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PubMed2004

Is the Health Utilities Index valid in total hip arthroplasty patients?

PURPOSE: The purpose of the study was to examine the construct validity of the Health Utilities Index Mark 2 (HU12) and Mark 3 (HU13) in patients with osteoarthritis (OA) needing total hip arthroplasty (THA). BACKGROUND: One hundred and fourteen OA patients (mean age = 69.2; SD = 8.9) who were waiting to see a surgeon for an evaluation for THA completed baseline measures that included the HU12, HU13, SF-36, Harris Hip Scale, WOMAC, MACTAR, State-Trait Anxiety Inventory, and the 6-min walk test. METHODS: We examined 87 a priori hypotheses by correlating (one-tailed zero-order correlations) the single-attribute utility scores for the pain, emotion, mobility, ambulation, self-care, dexterity, vision, hearing, and speech attributes of the HU12 and HU13 and the overall HU12 and HU13 utility scores to specified subscales of the other measures. RESULTS: The zero-order correlations confirmed 75% of our a priori hypotheses suggesting that the constructs within the HU12 and HU13 were, in general, related to similar constructs in other measures as expected. CONCLUSIONS: The evidence suggests that HU12 and HU13 are valid for use in OA and THA studies.

Aged↗

PubMed2004

Construct validity of the RAND-12 and Health Utilities Index Mark 2 and 3 in type 2 diabetes.

OBJECTIVE: To assess the cross-sectional construct validity of the RAND-12 and the Health Utilities Index Mark 2 (HUI2) and Mark 3 (HUI3) in type 2 diabetes. METHODS: Parametric tests were used to test for differences in HRQL scores between known groups with type 2 diabetes, defined in terms of treatment intensity, duration of diabetes and glycemic control. RESULTS: The PHC of the RAND-12 was significantly lower for individuals treated with insulin (40.28 +/- 10.97) than diet alone (45.18 +/- 12.02, p < 0.01), as was the MHC (42.83 +/- 10.75 vs. 46.87 +/- 10.89, p < 0.05). MHC (43.56 +/- 10.20 vs. 46.18 +/- 9.94, p < 0.05) and PHC (41.04 +/- 10.64 vs. 45.62 +/- 10.48, p < 0.001) were both lower for those with longer duration of diabetes. Overall HUI3 scores were lower in individuals above the median duration of diabetes (5.0 years) as compared to those with a shorter duration (0.60 +/- 0.29 vs. 0.67 +/- 0.29, p < 0.01) and for individuals whose diabetes was managed using insulin compared to diet alone (0.59 +/- 0.30 vs. 0.69 +/- 0.30, p < 0.05). Disease severity was associated with impairment on the ambulation, dexterity and pain attributes of the HUI3. Similar results were found for the HUI2. Overall HUI2 scores were highest for individuals managed with diet alone compared to those managed with insulin. Disease severity was associated with the mobility and self-care attributes of the HUI2. No relationship was found between any of the measures of HRQL and glycemic control. CONCLUSIONS: Scores for individuals presumed to have more severe or advanced disease were significantly lower for many comparisons using the RAND-12, HUI2 and HUI3. The results of this study contribute evidence of construct validity of the HUI2, HUI3 and RAND-12 in type 2 diabetes.

Aged↗

PubMed2000

Training-induced changes of motor cortex representations in stroke patients.

OBJECTIVE: To study changes in motor cortex representations after a single session of physiotherapy in stroke patients. METHODS: TMS mapping was used to evaluate the motor output map of the abductor pollicis brevis (APB) in both hemispheres. Stroke patients (4-8 weeks after the infarction) were studied prior to a training session aimed at improving dexterity and 1 h and 1 day after the training. RESULTS: Prior to the training, the APB representation area in the affected hemisphere was significantly smaller than on the non-affected side. After therapy, the cortical motor output to the paretic APB was significantly enlarged, and motor function was improved. One day later, these effects were partially reversed. Motor thresholds remained significantly increased in the affected hemisphere before and after the therapy. CONCLUSION: A single session of physiotherapy produces a use-dependent enlargement of motor cortex representations paralleled by an improvement of motor function in stroke patients.

Adult↗

PubMed1994

Peri-implant mucosal aspects of ITI implants supporting overdentures. A five-year longitudinal study.

Sixty-six ITI implants placed in the mandible of 33 edentulous elderly patients (mean age: 69 years) were observed longitudinally for 5 years. The implants served as overdenture anchorage either by means of a connecting bar or single spherical attachments. During the study period, 2 implants failed (one because of a peri-implant lesion and one because of a fracture) and had to be removed. At the beginning of the study, all implants were osseointegrated and had successfully been in function for 3-5 months. Oral hygiene practices and the peri-implant mucosal status were assessed according to the criteria of conventional periodontal parameters. Approximately 50% of the implants had been installed into lining mucosa and hence were to surrounded by keratinized mucosa. The peri-implant mucosal tissue was maintained healthy during the whole observation period, and no or only minimal loss of attachment was observed. The probing depths averaged approximately 3 mm. At the end of the study, orthopantomographic radiographs were obtained from all patients to assess the peri-implant bony structures. Small local angular bony defects were detected on 16 implants (22%) in 12 patients. Slightly increased probing depths were observed when angular bony defects were present. Loss of attachment was significantly less frequent when the implants had been placed following a prolonged period of edentulousness (> 5 years). This study demonstrated that advanced age, reduced dexterity of elderly patients and environmental conditions of overdentures do not represent a higher risk for the development of peri-implant lesions.

Aged↗

PubMed1976

Casual attributions for success and failure for psychiatric rehabilitees and college students.

College students and psychiatric rehabilitees performed a manual dexterity task in which consistent success or failure was maipulated over four consecutive task trials. Contrasting predictions for the use of casual attributions (luck, task difficulty, effort, and ability) following Trial 1 and Trial 4 for the two populations were derived from Heider's balance theory and "naive theory of action". Consistent with native theory, students who succeeded and rehabilitees who succeeded used unstable attributions only college students who failed used stable attributions to account for these trial outcomes, whereas students who failed and rehabilitees who failed made significant changes in their attributional patterns from Trial 1 to Trial 4. Results are discussed regarding intervention with psychiatric rehabilitees and other groups with severe achievement difficulties.

Achievement↗

PubMed1996

Hypertension and neuropsychological performance in men: interactive effects of age.

Potentially interactive effects of hypertension and age on the performance of neuropsychological and information processing tests were examined in 123 untreated hypertensive and 50 normotensive men. After covarying education, average alcohol consumption, trait anxiety, and depression scores, results indicated an interaction of age and hypertension. Young hypertensive men (23-40 years) scored significantly worse than young normotensive men on tests of attention/executive function and working memory; middle-aged hypertensive (41-56 years) and normotensive participants were not distinguished by any measures. Hypertensive men performed significantly more poorly than normotensive men on tests of manual dexterity. Results suggest that neuropsychological sequelae of hypertension are more pronounced in young than in middle-aged hypertensive individuals and are independent of various demographic, psychosocial, and alcohol-related factors.

Adult↗

PubMed1990

Marked sex differences on a fine motor skill task disappear when finger size is used as covariate.

Purdue Pegboard performance of 16 male and 25 female right-handed college students were compared, and results were replicated with 25 male and 28 female subjects. In agreement with the literature, women performed significantly better than men. When measures of index finger and thumb thickness were used as covariate, all significant sex differences in performance disappeared. Negative correlations between performance and finger size were observed in both sexes. Sex differences in fine manual dexterity tasks may therefore be confounded by sex differences in finger size.

Female↗

PubMed1997

Developmental changes in manipulation in tufted capuchins (Cebus apella) from birth through 2 years and their relation to foraging and weaning.

This study examined the contributions of physical and sensorimotor development to manipulation in capuchins (Cebus apella) from birth to 2 years. Between months 1-6 and 7-12, manipulation increased significantly in frequency, in the proportion that was vigorous or required fine motor control, and in the proportion directed at portable objects. Fine motor control, moving objects in relation to the body, and stamina are largely in place by 12 months, after which little changed. All elements of the manipulative repertoire have appeared, and vigorous and dexterous activities have peaked before fully independent foraging. Emergence of permanent dentition and achievement of approximately half of adult body size accompany the attainment of fully independent foraging at 15 months. Thereafter, increasing strength and specific knowledge probably contribute more to changing foraging competence in young capuchins than do stamina and sensorimotor development.

Aging↗

PubMed2003

Opposite turning behavior in right-handers and non-right-handers suggests a link between handedness and cerebral dopamine asymmetries.

The strong right hand preference in humans remains a riddle; no lateralized behavior other than fine finger dexterity relates to it. The relation between handedness and language dominance may be far weaker than currently judged; after all, both right-handers and non-right-handers utilize the left brain for speech. There is, however, a lateralized motor preference in animals, turning behavior, that is strongly associated with hemispheric dopamine (DA) asymmetries. Turning consistently occurs towards the side with less DA. The authors tested 69 right-handers and 24 non-right-handers with a device recording spontaneous turning behavior for 20 hr within 3 days. Findings indicate that right-handers preferred left-sided turning and non-right-handers preferred right-sided turning. This result suggests a link between handedness and DA asymmetries.

Adult↗

PubMed1980

Distracting information, motor performance and sex differences.

It is often argued that, in general, men are superior to women in perceptual motor skills (for example, car driving). Extensive reviews of the relevant literature do not give convincing evidence of sex differences in manual dexterity or motor skills in general. However, in the studies reported here, variables have been isolated which demonstrate that sex differences do exist in two perceptual motor tasks. These studies showed that females are adversely affected by irrelevant stimuli while performing tasks permitting freedom in movements but perform as well as males when the movement is stereotyped.

Adult↗

PubMed1982

Donor origin of the in vitro haematopoietic microenvironment after marrow transplantation in man.

The method for long-term culture of marrow cells in vitro as described by Dexter has recently been successfully applied to human marrow and is dependent on the development of an adherent stromal cell layer consisting of cells described as "endothelial-like cells, fat cells, and macrophages". The present study was designed to determine the origin and composition of the stromal cells forming the in vitro 'microenvironment' and maintaining haematopoiesis in long-term cultures grown from marrows of 14 patients who received marrow transplants from HLA identical siblings of the opposite sex. The presence of a Y chromosome was used as a marker to establish the donor or recipient origin of the cells. We found that the stromal cells became progressively donor in origin with time after transplantation and some reacted with antibody directed against factor VIII-associated antigen. In addition, donor-derived in vitro stromal cells synthesized both interstitial and basal lamina collagen types, indicating that the in vitro microenvironment is transplantable and composed in part of endothelial-like cells.

Adipose Tissue↗

PubMedDate not supplied

Task variables determine which biological clock controls circadian rhythms in human performance.

There are circadian (approximately 24 h) rhythms for a wide range of human physiological and psychological functions including mood and performance efficiency. These rhythms are self-sustaining in conditions of temporal isolation, indicating that internal oscillators (or biological clocks) control them. Recent research has proposed an endogenous two-oscillator model of the human circadian system, with one oscillator indicated by the core body temperature rhythm and a second oscillator responsible for the daily cycle of sleep and wakefulness. The present study was designed to produce a desynchronization in period between the two oscillators, to assess directly the behaviour of the rhythms of different performance tasks. The results, reported here, indicate that a simple manual dexterity task is almost entirely under the control of the temperature rhythm oscillator, whereas a more complex cognitive task demonstrates a periodicity which appears to be influenced by those oscillators controlling temperature and the sleep/wake cycle.

Adult↗

PubMed2006

Nogo-A-specific antibody treatment enhances sprouting and functional recovery after cervical lesion in adult primates.

In rodents, after spinal lesion, neutralizing the neurite growth inhibitor Nogo-A promotes axonal sprouting and functional recovery. To evaluate this treatment in primates, 12 monkeys were subjected to cervical lesion. Recovery of manual dexterity and sprouting of corticospinal axons were enhanced in monkeys treated with Nogo-A-specific antibody as compared to monkeys treated with control antibody.

Animals↗

PubMed1975

Spiroergometric and telemetric investigations during the XXI International Stoke Mandeville Games 1972 in Heidelberg.

Spiroergometric and telemetric investigations were carried out on 100 paralysed athletes during the XXI International Stoke Mandeville Games in Heidelberg, 1972. The technical and organisational difficulties in carrying out these measurements were engendered by the disabilities of subjects. The maximum oxygen uptake observed and the oxygen pulse were lower than in non-disabled persons. There were no differences in the peak heart rates (180-200 beats/min.) as compared with non-disabled athletes during particular competition situations. Sports characterised by quickness, dexterity and strength are not able to train the cardiopulomnary system substantially. Swimming is recommended as beneficial. Psychological and training physiological considerations suggest that long-distance wheelchair races should be adopted as a Stoke Mandeville event.

Adult↗

PubMed1981

Morphological and histochemical correlation of recovery after spinal transection in rat.

Previous studies from our laboratory have shown disappearance of aminergic terminals with relative preservation of cholinergic activity below the level of the lesion (Rodriques & Sahgal, 1978). Since then we have extended our study to look at the behaviour of aminergic fibres and neurons at various time intervals following the lesion and attempted to correlate with the functional recovery. Three to 4 weeks after spinal transection (thoracic), the rats started to show spinal-stepping which became stronger and dexterous with the passage of time. Up to 6 months after thoracic transection, maximum recovery was observed. Studies of catecholamine fluorescence revealed proliferation of new aminergic terminals which were observed four or five segments below the transection. These observations demonstrate regeneration of aminergic fibres in rat. The significance of the data in the light of neurophysiologic studies will be discussed.

Acetylcholinesterase↗

PubMed1982

Experience with self intermittent catheterisation for women with neurological dysfunctions of the bladder.

Self intermittent catheterisation (SIC) was taught to 24 women with neurological diseases involving the bladder. The major causes of neuropathic bladders were traumatic lesions of the spinal cord (17 cases, 70 per cent), diabetes and multiple sclerosis. Patients were aged 16--65 years (mean 36 years). Initial acceptance of the procedure proved to be a temporary problem in some fastidious women, but the majority eagerly accepted the opportunity to be free of permanent drainage equipment. A bladder relaxant drug was used in order to suppress spontaneous detrusor contractions in patients with intact lower motor neurones. A training period of 1 day to 2 weeks, depending on manual dexterity, was sufficient to ensure competence in the technique. All patients were able to perform the procedure with few incidents of infection while in the Hospital, but in four patients it proved to be impractical and was discontinued after 1 to 2 weeks. After discharge home three patients have gone back to permanent Foley drainage. Women who have good home settings or who are able to ambulate to some degree, do well on SIC, but the advantages of prevention of infection and freedom from drainage bags do not, as yet, outweigh the social problems for many women confined to wheelchairs such as architectural barriers, time schedules and suitable clothing. Selected patients must be both well motivated and independent in transfers so that while an excellent solution for some, SIC is far from being the solution for all women with neurological dysfunction of the bladder.

Adolescent↗

PubMed2004

Optimization of operator and physical parameters for laser welding of dental materials.

OBJECTIVE: Interactions between lasers and materials are very complex phenomena. The success of laser welding procedures in dental metals depends on the operator's control of many parameters. The aims of this study were to evaluate factors relating to the operator's dexterity and the choice of the welding parameters (power, pulse duration and therefore energy), which are recognized determinants of weld quality. DESIGN: In vitro laboratory study. MATERIALS AND METHODS: FeNiCr dental drawn wires were chosen for these experiments because their properties are well known. Different diameters of wires were laser welded, then tested in tension and compared to the control material as extruded, in order to evaluate the quality of the welding. Scanning electron microscopy of the fractured zone and micrograph observations perpendicular and parallel to the wire axis were also conducted in order to analyse the depth penetration and the quality of the microstructure. Additionally, the micro-hardness (Vickers type) was measured both in the welded and the heat-affected zones and then compared to the non-welded alloy. RESULTS: Adequate combination of energy and pulse duration with the power set in the range between 0.8 to 1 kW appears to improve penetration depth of the laser beam and success of the welding procedure. Operator skill is also an important variable. CONCLUSION: The variation in laser weld quality in dental FeNiCr wires attributable to operator skill can be minimized by optimization of the physical welding parameters.

Chromium Alloys↗

PubMed1997

Photochemical purging of autologous bone marrow grafts: assessment of damage to stem cells and the microenvironment in long-term marrow cultures.

Toxicity of merocyanine 540 (MC540) was assessed in long-term (Dexter-type) bone marrow cultures and in a short-term in vitro clonal assay of fibroblast colony-forming cells (CFU-F). Exposure of freshly explanted mouse bone marrow cells to MC540 (15 micrograms/ml) and white light (fluence: 126 kJ/m2) reduced CFU-F by approximately 2 logs but did not abrogate the cells' capacity to establish and maintain long-term bone marrow cultures. Fat cells were rare or absence in adherent layers established with photosensitized bone marrow cells but the cultures' capacity to generate non-adherent cells, granulocyte/macrophage progenitors (CFU-GM), and early erythroid progenitors (BFU-E) was only moderately (28-36%) reduced.

Animals↗