Search PubMed⌕ Search

Biomedical subjects

Donna Moxley Scarborough

Publications and source records attributed to Donna Moxley Scarborough.

5 recordsLinked to original sources

Acupuncture for upper-extremity rehabilitation in chronic stroke: a randomized sham-controlled study.

OBJECTIVE: To compare the effects of traditional Chinese acupuncture with sham acupuncture on upper-extremity (UE) function and quality of life (QOL) in patients with chronic hemiparesis from stroke. DESIGN: A prospective, sham-controlled, randomized controlled trial (RCT). SETTING: Patients recruited through a hospital stroke rehabilitation program. PARTICIPANTS: Thirty-three subjects who incurred a stroke 0.8 to 24 years previously and had moderate to severe UE functional impairment. INTERVENTIONS: Active acupuncture tailored to traditional Chinese medicine diagnoses, including electroacupuncture, or sham acupuncture. Up to 20 treatment sessions (mean, 16.9) over a mean of 10.5 weeks. MAIN OUTCOME MEASURES: UE motor function, spasticity, grip strength, range of motion (ROM), activities of daily living, QOL, and mood. All outcomes were measured at baseline and after treatment. RESULTS: Intention-to-treat (ITT) analyses found no statistically significant differences in outcomes between active and sham acupuncture groups. Analyses of protocol-compliant subjects revealed significant improvement in wrist spasticity (P<.01) and both wrist (P<.01) and shoulder (P<.01) ROM in the active acupuncture group, and improvement trends in UE motor function (P=.09) and digit ROM (P=.06). CONCLUSIONS: Based on ITT analyses, we conclude that acupuncture does not improve UE function or QOL in patients with chronic stroke symptoms. However, gains in UE function observed in protocol-compliant subjects suggest traditional Chinese acupuncture may help patients with chronic stroke symptoms. These results must be interpreted cautiously because of small sample sizes and multiple, unadjusted, post hoc comparisons. A larger, more definitive RCT using a similar design is feasible and warranted.

Activities of Daily Living↗

Instant of chair-rise lift-off can be predicted by foot-floor reaction forces.

OBJECTIVE: To develop a predictive model of the lift-off event during chair rise in healthy subjects, using foot-floor reaction forces. BACKGROUND: An important event during chair rise is lift-off from the seat: the transition from the inherently stable three-point contact to the unstable two-point contact. There is no consistent or generally agreed upon method for estimating the time of lift-off when an instrumented seat is unavailable. METHODS: Twenty healthy volunteers were divided into a testing set and training set. Each subject performed repeated chair rise trials at different speeds. Seat-floor and foot-floor forces, recorded with two force platforms, were used to develop a model of the lift-off event. RESULTS: The magnitude of the vertical foot-floor reaction at lift-off (F0VF) was linearly related (R2 = 0.71, P < 0.001) to the peak vertical foot-floor reaction force (FMVF). A linear model was developed for the training group, which enabled prediction of lift-off time for the testing group with an absolute average error of 6 ms (about 1 data frame at 150 Hz). The linear model derived for the entire sample was: F0VF = 28.14 + FMVF * (0.6434). CONCLUSIONS: The lift-off event for healthy subjects performing chair rise can be accurately predicted from foot-floor reaction forces, without requiring an instrumented seat.

Body Weight↗

Tai Chi and vestibular rehabilitation effects on gaze and whole-body stability.

Tai Chi (TC) is a comparatively new intervention for peripheral vestibular hypofunction, which is often treated with vestibular rehabilitation (VR). We compared gaze stability (GZS), whole-body stability (WBS) and footfall stability (FFS) during locomotion among 26 people with vestibulopathy (VSP), randomized into two treatment arms (13 TC and 13 VR). Each intervention program was offered for 10 weeks. GZS improved more for VR than for TC, but WBS (and FFS) improved more for TC than for VR. There was a significant relationship between changes in GZS and WBS for the VR subjects (r=0.60, p=0.01), but not for TC subjects. There was a significant relationship between changes in WBS and FFS for both VR (r=0.65, p <0.01) and TC (r=0.58, p=0.02) groups; the relationship disappeared in the VR but not the TC group when controlling for GZS. These findings suggest that VR and TC both benefit patients with VSP but via differing mechanisms. Moreover, these data are the first to test the assumption that improving gaze control among patients with VSP perforce improves postural stability: it does not. We conclude that GZS is most improved in those who receive VR, but that TC improves WBS and FFS without improving GZS, suggesting patients with VSP can rely on non-gaze related mechanisms to improve postural control.

Female↗