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Biomedical subjects

Suzanne McDonough

Publications and source records attributed to Suzanne McDonough.

6 recordsLinked to original sources
PubMed2006

Electrical stimulation in cerebral palsy: a randomized controlled trial.

A randomized placebo-controlled trial was carried out to investigate the efficacy of neuromuscular electrical stimulation (NMES) and threshold electrical stimulation (TES) in strengthening the quadriceps muscles of both legs in children with cerebral palsy (CP). Sixty children (38 males, 22 females; mean age 11y [SD 3y 6mo]; age range 5-16y) were randomized to one of the following groups: NMES (n=18), TES (n=20), or placebo (n=22). Clinical presentations were diplegia (n=55), quadriplegia (n=1), dystonia (n=1), ataxia (n=1), and non-classifiable CP (n=2). Thirty-four children walked unaided, 17 used posterior walkers, six used crutches, and the remaining three used sticks for mobility. Peak torque of the left and right quadriceps muscles, gross motor function, and impact of disability were assessed at baseline and end of treatment (16wks), and at a 6-week follow-up visit. No statistically significant difference was demonstrated between NMES or TES versus placebo for strength or function. Statistically significant differences were observed between NMES and TES versus placebo for impact of disability at the end of treatment, but only between TES and placebo at the 6-week follow-up. In conclusion, further evidence is required to show whether NMES and/or TES may be useful as an adjunct to therapy in ambulatory children with diplegia who find resistive strengthening programmes difficult.

Adolescent↗
PubMed2005

Development of a virtual reality system for the rehabilitation of the upper limb after stroke.

Virtual reality (VR) provides a three-dimensional computer representation of a real world or imaginary space through which a person can navigate and interact with objects to carry out specific tasks. One novel application of VR technology is in rehabilitation following stroke, particularly of the upper limb. This paper describes the development of a VR system for use in this field. This system gives the user the ability to interact with objects by touching, grasping and moving their upper limb.

Biomedical Technology↗
PubMed2003

The passive straight leg raising test in the diagnosis and treatment of lumbar disc herniation: a survey of United kingdom osteopathic opinion and clinical practice.

STUDY DESIGN: Postal questionnaire survey. OBJECTIVES: To carry out a confidential postal survey of United Kingdom osteopaths in order to record and assess their use of the passive straight leg raising test in the diagnosis of, and choice of, manipulation for lumbar disc herniation. The study also sought to determine whether an association existed between osteopaths' manipulation of suspected lumbar disc herniation and their use of the straight leg raising test, the length of their working hours, and their use of manipulation for the treatment of other lumbar conditions. SUMMARY OF BACKGROUND DATA: The literature is not agreed on important aspects of the straight leg raising test, or on the use of spinal manipulation for suspected lumbar disc herniation. This is thought to be the first study to investigate opinion and practice in a large group of spinal manipulators, in this case United Kingdom osteopaths. METHODS: A questionnaire was sent to all 1030 United Kingdom osteopaths registered with the General Osteopathic Council in January 2000. It comprised four sections: personal characteristics, professional characteristics, background to low back pain cases, details of straight leg raising test understanding and use within the diagnosis and treatment of lumbar disc herniation. RESULTS: A response rate of 44% was achieved. United Kingdom osteopaths' opinions of low back pain and lumbar disc herniation clinical presentations, details of straight leg raising test mode of action, procedure, and interpretation were in keeping with the literature. Fifty-four percent of respondents sometimes employed manipulation in the treatment of lumbar disc herniation, but most of the others described the practice as "dangerous." The literature is similarly divided on the practice. Chi-square and Cramer V analysis implied that respondents were not influenced in choosing manipulation for lumbar disc herniation by their use of the straight leg raising test (chi2 = 4.002, df = 3, Cramer V = 0.0959, P = 0.261, alpha 0.05, n = 435). A moderate association implied that the frequency of use of such manipulation for all lumbar conditions influenced the choice of that treatment for lumbar disc herniation (chi2 = 81.808, df = 4, Cramer V = 0.4302, P < 0.001, alpha = 0.05, n = 442). There was also a weak association suggesting that hours worked per week influenced the choice of manipulation for lumbar disc herniation (chi2 = 9.840, df = 3, Cramer V = 0.1499, P = 0.020, alpha = 0.05, n = 438). CONCLUSIONS: Respondents to this survey frequently treated low back pain and often employed the straight leg raising test in its diagnosis. Their recognition of the clinical presentation of lumbar disc herniation and their use and understanding of the straight leg raising test were in keeping with the literature. Respondents were divided nearly equally between those who would expect patient benefit from the use of manipulation for lumbar disc herniation and those who criticized the practice. There is a need for further research into the clinical reasoning employed for the manipulative treatment of lumbar disc herniation.

Attitude of Health Personnel↗
PubMed2002

A systematic review of the passive straight leg raising test as a diagnostic aid for low back pain (1989 to 2000).

STUDY DESIGN: A systematic review. OBJECTIVES: This systematic review sought papers (January 1989-January 2000) on the passive straight leg raising test (PSLR) as a diagnostic component for low back pain (LBP) to identify, summarize, and assess developments in the test procedure, the factors influencing PSLR outcome, and the clinical significance of that outcome. SUMMARY OF BACKGROUND DATA: Previous studies suggested that the PSLR tractioned the sciatic nerve and that diminished leg elevation with reproduced pain indicated low lumbar intervertebral disc pathology. METHODS: Searches on six computerized bibliographic databases identified publications written about the PSLR. Papers were excluded if they were published before January 1989, were non-English language papers, or employed either an active SLR or a PSLR for purposes other than LBP diagnosis. The references of qualifying papers (and the references of references) were searched. Contact with primary authors, and others known to be active in this field, was attempted. RESULTS: The PSLR procedure remains unchanged. The influence of hip rotation during the PSLR was discussed without consensus. Biomechanical devices improved intra- and interobserver reliability and so increased test reproducibility. Hamstrings were found to have a defensive role in protecting nerve roots by limiting PSLR range in cases of nerve root inflammation. A small diurnal variation in the PSLR may imply a poorer prognosis. A positive PSLR at 4 months after lumbar intervertebral disc surgery predicted poor reoperative outcome, and a negative 4-month PSLR predicted excellent outcome. The influence of psychosocial factors was not discussed, neither was the diagnostic significance of a negative PSLR outcome. CONCLUSIONS: There remains no standard PSLR procedure, no consensus on interpretation of results, and little recognition that a negative PSLR test outcome may be of greater diagnostic value than a positive one. The causal link between LBP pathology and hamstring action remains unclear. There is a need for research into the clinical use of the PSLR; its intra- and interobserver reliability; the influences of age, gender, diurnal variation, and psychosocial factors; and its predictive value in lumbar intervertebral disc surgery.

Age Factors↗
PubMedDate not supplied

The use of ice in the treatment of acute soft-tissue injury: a systematic review of randomized controlled trials.

BACKGROUND: There are wide variations in the clinical use of cryotherapy, and guidelines continue to be made on an empirical basis. STUDY DESIGN: Systematic review assessing the evidence base for cryotherapy in the treatment of acute soft-tissue injuries. METHODS: A computerized literature search, citation tracking, and hand searching were carried out up to April 2002. Eligible studies were randomized-controlled trials describing human subjects recovering from acute soft-tissue injuries and employing a cryotherapy treatment in isolation or in combination with other therapies. Two reviewers independently assessed the validity of included trials using the Physiotherapy Evidence Database (PEDro) scale. RESULTS: Twenty-two trials met the inclusion criteria. There was a mean PEDro score of 3.4 out of of 10. There was marginal evidence that ice plus exercise is most effective, after ankle sprain and postsurgery. There was little evidence to suggest that the addition of ice to compression had any significant effect, but this was restricted to treatment of hospital inpatients. Few studies assessed the effectiveness of ice on closed soft-tissue injury, and there was no evidence of an optimal mode or duration of treatment. CONCLUSION: Many more high-quality trials are needed to provide evidence-based guidelines in the treatment of acute soft-tissue injuries.

Athletic Injuries↗