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Biomedical subjects

C Ekdahl

Publications and source records attributed to C Ekdahl.

50 records · Page 3Linked to original sources
PubMed1994

Standing balance in trans-tibial amputees following vascular disease or trauma: a comparative study with healthy subjects.

Standing balance measured as sway and standing time both on one and two legs, was studied by use of a stable force platform (Kistler) in 36 patients aged 48-87 years with trans-tibial amputation and 27 healthy subjects matched for age. The aim of the study was to compare postural function in standing in two groups with unilateral trans-tibial amputations, separating vascular disease from trauma. Results revealed that the vascular group had a significantly increased sway in the lateral direction compared with the healthy group, when standing on both feet close together for 30 seconds, looking straight ahead or blindfolded (p values ranging from 0.003 to 0.02). In the sagittal direction the trauma amputees had a significantly decreased sway when looking straight ahead, compared to the vascular and healthy groups (p values = 0.03). No significant differences in the lateral or sagittal direction were seen among the three groups when comparing standing on one leg. There was a significant difference, however, in the standing time in the one-leg standing test of the vascular group when compared with the trauma and healthy groups (p values ranging from 0.0009 to 0.02). In contrast to the vascular group, all subjects in the trauma and healthy groups from 48 to 59 years could stand on the healthy leg for 30 seconds when looking straight ahead, and from 60 to 79 years they could stand for 5 seconds. None in the vascular or trauma group older than 80 years could stand on the healthy leg for 5 seconds.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1994

Dynamic training and circulating neuropeptides in patients with rheumatoid arthritis: a comparative study with healthy subjects.

This study aimed at evaluating the effects of a dynamic physical training programme on circulating levels of corticotropin-releasing hormone (CRH), beta-lipotropin (beta-LPH), and beta-endorphin (beta-EP) after high-intensity training for 6 weeks (60 min twice a week) and after low-intensity training (home-training) for another 6 months in patients with rheumatoid arthritis (RA) and in healthy subjects. Additionally, differences in neuropeptide levels between the two groups were studied. A total of 30 patients with RA were randomly allocated to the study, 15 in the training group (TG) and 15 in the control group (CG). In addition, 20 healthy subjects (10 in TG; 10 in CG) participated. In addition to the biochemical analyses, the following variables were assessed for the RA group: pain and disability (Stanford health assessment questionnaire), joint tenderness (Ritchie articular index), disease activity, muscle function, aerobic capacity, sociodemographic data and attitudes. The results obtained at the start revealed significant differences (p < 0.05) between RA patients and healthy subjects concerning CRH levels, RA patients showing the lower levels (RA-group Md = 24 pmol/L, healthy group Md = 29 pmol/L). No significant differences concerning beta-LPH and beta-EP were found here. After the high-intensity training period, a significant increase of the CRH levels were found for the RA-TG (pretest Md = 24 pmol/L, after 6 weeks Md = 27 pmol/L, p < 0.05). No such results were found for the healthy-TG or the control groups. Concerning beta-EP, significant differences between the RA-TG and healthy-TG were found after the training. RA patients generally showing higher levels as compared with the healthy (RA-group Md = 42 pmol/L, healthy group Md = 36 pmol/L, p < 0.05). The same pattern was found for the beta-LPH levels. In conclusion, the effects of physical training on circulating neuropeptides remain still incompletely examined, and there is no definite answer to the question whether increased beta-EP levels are good or bad.

Adult↗
PubMed1992

Self-appraisal and coping in out-patients with chronic disease.

Self-appraisal, coping efforts, muscle function, and activity and severity of disease were examined in out-patients with rheumatoid arthritis, osteoarthrosis or diabetes mellitus. Factor analysis of a 31-item self-appraisal and coping questionnaire yielded eight factors (self-appraisal, acceptance, minimization, planful problem-solving, avoidance, persistence, attribution of responsibility, and support seeking). For the factors of avoidance, minimization, and persistence, as well as for measures of activity and severity of disease, significant differences between the diagnostic groups were found. For patients with rheumatic arthritis, hierarchical regression analysis indicated disease duration to be associated with acceptance and with attribution of responsibility, and disability measures to be associated with self-appraisal. For patients with osteoarthrosis, they showed disability in muscle function to be associated with avoidance, and more negative self-appraisal as well as lower levels of support seeking to be associated with long disease duration. Results are discussed in terms of structural and adaptive defence forms and of adherence to a coping model ("medical model") which tends to foster acceptance and dependency.

Activities of Daily Living↗
PubMed1992

Muscle strength, endurance, and aerobic capacity in rheumatoid arthritis: a comparative study with healthy subjects.

Isometric/isokinetic muscle strength and isokinetic endurance of the lower extremities as well as aerobic capacity were evaluated in 67 patients (43 female, 24 male; mean age 53 years, range 23-65) with classical/definite rheumatoid arthritis (RA) of functional class II. Results obtained were compared with those of a healthy reference group matched for age and sex. Disease characteristics of the group with RA were registered and lifestyle characteristics, such as work load, exercise, diet, smoking, and alcohol habits, were reported by both groups. Generally, results showed that the group with RA had decreased functional capacity. Isometric hip and knee muscle strength of the rheumatoid group was reduced to about 75% of normal function, isokinetic knee muscle strength at the velocities of 60 and 180 degrees/s to about 65% and 75% of normal function respectively, isokinetic endurance of the knee muscle groups to about 45%, and aerobic capacity to about 80% of the results obtained for the healthy reference group. Analyses of variance showed that the rheumatoid group, compared with the healthy group, had significantly reduced function on all isometric and isokinetic tests of the extensors and flexors of the knee. Results for isometric hip muscle strength were similar--all tests but one yielding highly significant differences. To avoid unnecessary functional deficits it seems important to include muscular training in rehabilitation programmes for patients with RA.

Activities of Daily Living↗
PubMed1992

Postural control, muscle function and psychological factors in rheumatoid arthritis. Are there any relations?

The aim of the present study was to relate postural control, as measured on a quantitative test battery as standing balance on an AMTI force platform, to results of muscle function of the lower extremities, aerobic capacity, disease characteristics, attitudes revealing anxiety, and demographic variables in patients with rheumatoid arthritis (RA). A group of 61 patients with RA was investigated. Multiple regression analyses, using both the stepwise and the backward elimination method, were employed for length of sway path in two-leg standing looking straight ahead and blindfolded as dependent variables. The results revealed postural control in two-leg standing looking straight ahead to be highly related to age and sex but also to isokinetic endurance and to anxiety. In the model, 55% of the variance was explained by these variables at a significance level of p = 0.05. Characteristics of the RA disease, such as c-reactive protein and joint-mobility did not play any major role in explaining postural control.

Adult↗
PubMed1990

Dynamic versus static training in patients with rheumatoid arthritis.

Sixty-seven patients with classical or definite rheumatoid arthritis (RA) were studied concerning the effects of standardized physical training on muscle function in the lower extremities. The patients were randomly assigned to four different training groups and were given 6 weeks of training supervised by a physiotherapist at a health care centre. The groups differed according to type (dynamic or static) and extent (12 or 4 times) of training. During this training period as well as for an additional 3 months, the patients carried out programs of exercise at home (either dynamic or static). A significantly greater increase in function during the 6-week period as regards muscle strength, endurance, aerobic capacity, and functional ability was found for the dynamic as compared with the static groups. The findings at follow-up 3 months later were similar. The effectiveness of the programs did not vary with the extent of training. In conclusion, in RA patients, dynamic training gives a greater increase in physical capacity than does static training.

Activities of Daily Living↗
PubMed1990

Muscle function in rheumatoid arthritis. Assessment and training.

The conclusions can be summarized as follows: experienced problems of muscle function were reported in about 80% of RA and OA patients for whom there was involvement of large joints of the lower extremities; RA and OA patients did not differ as to experienced problems of muscle strength, endurance and balance/coordination; problems of muscle function were correlated with functional tests of muscle strength but not with those of endurance and balance/coordination; problems of muscle strength were found to correlate with LE-ADL, whereas problems of endurance and balance/coordination were not found to correlate with the latter; the translated and slightly modified version of the HAQ questionnaire appeared to possess a high degree of reliability and validity in assessing disability in patients with RA under Swedish conditions; a quantitative battery of tests for the evaluation of standing balance on a computerized force platform was found to be satisfactorily reliable and to correlate in healthy subjects with most of the functional tests employed; in healthy subjects, standing balance appeared to be related not only to age but also to sex, males and older age groups showing greater postural sway than females and persons of younger age groups; compared with healthy subjects, RA subjects showed significantly greater postural sway, differences being greatest for those tests representing a relatively high level of difficulty; dynamic training for six weeks appeared to provide RA patients with a greater increase in physical capacity of the lower extremities than did static training, the gains thus obtained still being present after an additional three-month period; the effectiveness of the dynamic training programs did not vary with the degree of supervision of training by a physiotherapist, i.e. of 12 visits or 4 being made at the health care centre; despite the intensity of the dynamic training-program employed with RA patients, no increase in pain experience or disease activity was found during the training-period; during short-term high-intensity training a significant increase in circulating beta-EP was found between the 3rd and 6th weeks of training, no increase in CRF and beta-LPH being present; following a long-term low-intensity training period, a significant increase of CRF and beta-LPH was found, no similar increase being noted for beta-EP.

Arthritis, Rheumatoid↗
PubMed1989

Muscle function of the lower extremities in rheumatoid arthritis and osteoarthrosis. A descriptive study of patients in a primary health care district.

Thirty-six patients with rheumatoid arthritis (RA), 30 patients with cox- or gonarthrosis (OA), and a control group of 40 patients with diabetes mellitus (DM) were studied with the aim of analyzing and comparing patient experienced muscular problems of muscle-strength analyzing and comparing patient experienced muscular problems of muscle-strength, endurance and balance/coordination with muscle function as assessed by standardized tests. The results indicated that patient-experienced problems of muscle function of the lower extremities were frequent in both the RA and the OA groups (about 80%) compared to the DM group (10%). Multivariate analyses of variance (MANOVAs) on experienced and tested muscle strength, endurance and balance/coordination, revealed a significant RA-OA difference (p less than 0.05). Separate analyses of variance (ANOVAs) indicated OA patients to show decreased tested endurance compared with the RA group. There was no significant RA-OA difference as to pain. Results provide evidence for considering muscle function of the lower extremities in therapeutic programs for RA and OA within primary health care.

Activities of Daily Living↗
PubMed1989

Standing balance in rheumatoid arthritis. A comparative study with healthy subjects.

Standing balance was studied with use of a force platform (AMTI) in 67 subjects with classical/definite rheumatoid arthritis (RA) and 152 healthy subjects, 67 of whom formed a group matched for sex and age. Compared with healthy subjects, RA subjects showed significantly (p less than 0.01) greater postural sway, reflected by increased area and length of sway path, differences being greatest in those tests representing a relatively high level of difficulty, involving standing on one leg, looking straight ahead.

Adult↗
PubMed1989

Standing balance in healthy subjects. Evaluation of a quantitative test battery on a force platform.

A quantitative battery of tests for standing balance is needed in the assessment of functional impairments. The aims of the present study were to obtain stabilometric reference values for healthy females and males, 20-64 years of age, on a stable computerized force platform (AMTI) and to relate the balance data thus obtained to some traditional functional balance tests. Altogether, 152 subjects performed a series of tests. The test battery on the force platform comprised tests of standing with feet close together or on one leg while looking straight ahead or while blindfolded. Traditional functional balance tests were checked and various background data were collected through a questionnaire. Results of a separate test-retest reliability study of the test battery given on the force platform appeared promising, especially for the tests with eyes open. In the main study, results obtained on the force platform correlated significantly (p less than 0.001) with results of most of the functional tests. Women showed higher standing balance as compared with men. The results suggest the importance of relating the test-data not only to age but also to sex.

Adult↗
PubMed1988

Assessing disability in patients with rheumatoid arthritis. Use of a Swedish version of the Stanford Health Assessment Questionnaire.

The validity and reliability under Swedish conditions of a translated and slightly modified version of the Stanford Health Assessment Questionnaire (HAQ), referred to here as the ADL questionnaire, was studied. Sixty-four patients with definite/classical rheumatoid arthritis (RA) participated in the major part of the investigation. In addition, inter-observer reliability was studied in the testing of 15 other patients with RA. The questionnaire was filled in by the patients twice (ADL Tests 1 and 2) with a one-week interval between. A physiotherapist or occupational therapist also assessed each of the patients on a sample of ADL functions (ADL Test 3). Joint mobility, grip-strength, pain, Ritchie index and ESR were likewise checked. Results indicated inter-observer reliability to be high for the ADL (r(S) = 0.98), for joint mobility (r(S) = 0.86), and for the Ritchie index (r(S) = 0.83). The test-retest reliability for the ADL questionnaire which the patients filled in (Tests 1 and 2) was high r(S) = 0.91. Results of the ADL questionnaires the patients completed were found to correlate fairly closely with the observations of the therapists, r(S) = 0.71. The validity of the scoring system was found to be sufficient, using Ward's cluster analysis for comparing the original HAQ scores with scores on all the questions included in the questionnaire. Thus, the translated and somewhat modified version of the ADL questionnaire studied here appears to possess a high degree of reliability and validity in assessing patients with RA.

Activities of Daily Living↗
PubMed1981

Comparison of diflunisal and acetylsalicylic acid in patients with rheumatoid arthritis.

A double-blind comparison of the clinical efficacy and tolerance of varying doses of diflunisal (DFS) and acetylsalicylic acid (ASA) was carried out in 15 patients with rheumatoid arthritis who were given no other antirheumatic medication. An effort was made to select appropriate anamnestic, functional and sociofunctional tests and to optimize their validity by careful measurements performed by the same specialized physiotherapist and occupational therapist. In addition, the serum concentration of DFS and salicylic acid were monitored by high-pressure liquid chromatography. The therapeutic effects of DFS was at least as good as that of ASA. Moreover, DFS was better tolerated; all 7 patients on DFS could sustain the maximum dose (1g) of this drug, while that of ASA (4g) was tolerated by only one of 8 patients. All these experienced side effects, necessitating drug withdrawal in 3 cases, one being a serious hepatotoxic reaction. DFS treatment, on the other hand, was associated with only one minor side effect. The side effect difference was statistically significant (p less than 0.01). The analyses of drug concentrations in serum verified that all patients were exposed to DFS and ASA as planned, adding safety to the judgement of the therapeutic effects. The findings support the view that the novel salicylic acid derivative DFS may offer a therapeutic advantage in the treatment of rheumatoid arthritis; it seems to have at least the same therapeutic effect as ASA an may be better tolerated.

Adult↗
PubMedDate not supplied

A study of the usage of a decision-support system for infective endocarditis.

The objective of this study was to examine a design for a World Wide Web-based decision-support system in use by clinically active physicians. A prototype implementation of the design concerned management of infective endocarditis patient cases. The design was based on an integration of hypertext and rule-based knowledge. In the study sessions, physicians in the field of internal medicine worked on managing authentic patient cases in a laboratory setting. Data was collected from interviews with the physicians using video recordings and stimulated recall technique. The qualitative data was analysed according to the constant comparative method in order to develop a model of the physicians' usage of the system. The resulting model describes perceived contributions and criteria for usefulness of the system. The ways the physicians used the system showed that it was able to provide patient-specific support for confirming clinical decisions, for higher-level patient management, and for preparing for and initiating expert consultations. Users also stated that new medical knowledge could be gained as a side effect of using the system.

Attitude to Computers↗