' lengths of stay (LOS) were not prolonged (mean LOS = 33.1 days compared to 35.9 days for all 191 admissions). It is concluded that severe visual impairment is not uncommon among rehabilitation inpatients, particularly those aged 70 or older. Health care professionals working in rehabilitation should become more familiar with, and proficient in, the basic principles and treatment techniques used in the rehabilitation of visually impaired persons.

Adult↗
PubMed1987

The physically disabled physician.

This article reviews the available literature on physically disabled physicians and discusses the attitudinal, environmental, and political barriers they may encounter. Information on 215 physicians and 92 medical students with a wide range of disabilities was analyzed. Currently available personal and technological resources are outlined and special issues pertaining to medical education are highlighted. Greater awareness and acceptance by medical peers are essential for professional success.

Architectural Accessibility↗
PubMed1987

Physical disability among physicians: an analysis of 259 cases.

This article presents data on 259 physicians and medical students with a wide range of physical disabilities and specialty training. Three out of four were in active medical practice despite their disability, most often in the specialties of internal medicine, family practice, or psychiatry. Neurological disorders accounted for over half the sample, with spinal cord injury, multiple sclerosis, stroke, and post-polio weakness being the most commonly encountered diagnoses. These data indicate that physically disabled physicians are more numerous than the previous literature would suggest that they are capable of practising in many professional specialties.

Adult↗
PubMed1985

Stubby prostheses: an alternative to conventional prosthetic devices.

Stubby prostheses offer potential advantages over conventional prosthetic devices in terms of safety, stability, and energy efficiency. Although cosmesis is compromised in the process, these short nonarticulated pylon prostheses may be a viable option to consider in bilateral A-K or knee disarticulation amputee patients under the following circumstances: (1) as a training tool to determine whether progression to full-length articulated devices is feasible; (2) as permanent prostheses for the patient whose primary need for ambulation is within his own home; (3) for the elderly bilateral amputee in whom ambulation is feasible but safety and energy efficiency are of particular importance; and (4) as a definitive device in the patient who expresses a preference for them. Two patients who have become successful users of stubby prostheses are presented to illustrate these points.

Adult↗
PubMed1985

Electrotherapy for acceleration of wound healing: low intensity direct current.

Accelerated wound healing has been an observed effect of low intensity direct current (LIDC) in the range of 200 microA to 800 microA, but present electrotherapeutic equipment has been less than optimal in providing this range of stimulation. A small and portable LIDC stimulator was specially constructed and used in a study of the effects of LIDC on wound healing rates among inpatients here. Thirty patients with indolent ulcers located either below the knee or in the sacral area were randomly assigned to the LIDC protocol or to more conventional wound therapy. The patients in each treatment group were matched by age, diagnosis, wound size, and wound etiology. Comparison revealed 1.5 to 2.5 times faster healing in those receiving LIDC, which was statistically significant. The wounds treated with LIDC required less debridement and the healed scars were more resilient. Additionally, no wound infections occurred and patients reported less discomfort at the wound site. Low intensity direct current appears to be a convenient, reproducible, and effective method for improved healing of chronic open wounds and warrants more widespread use in the clinical setting.

Aged↗
PubMed1985

Ulnar nerve compression by heterotopic ossification in a head-injured patient.

Although heterotopic ossification (HO) at the elbow is a frequent occurrence following head injury, nerve compression by heterotopic bone is quite rare. We report the case of a 22-year-old woman with head injury and well-documented HO at the left elbow who developed signs and symptoms of an ulnar neuropathy four months after her original injury. Electrodiagnostic studies confirmed the presence of a severe ulnar nerve lesion at the level of the elbow. Anterior transposition of the left ulnar nerve showed the nerve to have been compressed by heterotopic bone.

Adult↗
PubMed1985

Statistical methods in rehabilitation research.

Of 128 articles in Volume 63 (1982) of the Archives of Physical Medicine and Rehabilitation 48 (37.5%) utilized some form of statistical methodology. The most commonly encountered methods were: mean (with or without standard deviation or standard error); analysis of variance (ANOVA); t-tests; simple correlation/linear regression; and chi-square analysis. A critical review of the analytic statistics used in 40 of these articles revealed that only 23 (57.5%) were considered satisfactory in descriptive and methodologic terms. The most frequently encountered deficiencies were: inadequate description of methods; misuse of t-tests; absence of appropriately complex statistical analysis. A greater understanding of and familiarity with biostatistics is essential for all readers of the Archives to allow critical evaluation of the rehabilitation literature.

Humans↗
PubMed1985

Paraplegia following epidural anesthesia. A case report and a literature review.

This article reports the case of a man who developed a pure motor paraplegia following epidural anesthesia with a pattern of slow recovery over subsequent months. Reviewing the available literature on post-epidural paraplegia we noted a number of potential etiologies and analyzed their role in its causation. On the basis of this analysis we have identified five distinct clinical groups and a constellation of factors which can lead to an increased risk of post-epidural paraplegia in susceptible surgical patients.

Aged↗
PubMed1984

Rehabilitation of the blind stroke patient.

Over a two-year period 220 consecutive stroke admissions to a rehabilitation medicine inpatient service were reviewed. There were nine admissions (4.1%) involving seven separate patients who were also legally blind. The characteristics, outcomes, and special problems of these patients are reviewed. Despite their advanced age and double disability almost all became ambulatory and a majority of them were able to be discharged to their homes. Visual loss was often the primary limiting factor in functional outcome. A striking finding was the lack of perceptual problems in those right brain damaged patients with the greatest degree of visual impairment.

Activities of Daily Living↗
PubMed1984

Spastic hemiplegia in a quadriplegic patient: treatment with phenol nerve block.

A quadriplegic patient with a C6 lesion had a stroke with aphasia and right hemiplegia 20 years after his cervical cord injury. The combination of hemiplegia and quadriplegia created unusual rehabilitation problems, the most disabling of which was a painful flexion contracture of the right elbow that prevented any useful right arm function. A sequence of phenol nerve blocks produced almost complete resolution of this contracture and was a key factor in his successful return to independent living. Although phenol block is much less commonly performed in the upper than lower extremities, its judicious use in carefully selected cases may be beneficial to the patient's functional outcome.

Adult↗
PubMed1984

Reflex sympathetic dystrophy in quadriplegia: case report.

A patient with quadriplegia developed severe localized unilateral hand pain associated with clinical evidence of abnormal sympathetic hand activity. Diagnosis revealed reflex sympathetic dystrophy (RSD), which was resolved with conservative management. The association of RSD with spinal cord injury has been reported only rarely. Since few speculations about this condition have been made, we suggest that unexplained painful syndromes in the extremities of patients with spinal cord injury be carefully evaluated to rule out the possibility of RSD.

Adolescent↗
PubMed1984

Post-hypoxic leukoencephalopathy with late recovery.

A man developed severe spastic quadriplegia following a mixed drug overdose-induced coma. Diagnostic studies were consistent with hypoxic leukoencephalopathy. The patient made a dramatic functional recovery 3 1/2 months after admission, with Computed tomography scan and EEG findings returning to normal. The time course of recovery suggests that remyelination may have taken place. This case illustrates the importance of early and continued vigorous rehabilitation therapy for patients in whom late recovery from critical illness is possible.

Adult↗
PubMed1984

Pantyhose prosthesis: a cosmetic alternative.

A cosmetic prosthesis for the nonambulatory patient with unilateral or bilateral above-knee amputation is described. This device can be made with minimal cost and difficulty, and it offers advantages of durability, flexibility, and excellent appearance. Cosmetic prostheses for patients with below-knee or hip disarticulation amputations can be made in a similar manner.

Artificial Limbs↗
PubMed1983

Predictors of stroke outcome.

Findings from several studies of stroke victims indicate that consistent negative predictors of outcome are significant perceptual or cognitive dysfunction, prior stroke, delay in initiating rehabilitation therapy, the presence of nystagmus, and poor motivation. Factors associated with a good prognosis after rehabilitation include early return of voluntary movements, bladder control, high intelligence and feeding skills.

Activities of Daily Living↗