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Biomedical subjects

S R Hinderer

Publications and source records attributed to S R Hinderer.

11 recordsLinked to original sources
PubMed1996

Functional outcome measures to assess interventions for spasticity.

PURPOSE: Clinicians use functional loss as a criterion to treat spasticity, but the connection between function and severity of spasticity is not well established for monitoring spasticity treatment effect. Studies were reviewed which have implemented outcome measures to assess functional changes relative to changes in spasticity. Criteria for review included the reliability and internal validity of the functional measures used and the strengths/weaknesses of the study designs that likely affected the external validity of the measures for this application. Guidelines are provided for the use and development of functional outcome measures in futures studies of spasticity treatment based on this review. DATA IDENTIFICATION: An English-language literature search using MEDLINE and bibliographies of published articles and textbooks was conducted. RESULTS: Very few functional measures demonstrated changes concurrent to a reduction in spasticity. There were multiple potential confounding factors in study protocols, reporting of results, and data analysis that might account for the limited number of measures shown to be valid for this application. Selected standardized ordinal functional outcome scales (the PECS and PEDI) and specific functional tasks were identified as measures that show promise for assessing changes concurrent with altered spasticity level. CONCLUSION: Based on a review of previous studies, functional measures involving posture, positioning, balance, and certain mobility skills have potential, with further test development, to provide needed information regarding the impact of spasticity on functional outcome.

Disability Evaluation↗
PubMed1996

Practically perfect planning.

Planning is a routine human activity performed daily that often challenges confident professionals. The nursing process, adapted as a planning tool, provides the means to achieve institutional goals. The application of the nursing process to planning in one operating room setting resulted in the preparation of more than 1,500 surgical case supply preference lists in 5 weeks' time. The achievement facilitated timely implementation of an automated charging system for surgical cases through practically perfect planning.

Humans↗
PubMed1995

Rehabilitation in joint and connective tissue diseases. 1. Systemic diseases.

This self-directed learning module highlights new advances in this topic area. It is part of the chapter on rehabilitation in joint and connective tissue diseases in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article discusses treatment and outcome in rheumatoid arthritis, musculoskeletal involvement in human immunodeficiency virus infection, scleroderma, systemic lupus erythematosus, and intraarticular injection of corticosteroids.

Adrenal Cortex Hormones↗
PubMed1995

Rehabilitation in joint and connective tissue diseases. 2. Inflammatory and degenerative spine diseases.

This self-directed learning module highlights new advances in this topic area. It is part of the chapter on rehabilitation in joint and connective tissue diseases in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article discusses ankylosing spondylitis and spinal stenosis, including differential features, diagnostic strategy, rehabilitation management, spinal complications of ankylosing spondylitis, and pathophysiology of spinal stenosis.

Electromyography↗
PubMed1995

Rehabilitation in joint and connective tissue diseases. 3. Limb disorders.

This self-directed learning module highlights new advances in this topic area. It is part of the chapter on rehabilitation in joint and connective tissue diseases in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article discusses the following: differential features, diagnostic strategy, and rehabilitation management of hip, knee, foot, and shoulder pain; indications, contraindications, and postsurgical management for joint arthroplasty; management of gout and chondrocalcinosis; and rehabilitation issues related to hip and shoulder fracture.

Femur Head Necrosis↗
PubMed1992

Measurement standards for interdisciplinary medical rehabilitation.

Rehabilitation must address problems inherent in the measurement of human function and health-related quality of life, as well as problems in diagnosis and measurement of impairment. This educational document presents an initial set of standards to be used as guidelines for development and use of measurement and evaluation procedures and instruments for interdisciplinary, health-related rehabilitation. Part I covers general measurement principles and technical standards, beginning with validity, the central consideration for use of measures. Subsequent sections focus on reliability and errors of measurement, norms and scaling, development of measures, and technical manuals and guides. Part II covers principles and standards for use of measures. General principles of application of measures in practice are discussed first, followed by standards to protect persons being measured and then by standards for administrative applications. Many explanations, examples, and references are provided to help professionals understand measurement principles. Improved measurement will ensure the basis of rehabilitation as a science and nourish its success as a clinical service.

Disability Evaluation↗
PubMed1990

The supraspinal anxiolytic effect of baclofen for spasticity reduction.

Recent studies in the psychiatric literature indicate that baclofen has an anxiolytic action in certain psychopathologic conditions. Clinical observation has shown that manifestations of spasticity are increased in anxious individuals, implicating a supraspinal site of mediation for these responses. The purposes of this study were to determine if baclofen reduced anxiety in individuals with traumatic spinal cord lesions and whether that reduction was correlated with decreased spasticity from the baclofen. Five adult males with traumatic spinal cord injury were randomly assigned to the study protocol. A double-blind, repeated measures, multiple base-line, single-case research design was employed. The independent variable was dose of medication with the three levels being placebo, 40 mg/day of baclofen and 80 mg/day of baclofen, in four evenly divided doses. The dependent variable was the score obtained on the Beck Inventory-A anxiety scale (BIA). The subjects were administered the BIA twice per week for a nine-week period of time, during which they received the doses of medication as described. Quantitative measurements of spasticity were also taken at each session. Visual inspection analysis of the data showed that two subjects had no measurable anxiety of the BIA throughout the study. Three subjects had measurable anxiety on the BIA during the base-line/placebo phase. They showed a decreased level of their BIA scores with 40 mg/day of baclofen, and a further level reduction with 80 mg/day of baclofen. The reduction in BIA scores was statistically significant using the standard deviation band test in one of these subjects. These data indicate that BIA probably has an anxiolytic effect for individuals status post-traumatic spinal cord injury.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Spasticity in spinal cord injured persons: quantitative effects of baclofen and placebo treatments.

Spasticity commonly occurs after a spinal cord injury and is characterized by increased resistance to passive movement of peripheral joints. This study examined the effect of an antispasticity medication on stiffness from the myotatic reflex response generated by passive sinusoidal ankle motion. A repeated measures, multiple base-line, single-subject, double-blind design was employed. The independent variable was spasticity medication treatment, where the levels were 40 mg/day and 80 mg/day of baclofen v placebo treatment. Viscous and elastic stiffness measurements were taken at the ankle joint during a placebo base-line phase and during treatment with baclofen for five adult males with traumatic spinal cord injuries. Ankle sinusoidal oscillation frequencies were from 3 to 12 Hz during test sessions. Mean viscous and elastic stiffness scores for all frequencies were calculated for each phase of the study. Randomization tests of mean changes in stiffness measurements between each treatment phase of the study failed to provide any convincing evidence of a significant treatment effect for reduction of spasticity in the traumatic spinal cord injured subjects studied. Further testing is needed to exclude potential confounding factors before this conclusion can be confirmed. The results suggest that baclofen is not a universal treatment of choice for all individuals with spasticity resulting from traumatic spinal cord injury.

Adult↗
PubMed1990

Physiatric therapeutics. 4. Transfers and mobility/community reentry.

This self-directed learning module highlights advances in transfer and mobility skills, and community reentry. It is part of the chapter on physiatric therapeutics for the Self-Directed Medical Program Study Guide for practitioners and trainees in physical medicine and rehabilitation. This section contains essential information on bed mobility, dependent or assisted bed transfers, assisted and independent wheelchair transfers, advanced wheelchair skills, mobility in the community, activities of daily living and advanced living skills, communication, social support, adjustment to disability, prevocational and vocational issues, options for community living, and public policies regarding people with disabilities.

Activities of Daily Living↗
PubMed1990

Physiatric therapeutics. 2. Therapeutic heat and cold, electrotherapy, and therapeutic exercise.

This self-directed learning module highlights the general concepts and advances in therapeutic heat and cold, electrotherapy, and therapeutic exercise. This article is part of the chapter on physiatric therapeutics for the Self-Directed Medical Knowledge Program Study Guide for practitioners and trainees in physical medicine and rehabilitation. Special advances include lasers in medicine and the description of the appropriate type of exercise for weight control.

Cold Temperature↗