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At least 1,621 records · Page 90Linked to original sources

PubMed2003

A waitlist control-group study of cognitive, mood, and quality of life outcome after posteroventral pallidotomy in Parkinson disease.

OBJECT: The aim of this study was to examine neuropsychological outcome from unilateral posteroventral pallidotomy (PVP) in Parkinson disease while controlling for confounding factors such as test practice and disease progression. METHODS: Participants underwent baseline and 2-month follow-up assessments of cognition, quality of life, mood, and motor functioning. The surgery group (22 patients) underwent PVP (15 left, seven right) after baseline assessment. The waitlist group (14 patients) underwent PVP after follow up. At follow up, the left PVP group exhibited a decline on verbal measures of learning, fluency, working memory, and speeded color naming. The incidence of significant decline on these measures after left PVP ranged from 50 to 86%. The right PVP group did not exhibit a significant cognitive decline, but fluency did decline in 71% of patients who underwent right PVP. Participants who underwent PVP reported better bodily pain and social functioning at follow up than participants in the waitlist group. Improved bodily pain was evident for 62% of the surgery group, and social functioning improved for 19%. Surgery did not alter reported physical functioning or mood. Dyskinesia improved after surgery, but there were no improvements in "on-state" manual dexterity or handwriting. CONCLUSIONS: Most patients who underwent left PVP exhibited declines in learning, fluency, working memory, and speeded color naming. Accounting for retesting effects altered the magnitude of these declines by up to one quarter of a standard deviation, but did not increase the breadth of postsurgical neuropsychological decline beyond that typically reported in the literature. It was found that PVP improved dyskinesia, bodily pain, and social functioning, but did not lead to improvement on other objective and self-reported measures of motor functioning.

Aged↗

PubMed2005

Microsurgical robotic system for the deep surgical field: development of a prototype and feasibility studies in animal and cadaveric models.

OBJECT: To enhance the surgeon's dexterity and maneuverability in the deep surgical field, the authors developed a master-slave microsurgical robotic system. This concept and the results of preliminary experiments are reported in this paper. METHODS: The system has a master control unit, which conveys motion commands in six degrees of freedom (X, Y, and Z directions; rotation; tip flexion; and grasping) to two arms. The slave manipulator has a hanging base with an additional six degrees of freedom; it holds a motorized operating unit with two manipulators (5 mm in diameter, 18 cm in length). The accuracy of the prototype in both shallow and deep surgical fields was compared with routine freehand microsurgery. Closure of a partial arteriotomy and complete end-to-end anastomosis of the carotid artery (CA) in the deep operative field were performed in 20 Wistar rats. Three routine surgical procedures were also performed in cadavers. The accuracy of pointing with the nondominant hand in the deep surgical field was significantly improved through the use of robotics. The authors successfully closed the partial arteriotomy and completely anastomosed the rat CAs in the deep surgical field. The time needed for stitching was significantly shortened over the course of the first 10 rat experiments. The robotic instruments also moved satisfactorily in cadavers, but the manipulators still need to be smaller to fit into the narrow intracranial space. CONCLUSIONS: Computer-controlled surgical manipulation will be an important tool for neurosurgery, and preliminary experiments involving this robotic system demonstrate its promising maneuverability.

Anastomosis, Surgical↗

PubMed2006

Gender-specific movement strategies using a computer-pointing task.

Females typically demonstrate a movement time advantage for tasks requiring high levels of manual dexterity, whereas males are notably better at targeting activities. According to D. Kimura (2000), the hunter-gatherer hypothesis primarily accounts for those performance advantages; that dichotomy fails, however, when one makes movement outcome predictions for tasks that are not clearly fine-motor or interceptive in nature. Investigators have recently proposed that time constraints (M. Peters, 2005) and gender-specific response style differences (M. Peters & P. Campagnaro, 1996; L. E. Rohr, 2006) affect motor performance. Here, the author used a computer-pointing task measuring both movement error and movement time in 16 participants to further investigate response style differences. Kinematic and linear regression analyses between resultant error and both movement time and task difficulty reinforced the notion that gender-specific movement biases emphasize speed and accuracy, respectively, for men and women.

Computer Graphics↗

PubMed1994

Ten years of experience with various penile prosthesis in Korean.

Currently there are more than 10 types of penile prosthesis available, ranging from the very simple to the very sophisticated. We review our experiences with various penile prosthesis, with particular regard to the complication rate. From Dec. 1983 to Jul. 1993, we implanted 295 penile prosthesis of eight different types. The average age of patients was 44 years. Every patient was evaluated with various multidisplinary diagnostic approaches. The etiologies of impotence were vasculogenic 29%, diabetogenic 22%, spinal cord injury 16%, pelvic bone injury 11%, etc. The types of implanted prosthesis were AMS malleable 143, Jonas 42, Dynaflex 36, Hydroflex 8, Uni-Flate 1000 2, AMS 700 CXM 58, Ultrex 3, Mentor alpha-1 3 and the mean follow-up period was 34 months. The diameters of implanted prosthesis were from 9.5 mm to 13 mm, mostly 9.5 mm (52.9%). The length of implanted prosthesis were from 10 cm to 20 cm, mostly 16 approximately 18 cm (68.8%). Cases with uneven diameters or lengths were 20 (6.8%). The int aoperative complications were 1 corporeal rupture and 1 bladder rupture, and the postoperative complications were 2 prosthesis infections, 2 mechanical failures, and 1 prosthesis infection with mechanical failure. In those 4 patients reimplantations were successful. More than 99% (290/291) patients still have functioning prosthesis. Every prosthesis has their advantages and disadvantages. Factors to be analysed in the selection of proper prosthesis should include patients economic status, education, personality, social activity, hand dexterity, and penile size.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed2003

Cloning and analysing the up-regulated expression of transthyretin-related gene (LR1) in rat liver regeneration following short interval successive partial hepatectomy.

AIM: Cloning and analysing the up-regulated expression of transthyretin-related gene following short interval successive partial hepatectomy (SISPH) to elucidate the mechanism of differentiation, division, dedifferentiation and redifferentiation in rat liver regeneration (LR). METHODS: Lobus external sinister and lobus centralis sinister, lobus centralis, lobus dexter, lobus candatus were removed one by one from rat liver at four different time points 4, 36, 36 and 36 hr (total time: 4 hr, 40 hr, 76 hr, 112 hr) respectively. Suppression subtractive hybridization (SSH) was carried out by using normal rat liver tissue as driver and the tissue following short interval successive partial hepatectomy (SISPH) as tester to construct a highly efficient forward-subtractive cDNA library. After screening, an interested EST fragment was selected by SSH and primers were designed according to the sequence of the EST to clone the full-length cDNA fragment using RACE (rapid amplification of cDNA end). Homologous detection was performed between the full-lenth cDNA and Genbank. RESULTS: Forward suppression subtractive hybridization (FSSH) library between 0 h and 112 h following SISPH was constructed and an up-regulated full-length cDNA (named LR1), which was related with the transthyretin gene, was cloned by rapid amplification of cDNA end. It was suggested that the gene is involved in the cellular dedifferentiation in LR following SISPH. CONCLUSION: Some genes were up-regulated in 112 h following SISPH in rat. LR(1) is one of these up-regulated expression genes which may play an important role in rat LR.

Animals↗

PubMed2005

Normative data for the Attitudes towards Loss of Hearing Questionnaire.

Investigations have shown that patient attitudes toward hearing loss and hearing aids impact self-reported handicap and disability, hearing aid benefit, and hearing aid use. The Attitudes towards Loss of Hearing Questionnaire (ALHQ) was developed by Saunders and Cienkowski (1996) to examine some of the psychosocial factors underlying the use and acquisition of hearing aids. Here we report data from a new version of questionnaire (ALHQ v2.1), which examines attitudes towards hearing loss and hearing aids on five scales: Denial of Hearing Loss, Negative Associations, Negative Coping Strategies, Manual Dexterity and Vision, and Hearing-Related Esteem. Reliability values, internal consistency values, and cut points for typical and atypical scores are provided, along with comparison of the scores of women, men, current hearing aid users, non-hearing aid users, and paying versus nonpaying individuals. The ALHQ takes about ten minutes to complete and identifies for the clinician some of the issues that might jeopardize successful hearing aid outcome.

Adaptation, Psychological↗

PubMed1991

Overcoming the clinical barriers of low literacy and medication noncompliance among the elderly.

Common barriers to medication noncompliance include complex medication schedules, inadequate teaching, poor vision, or loss of dexterity. However, a less obvious factor is that of low literacy. Tailoring and cuing, derived from theories of behavior modification, define the problem by the current, immediate behaviors of the patient and analyze the events that normally occur immediately before and after prescribed medication times. Through the use of tailoring and cuing, the person's everyday life will not be drastically altered and the patient will feel in control of the medication schedule.

Aged↗

PubMed1999

Implementing an incontinence program in long-term care settings. A multidisciplinary approach.

Urinary incontinence is a prevalent and costly problem in long-term care settings. Impaired bladder function can cause many physical and social problems, such as impaired skin integrity, falls, and altered psychological well-being. Fortunately, there are several low-risk interventions that can cure or improve continence status in many individuals, regardless of cognitive status. Basic assessment of medical and environmental status, as outlined in this article, can assist staff in determining transient conditions which often alter bladder control. Because many interventions are dependent on mobility, dexterity, and diet, an interdisciplinary approach is ideal.

Aged↗

PubMed2001

TNF-alpha-converting enzyme cleaves the macrophage colony-stimulating factor receptor in macrophages undergoing activation.

We previously reported that macrophage activators such as LPS, IL-2, and IL-4 down-modulate the M-CSFR via a mechanism involving protein kinase C and phospholipase C. In this study, we showed that M-CSFR is shed from macrophage surface and identified the protease responsible for M-CSFR cleavage and down-modulation. The shedding of M-CSFR elicited by phorbol esters (tetradecanoylphorbol myristate acetate (TPA)) or LPS in murine BAC.1-2F5 macrophages was prevented by cation chelators, as well as hydroxamate-based competitive inhibitors of metalloproteases. We found that the protease cleaving M-CSFR is a transmembrane enzyme and that its expression is controlled by furin-like serine endoproteases, which selectively process transmembrane metalloproteases. M-CSFR down-modulation was inhibited by treating cells in vivo, before TPA stimulation, with an Ab raised against the extracellular, catalytic domain of proTNF-converting enzyme (TACE). TACE expression was confirmed in BAC.1-2F5 cells and found inhibited after blocking furin-dependent processing. Using TACE-negative murine Dexter-ras-myc cell monocytes, we found that in these cells TPA is unable to down-modulate M-CSFR expression. These data indicated that TACE is required for the TPA-induced M-CSFR cleavage. The possibility that the cleavage is indirectly driven by TACE via the release of TNF was excluded by treating cells in vivo with anti-TNF Ab. Thus, we concluded that TACE is the protease responsible for M-CSFR shedding and down-modulation in mononuclear phagocytes undergoing activation. The possible physiological relevance of this mechanism is discussed.

ADAM Proteins↗

PubMed2003

Rheumatoid arthritis: hand function, activities of daily living, grip strength and essential assistive devices.

UNLABELLED: Persons with rheumatoid arthritis use assistive devices to enable them, in spite of impaired hand dexterity and grip strength, to manage Activities of Daily Living (ADL). The aim of the research was to lay the foundation for a list of essential assistive devices through determining which assistive devices for ADL were most often used and requested, investigating whether there was a correlation between grip strength and the number of assistive devices, duration of disease, degree of difficulty in performing ADL and by investigating whether there was a correlation between difficulty in ADL and number of assistive devices, duration of the disease. STUDY SAMPLE: Fifty five persons, 42 females and 13 males, seen at the Pretoria Academic Hospital's Arthritis Clinic were recruited. MATERIALS AND METHODS: A questionnaire was used to determine the level of difficulty with ADL. Details about assistive devices were recorded. The modified sphygmomanometer was used to measure grip strength. RESULTS: Assistive devices most in use were the tap turner and the dagger knife with built up handle. The highest correlation was found between grip strength and difficulty in ADL and between difficulty in ADL and the number of assistive devices used. It seems therefore that loss of grip strength is the main indicator for assistive devices.

Academic Medical Centers↗

PubMed1986

The Purdue Pegboard: norms for 14- to 19-year-olds.

The purpose of this study was to collect normative data on the Purdue Pegboard, a test of finger dexterity, for individuals aged 14 to 19 years. Three trials were administered to 176 subjects from the seven-county Milwaukee area. Results indicated that females performed better than males on three out of four subtests, suburban subjects scored better than urban subjects on two of four subtests, and scores increased with age. The normative data collected provide a means of comparing a patient's score with normal individuals of the same sex and age and aid in determining a patient's need for therapy and in setting appropriate treatment goals.

Adolescent↗

PubMed1987

Functional hand evaluations: a review.

Describing hand prehension patterns in the context of functional hand evaluations may not provide the therapist or surgeon with an accurate portrayal of a patient's capabilities. Although dexterity involves both static and dynamic components of hand usage, most descriptions of prehension patterns study the static phase alone. Hand use is a function of anatomic integrity, mobility, strength, sensation, coordination, age, sex, mental status, disease or trauma, and the condition of other proximal extremity joints (shoulder, elbow, wrist). In this study, various descriptions of hand prehension patterns were reviewed and 11 functional hand evaluations were analyzed. The purpose was to see if the descriptions and the evaluations have common elements. The conclusions are that there are no common elements, that no hand function evaluation is appropriate for all types of patients, and that such evaluations should consist of tasks representative of everyday functional activities.

Functional Laterality↗

PubMed1991

The effects of a short thumb opponens splint on hand function in cerebral palsy: a single-subject study.

An AB single-subject research design was used to assess the effectiveness of a short thumb opponens splint on hand function in a 4-year-old girl with cerebral palsy. Baseline data for active range of motion, grip and pinch strength, grasp patterns, the Box and Block Test of manual dexterity (Mathiowetz, Voland, Kashman, & Weber, 1985), and 1-in. cube stacking were collected twice a week for 4 weeks. The child was fitted with a short thumb opponens splint, which was worn 6 hr during the day and all night for 4 weeks. The twice-weekly measures of the dependent variables continued during the treatment phase. Visual and statistical analysis of the data indicate that the child showed a clinically significant improvement in palmar and radial abduction, thumb opposition, grip strength, performance on the Box and Block Test scores, cube stacking, and lateral pinch. These results suggest that for this child with cerebral palsy, the use of a short thumb opponens splint improved underlying aspects of hand function as well as hand function itself. Replication of this study with a more complex single-subject design involving more subjects is recommended to confirm these results.

Biomechanical Phenomena↗

PubMed1993

Training for a patient with shoulder disarticulation.

This patient received 26 outpatient occupational therapy sessions for a total of 32.5 hr during an 18-week period. All treatment goals were achieved with the exception of psychosocial adjustment issues, which are ongoing. He made significant gains in right upper quadrant muscle isolation and demonstrated control and strength of the upper, middle, and lower trapezius fibers adequate for a myoelectric prosthetic. He also made improvement with left manual dexterity and unilateral coordination with regard to activities of daily living. He was discharged from outpatient occupational therapy services and referred to another medical center for prosthetic evaluation. Twenty weeks after discharge from our facility, he returned for a follow-up visit. He had been fitted with a shoulder cap and his tolerance for wearing it was approximately 10 hr per day. Thirteen weeks after the follow-up visit he resumed outpatient occupational therapy. We are evaluating his tolerance to the placement of a passive arm to the shoulder cap.

Activities of Daily Living↗

PubMedDate not supplied

Interrater reliability of the Peabody Developmental Motor Scales: fine motor scale.

OBJECTIVE: The interrater reliability of the Peabody Developmental Motor Scales (PDMS) fine motor scale was examined in 23 children with developmental disabilities who were between 2 years and 5 years of age. METHOD: Three occupational therapists viewed videotapes of the children and scored each child's performance on the fine motor section of the test. Data were analyzed with the intraclass correlation (ICC) approach; ICC values ranged from 0.90 to 0.97 for the subskills of Grasping, Hand Use, Eye-Hand Coordination, and Manual Dexterity. RESULTS: The ICC interrater reliability value for the total fine motor score was 0.99. Reliability values were additionally computed with the PDMS fine motor scale age-equivalent scores and Z scores. The ICC values for these methods of scoring the PDMS were 0.99 and 1.00, respectively. CONCLUSION: The PDMS fine motor scale can be used consistently to evaluate fine motor delays in this population of young children.

Child, Preschool↗

PubMed1997

Therapists' consistency in following their treatment plans for sensory integrative and perceptual-motor therapy.

OBJECTIVES: Treatment integrity is concerned with whether treatment conditions as provided are consistent with specifications for the treatment. Therapists' consistency in following their treatment plans that called for the use of sensory integrative and perceptual-motor techniques was evaluated. METHOD: Three occupational therapists were rated on their consistency in 46 sessions each of sensory integrative and perceptual-motor therapy. Ratings were made both earlier (1 month) and later (4 months) in treatment. Consistency was rated with a five-point scale for 10 categories of the treatment plans. RESULTS: Overall consistency did not differ significantly (86% for sensory integrative techniques and 79% for perceptual-motor techniques). Perceptual-motor activities showed less consistency early in treatment but approached the level for sensory integrative techniques by later treatment sessions. Consistency differed significantly among therapists for sensory integrative activities that addressed tactile defensiveness and perceptual-motor activities associated with fine coordination and dexterity. CONCLUSION: Despite the less structured, more child-centered nature of sensory integrative techniques, consistency in using these techniques was as high as that found for more scripted, program-centered, perceptual-motor techniques. Therapists reported that gaining the interest and attention of some children with the more structured perceptual-motor activities was more difficult early in treatment but could be achieved with time. Differences in consistency among therapists require verification with a larger sample.

Adult↗

PubMedDate not supplied

The Movement Assessment Battery for Children: a comparison of 4-year-old to 6-year-old children from Hong Kong and the United States.

OBJECTIVE: There is little information available on the appropriateness of tests developed in the West for children of different ethnicities. The aim of this study was to examine the suitability of the Movement Assessment Battery for Children (Movement ABC) for use with Hong Kong Chinese preschool children. METHOD: The performance of 255 Hong Kong Chinese children between the ages of 4 years and 6 years was compared with that of the 493 children of the same age from the United States who took part in the most recent standardization of the Movement ABC. RESULTS: The test content was found to be suitable for use with Hong Kong Chinese children. However, cross-cultural differences were found on a number of the test items. Chinese children performed significantly better on items contained in the manual dexterity and dynamic balance sections, whereas American children were better at the projection and reception of moving objects. CONCLUSION: These findings highlight the need to ensure that norms for all tests are appropriate for the specific cultural groups being assessed.

Child↗

PubMedDate not supplied

Handwriting difficulties in primary school children: a search for underlying mechanisms.

OBJECTIVE: This study investigated the contribution of perceptual-motor dysfunction and cognitive planning problems to the quality or speed of handwriting in children with handwriting problems (HWP). METHOD: Twenty-nine children with HWP and 20 classroom peers attending regular schools (grade 2 and grade 3) were tested with regard to visual perception, visual-motor integration, fine motor coordination, and cognitive planning abilities. RESULTS: The HWP group scored significantly lower on visual perception, visual-motor integration, fine motor coordination, and cognitive planning in comparison with classroom controls. Regression analyses showed that visual-motor integration was the only significant predictor for quality of handwriting in the HWP group, whereas fine motor coordination (i.e., unimanual dexterity) was the only significant predictor of quality of handwriting in the control group. CONCLUSIONS: Results suggest that two different mechanisms underlie the quality of handwriting in children with and without handwriting problems. Poor quality of handwriting of children with HWP seems particularly related to a deficiency in visual-motor integration.

Child↗