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Biomedical subjects

T M Cutson

Publications and source records attributed to T M Cutson.

6 recordsLinked to original sources
PubMed1997

Reliability of impairment and physical performance measures for persons with Parkinson's disease.

BACKGROUND AND PURPOSE: Parkinson's disease (PD) is characterized by rigidity, postural instability, bradykinesia, and tremor, as well as other musculoskeletal impairments and functional limitations. The purpose of this investigation was to determine the reliability and stability of measures of impairments and physical performance for people in the early and middle stages of PD, Subjects. Thirteen men and 2 women in Hoehn and Yahr stages 2 and 3 of PD participated. Their mean age was 74.5 years (SD = 5.7, range = 64-84). METHODS: Thirteen impairment-level variables and 8 physical performance variables were measured. Measurements were taken on two consecutive days and again a week later on the corresponding two consecutive days. Reliability and stability were assessed using analysis of variance and intraclass correlation coefficients (ICCs). RESULTS: Test-retest reliability (ICCs) of variables ranged from .69 (hamstring muscle length) to .97 (lumbar flexion). Intraclass correlation coefficients were .85 or greater for 10 of the variables. CONCLUSIONS AND DISCUSSION: The results suggest that in the early and middle stages of PD, many of the measures of impairment and physical performance are relatively stable.

Activities of Daily Living↗
PubMed1997

Effect of a single dose of diazepam on balance measures in older people.

OBJECTIVE: This study examines the effect of a single dose of diazepam on a spectrum of balance measures in healthy older subjects. The measures include static (postural sway), dynamic (anterior tibialis muscle activation latency), and a complex self-initiated task of balance (functional reach) in addition to neuropsychological tests of attention. DESIGN: A double-blind, two-period, cross-over trial. SETTING: The community surrounding a university hospital. PARTICIPANTS: Community-dwelling, nonsmoking volunteers 65 years of age and older. MEASUREMENTS: Measures included response to unexpected perturbation (platform/EMG muscle latency), self-initiated perturbation (functional reach), and a static measure of balance (postural sway). Neurocognitive tests (digital symbol substitution test, card sorting) were included to document the cognitive effect. RESULTS: Twelve nonsmoking healthy subjects (average age = 70.4 years (66-76 years)) participated. The anterior tibalis muscle latency increased in response to a sudden perturbation with diazepam compared with placebo (TA latency 149 ms vs 142 ms, P < .001). Neurocognitive tests were adversely affected for 90 minutes after diazepam administration compared with placebo (P < .05). Other measures did not demonstrate significant effect of diazepam. CONCLUSIONS: This is among the first reports showing that benzodiazepines affect neuromuscular processing related to balance control. Increased muscle latency to sudden perturbations may represent an effect of diazepam upon the oligosynaptic spinal reflex distinct from the sedation. Surface electromyography may be a valuable noninvasive tool for future studies of drug effect on balance and falls risk among older people.

Aged↗
PubMed1996

Rehabilitation of the older lower limb amputee: a brief review.

OBJECTIVE: To review outcomes, over the last 25 to 30 years, of prosthetic rehabilitation in the older patient with a major lower limb amputation. DESIGN: Literature review of articles and reports about lower limb amputation, using key words elderly amputee rehabilitation, and lower limb amputation, through a computerized Medline Search. CONCLUSIONS: Age alone should not determine prosthetic rehabilitation. Comorbidities and general health are important determinants. The more proximal the amputation, the more energy is demanded from the cardiovascular and pulmonary systems for prosthetic gait. Changes in surgical technique and revascularization procedures have allowed preservation of the knee, which decreases energy demands and allows more older patients a chance to undergo rehabilitation for ambulation. Although the ratio of below knee (transtibial) amputations to above knee (transfemoral) amputations has increased, overall postsurgical mortality (10-30%), long term survival (40-50%@2 years, 30-40%@5 years), and risk of loss of the contralateral leg (15-20%@2 years) has not changed significantly since the 1960s. Despite the lack of improvement in survival as a result of the systemic vascular disease, the older patient can benefit from rehabilitation efforts with goals of prosthetic ambulation or simply cosmesis. The shortened longevity emphasizes the need for timely rehabilitation to enhance the quality of the remaining years. The geriatrician can add to the presurgical care and preprosthetic phase of rehabilitation by attention to the problems common to the older patient, i.e., multiple comorbidities, polypharmacy, immobility, and depression. Postoperatively, early mobilization is crucial to avoid the deleterious effects of immobility in the older person. Further investigations into the psychosocial issues and cost benefits of limb loss and prosthetic rehabilitation are needed. In addition, comparison of the various rehabilitation protocols and the impact of cardiac resting before rehabilitation are needed.

Age Factors↗
PubMed1995

Pharmacological and nonpharmacological interventions in the treatment of Parkinson's disease.

Parkinson's disease is a neurodegenerative disorder of older persons that eventually leads to disability. It is characterized by tremor, rigidity, bradykinesia, and postural instability. Progressive stages can be identified, each with unique problems. The optimal management of Parkinson's disease requires multiple professionals to address the needs of the patients as well as those of the caregivers. In addition to pharmacologic management, patients with Parkinson's disease can benefit from physical intervention and psychological support. This article summarizes strategies incorporating the multiple disciplines for each stage of the disease. [Cutson TM, Laub KC, Schenkman M. Pharmacological and nonpharmacological interventions in the treatment of Parkinson's disease.

Antiparkinson Agents↗
PubMed1994

Falls in the elderly.

Falls in the elderly are a common problem with potentially serious consequences. Elderly persons who fall may incur physical injuries that result in hospitalization or even institutionalization. Fear of falling may cause the elderly to restrict their activities and become socially isolated. A fall is usually the result of a combination of factors involving the patient and the environment. A patient's risk of falls may be assessed on the basis of a complete history, including a drug review and an evaluation of the patient's environment, as well as a thorough physical examination with emphasis on neurologic components and functional performance. Correction or adjustment of even a few of these risk factors may allow the elderly patient to avoid falls.

Accidental Falls↗