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Biomedical subjects

T P Anderson

Publications and source records attributed to T P Anderson.

At least 19 recordsLinked to original sources
PubMed1990

Studies up to 1980 on stroke rehabilitation outcomes.

Although rehabilitation potentials are meant to be used in prognosis, they differ from the usual prognostic signs in the morbidity sense because they relate to behavioral outcomes rather than cure of neurologic deficits. Survival studies have shown that stroke patients who live through the acute phase after onset survive long enough to warrant rehabilitation. The most important overall conclusion from scientific studies of predictors of stroke rehabilitation outcome is that the identified predictors were not accurate enough to predict gains in the rehabilitation process or the disposition of the individuals at discharge. Instead, these predictors can only be used in a statistical sample to describe the general criteria of those patients who would do better versus those who would do worse in rehabilitation. Some of these general indicators include those that seem to have no effect on rehabilitation outcomes--age, sex, amount of paralysis, side of brain involved, and place of residence at the time of the stroke. Those factors for which the effects are still unknown are race and prolonged specialized training period in either proprioceptive neuromuscular facilitation or percent-concept organization and motor output training. Factors that positively affect rehabilitation outcomes are good family support and financial status, higher socioeconomic and educational levels, early referral to rehabilitation, and the type of rehabilitation center (comprehensive rehabilitation center versus nursing home).(ABSTRACT TRUNCATED AT 250 WORDS)

Cerebrovascular Disorders↗
PubMed1988

Stroke rehabilitation outcome studies: comparison of a Japanese facility with 17 U.S. facilities.

A Japanese university hospital collaborated with a mixed group of 17 American hospitals in using common measures of functional status and outcomes for patients undergoing rehabilitation after stroke. Management protocols were similar for all facilities. Philosophies and operational factors concerning length of stay and discharge destinations varied among facilities. In Japan there was little pressure for discharge of rehabilitation patients. Japanese patients were kept in the hospital as long as they improved in their functional scores. The Japanese sample had fewer patients with bilateral involvement, patients were younger, were admitted after a longer period of time following the onset of the stroke, had less severe disability on admission, and had longer lengths of stay, and this may have accounted for higher Barthel score gains for the Japanese sample. These factors may have worked together with the family support system in Japan to account for higher discharge rate to the community for the Japanese sample.

Activities of Daily Living↗
PubMed1984

Functional outcome of closed head injury in children and young adults.

A comprehensive questionnaire which measured gross and fine motor function in the area of cognition, communication, and social development was completed by parents of children and young adults who had suffered severe closed head injuries between the years 1967 and 1978. The final sample included 42 returned questionnaires. Of these patients, 15 (37%) were considered independent, 20 (49%) dependent, and 6 (14%) had died. The area of cognition and communication dysfunction seemed to contribute most to dependency. The younger age group and the patients who were comatose for a shorter period of time tended to do the best functionally. While severe closed head injury can result in significant disability, many patients can achieve functional independence.

Adolescent↗
PubMed1983

Strategies for recruiting medical students to physical medicine and rehabilitation.

Estimations that the incidence of need for health care among the chronically ill exceeds the need for acute episodic health care in the rest of the population indicate a misdirection of the focus of medical education. Estimates indicate not enough psychiatrists will be trained under the present program to meet the existing demands. Unless there can be some material increase in the number of psychiatrists trained, it appears that there will be extensive disability persisting because of lack of rehabilitation. Failure to expose medical students to rehabilitation, the lack of role models to demonstrate how a psychiatrist practices, and the less dramatic progress which occurs in rehabilitation all decrease the attractiveness of rehabilitation medicine for the medical student. The objective of this study was to develop suggestions for strategies to attract and recruit medical students into physical medicine and rehabilitation. The Regional Advisory Council of the Research and Training Center #2 at the University of Minnesota was asked to brainstorm as a group such suggestions. As a result 37 suggestions were generated which were grouped under 5 headings: A. Whom to recruit; B. Methods; C. Time and Place; D. Impediments; E. Advantages of a career in PM & R. Suggestions in each of the categories were then prioritized.

Career Choice↗
PubMed1983

Urinary tract care: improvement through patient education.

The purpose of this study was to determine if a special program of patient and family education in urinary tract care would result in improved control of urinary tract infection (UTI) by spinal cord injury patients at home. The Williamson Functional Impairment Scale, modified to measure outcomes of impairment due to UTI, was applied to 54 patients in 1975 and to 21 in 1979. Patients in the latter group had completed a special urinary tract care education program of classes, reading material, written examinations, and demonstrations of acquired skills. At follow-up, only 32% of the patients in the 1975 group were asymptomatic of UTI, compared with 71% of the 1979 group. Only 5% of the patients in the 1979 group lost time from their usual daily activities, compared with 23% of the 1975 group. The improvements in impairment outcomes were not related to a reduction in the incidence of confirmed or suspected UTI (found in 63% of patients in the 1975 group and 62% of patients in the 1979 group). It is concluded that the 1979 group recognized symptoms earlier and took definitive action which resulted in less impairment and time lost due to UTI. The patient education program did result in improved urinary tract care after discharge.

Activities of Daily Living↗
PubMed1979

Psychosocial factors associated with pressure sores.

To determine if psychosocial factors, not purely mechanical aspects, play an important part in the incidence of pressure sores, 141 subjects were tested on 3 psychosocial measures. Results indicate that differences exist among groups in pressure sore history and psychosocial measures. Contrary to the expectations of a mechanical skin problem model, quadriplegics as a group (rather than paraplegics) had a history of fewer pressure sores. Two variables, the subject's responsibility in skin care (RESPON) and his satisfaction with the activiities of life (SATIS), were significantly associated with the incidence of decubitus ulcers. The combination of RESPON, SATIS, and the total positive score from the Tennessee Self-Concept Scale in multiple linear regression accounted for (1) 26% of the pressure sore history in the total sample, (2) 40% in the paraplegic group, (3) 69% in the paraplegic with help group, and (4) 41% in the paraplegic without help group. The histories in the quadriplegic groups and subgroups did not show reliable associations with the 3 variables. SATIS contributed most in accounting for the incidence of pressure sores. The level of injury and these psychosocial factors are thus related to the incidence of pressure sores.

Activities of Daily Living↗
PubMed1979

Quality of care for completed stroke without rehabilitation: evaluation by assessing patient outcomes.

Using the method of quality assurance of stroke rehabilitation developed at the University of Minnesota (UMn) by assessing patient outcomes on the basis of a modification of the Williamson Functional Limitation Scale (WFLS), 84 patients (group H) with completed stroke were surveyed 8 months to 13 years following treatment without rehabilitation at Hennepin County General Hospital. Because a greater percentage (42%) than estimated (29%) had died, the percentage of those not independent in self-care (31%) was less than estimated (46%). These patients were not matched with a group given rehabilitation (group U) previously studied at UMn but were generally less severely involved, although older on the average. However, even so, only 47% of those still living were independent in self-care in group H in contrast to 69% in group U. Also 42% of group H were in nursing homes or board-and-care facilities while only 18% of the rehabilitated group were. Although the modified WFLS is used in outcome studies for quality of rehabilitation, it is even sensitive enough to show differences in outcomes in a comparative study such as this.

Activities of Daily Living↗
PubMed1978

Stroke rehabilitation: a reconsideration of some common attitudes.

Some common, yet erroneous, attitudes and perceptions about stroke still persist. These warrant reconsideration: (1) benefits of stroke rehabilitation (including validity of its basis, life expectancy, adequacy in nursing homes, outcome prediction, cost benefits, and vocational outcome); (2) gait training (including evaluation methods, gait patterns, hand supports, sensory deficits, and types of braces); (3) effects of training on regaining balance; (4) spasticity (as a negative factor, enhancement by spring-action brace, benefit of inhibition training, and importance of antispasmotic drugs); (5) danger of early activity; (6) depression; (7) effects on patients' sexuality; (8) effects of communication impairments on learning abilities as well as effectiveness of speech therapy; (9) application of neurphysiological principles (regarding decreasing synaptic resistance, applications of principles from cerebral palsy training, and benefits of training for percept-concept-motor function deficits); and (10) research including reliability of past reports and paucity of facilities for new research.

Attitude↗
PubMed1978

Stroke rehabilitation: evaluation of its quality by assessing patient outcomes.

A modified version of an outcome-oriented quality-assurance system was used to assess the care received by patients, aged 21 to 60 years, with completed stroke, who had participated for at least three weeks in a rehabilitation program. Care for 110 patients was evaluated by comparing actual results with a set of standards for outcomes produced by practicing rehabilitation professionals using small-group estimation techniques. Outcomes were better than estimated, standards having indicated that 29% of patients should be capable of self-care, while actually 43% were. When 50 of the 110 outcomes were individually investigated; only 5% of the total study population were probably not functioning at an optimal level, and 3% more might reach optimal functioning if existing follow-up procedures were extended and made more routine. Since only an estimated 3 to 6 cases per year would be affected, the cost of instituting such care would not be justified. Participants concluded that assessment of outcomes justified continuation on the existing processes for stroke rehabilitation.

Adult↗
PubMed1978

Educational frame of reference: an additional model for rehabilitation medicine.

Since much of medical rehabilitation is actually training which is focused on helping the patient and/or his/her family become active in the patient's daily care, the addition of the educational frame of reference can make rehabilitation professionals more effective. A recommended model for patient-family education has these components: (1) Identification of patient-family understanding necessary for dealing with his/her problems or potential problems; (2) assessment of current patient-family knowledge, attitudes, and life style; (3) setting of educational goals based on individual patient and family needs; (4) planning an appropriate method of achievement of those goals; (5) implementing the plan; and (6) evaluating according to goals.

Attitude to Health↗
PubMed1977

Suppression of immune complex-induced inflammation by the chemotactic factor inactivator.

Small amounts (10(-10) mol) of purified human chemotactic factor inactivator (CFI) suppress leukocytic infiltration, permeability changes, and hemorrhage associated with acute immune complex-induced injury in rats. The reversed passive dermal Arthus reaction and acute immune complex-induced alveolitis in rats have served as the model systems of inflammation. The mechanism of inhibition does not appear to relate to interference with formation and deposition of immune complexes, or with fixation of complement in vitro or iv vivo. Human CFI inhibits in vitro the chemotactic activity generated in complement-activated rat serum. The inhibitory effects of human CFI are not seen if it is first heat inactivated. The data provide the first direct support for the conclusion that CFI has anti-inflammatory activity.

Aminopeptidases↗