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Biomedical subjects

T M Khalil

Publications and source records attributed to T M Khalil.

13 recordsLinked to original sources

Stretching in the rehabilitation of low-back pain patients.

The major objective of this investigation was to study the effectiveness of the physical conditioning program used at the University of Miami Comprehensive Pain and Rehabilitation Center in restoring certain elements of the functional abilities of individuals suffering from chronic low-back pain and to evaluate the effectiveness of using a systematically applied, aggressive stretching maneuver as an add-on therapy in the treatment of chronic low-back pain patients. The effect(s) of the proposed stretching maneuver was evaluated. Twenty-eight chronic low-back pain patients were randomly assigned to one of two groups. The control group underwent a multimodal rehabilitation program, and the experimental group underwent the same rehabilitation program in addition to the systematic stretching maneuver under investigation. The results obtained showed that patients undergoing the multimodal rehabilitation program with and without the proposed systematic stretching maneuver showed a significant improvement in their functional abilities as seen from the significant increase in the static strength of the back extensors, with corresponding significant increase in back muscle myoelectric signals. Also, a significant decrease in their pain level was reported after 2 weeks of continuous treatment. The use of the systematic stretching maneuver enhanced the functional gains of chronic low-back pain patients compared to the control group.

Back Pain

Biofeedback in back muscle strengthening.

This study was undertaken to investigate the use of electromyography (EMG) biofeedback as an add-on therapy to standard exercise in the restoration of the functional abilities of the trunk extensor muscles in patients suffering from chronic low-back pain (CLBP). A controlled experimental investigation was conducted to study the effectiveness of using the proposed treatment modality in the management of the low-back pain problem. The results obtained indicate that the proposed methodology was an effective tool to achieve a significant improvement in the strength of lumbar paraspinal muscles of chronic low-back pain patients.

Adult

The utility of electromyographic biofeedback in the treatment of conversion paralysis.

Conversion paralysis has a poor prognosis when there is evidence of nonresponse to previous treatment, long duration, and secondary atrophy of the "paralyzed" muscles. The authors present four such cases in which conversion paralysis was treated successfully by means of electromyographic (EMG) biofeedback. Each of the four patients also suffered from a chronic pain condition. Results from statistical analyses indicated that the four patients demonstrated significant improvement in the functional capacity of the "paralyzed" muscles as measured by isometric maximum voluntary contraction and EMG activity. The improvements occurred without explicit psychotherapy and suggest that behavioral modification techniques alone may be helpful in such cases.

Adult

Functional electric stimulation in the reversal of conversion disorder paralysis.

Numerous reports have documented the usefulness of functional electric stimulation (FES) in restoring and/or improving the function of organically diseased or paralyzed muscles. There are few reports related to the use of FES in the treatment of conversion disorder paralysis of the hysterical type. This paper presents a case of hysterically paralyzed muscles where the patient received daily treatment with FES for two weeks. Electric current was applied to a weak quadriceps and to paralyzed tibialis anterior muscles. This electrotherapeutic modality was effective in improving the function of the quadriceps and in reversing the paralysis of the tibialis anterior muscles. The improvement in the muscles' functional abilities was documented through the use of quantitative measures of muscle strength as well as computerized analysis of EMG signals. The results showed that the administration of FES resulted in a dramatic increase in motor units recruitment, increased muscle strength, and improved voluntary muscle control.

Adult

Determination of lifting abilities: a comparative study of four techniques.

The main objective of this study was to test the differences among four techniques for the determination of lifting abilities. This study introduced a new submaximal isometric strength testing technique. The proposed test was based on the concept of acceptable maximum effort (AME) which is the level of static exertion the individual is willing to perform voluntarily and comfortably without over-exertion (as opposed to the maximum ability of performance). Twelve male and five female subjects underwent the protocol of the four strength testing techniques investigated: isometric maximum voluntary contraction (MVC); maximum acceptable weight (MAW); maximum dynamic lifting (MDL); and acceptable maximum effort (AME). The results showed that MAW recorded the lowest values followed by AME, then MDL, then MVC. The correlation between AME and MAW was higher than that found between MVC and MAW. Also, it was found that AME is a reproducible measure of muscular functional abilities. On the average, the coefficient of variation was less than 15% for data for both males and females. The implications of these results in determining lifting abilities are discussed.

Adult

Acceptable maximum effort (AME). A psychophysical measure of strength in back pain patients.

A new quantitative method for measuring functional abilities of chronic low-back pain patients is introduced. The method is based upon a psychophysical model referred to as acceptable maximum effort (AME). AME is the highest level of voluntary effort that a person can achieve without inducing unacceptable pain. In the current study, the AME method was applied to strength measurement. By use of a static strength measurement procedure, arm, leg, shoulder, back, and composite strengths were assessed upon admission to and discharge from a 4-week, nonsurgical comprehensive pain treatment program. The reliability of the AME method for each strength measure was assessed. In addition, the method was used to evaluate pre- to post-treatment changes in strength. Results indicate the AME method to be highly reliable and useful in determining treatment outcome. Reliability coefficients for all strength measures were above .90. The results are discussed in terms of their implications for standardized functional ability measurement in the area of chronic pain.

Back Pain

Physiologic responses to static, dynamic and combined work.

The main objective of the present study was to determine the effects on cardiovascular stress of tasks that have varying degrees of static and dynamic components (weight holding, manual lifting and stepping). Heart rate, oxygen consumption and blood pressure were used as indices of cardiovascular stress. The results showed that oxygen consumption and heart rate responses to manual lifting are significantly lower than those of stepping and higher than those of weight holding. A low frequency lifting task evoked significantly lower systolic blood pressure than a high frequency lifting task. This study supported the idea that a physiologic fatigue criterion (PFC) based on stepping should not be applied directly to tasks such as manual lifting. In addition, a PFC for manual lifting should not be based only on oxygen consumption or heart rate; it also should incorporate systolic blood pressure as one of the monitored stress factors in setting lifting standards.

Adult

Physiological limits in lifting.

Two different experiments were conducted to study the effects of frequency, height and load of lift on computed maximal oxygen uptake and to compare the data obtained to a standard bicycle ergometer. A progressive submaximal technique was used to predict maximal oxygen uptake. The results of the present study revealed that across all heights, an increase in either the frequency of lift or load of lift was accompanied by an increase in computed maximal oxygen uptake; however, all maximal oxygen uptake values reported showed a tendency to level off beyond the frequency of five lifts/min. The results also showed that combined arm and leg lifting recorded the highest maximal oxygen uptake followed by leg lifting then arm lifting, respectively. Maximal oxygen uptake values obtained for lifting tasks were much lower than those obtained for a bicycle ergometer. It is therefore recommended that limits for continuous work for a lifting task be based on the attainable maximal oxygen uptake for that particular task and not on a maximal oxygen uptake obtained from another task such as a bicycle ergometer test.

Adult

Work scheduling under normal and prolonged-vibration environments.

This paper summarizes the research conducted to study human performance and recovery under prolonged, whole-body, vertical vibration. The results showed that performance under vibratory environment is inferior to that under normal environment. Interaction between work-rest schedules and the vibratory environment was detected. Parameters affecting selection of optimum work-rest schedules are discussed.

Attention

Computer-aided design and analysis of the sitting workplace for the disabled.

This paper describes a personal microcomputer model to match the need of the ambulatory disabled to the physical workplace. It is noted that back pain resulting from working from wheelchairs is the most common complaint of many who continue or return to work. The use of computer-aided design in matching the person to his/her workstation is described.

Anthropometry