Biomedical subjects

E J Roth

Publications and source records attributed to E J Roth.

64 records · Page 4Linked to original sources

PubMed1988

Rehabilitation outcomes in C6 tetraplegia.

This study reports on the rehabilitation outcome of 69 C6 tetraplegic patients admitted to the Rehabilitation Institute of Chicago during an 8 year period. All patients' last normal level was C6 bilaterally. A 100-point modified Barthel Index was used to obtain measures of functional independence in 15 self-care and mobility tasks. The population consisted of 54 males and 15 females with an average age of 29.2 years. The average number of days from injury to admission to the rehabilitation unit was 58.6 and the average length of rehabilitation stay was 108.4 days. The average Modified Barthel Index score increased from 16.6 on admission to 50.1 on discharge. The Self-Care Subscore increased from 12.8 to 32.2 and the Mobility subscore from 3.7 to 17.9. There were statistically significant increases in the number of patients able to perform all tasks except ability to don an orthosis and ability to walk 50 yards. This study documents a significant increase in function of C6 spinal cord injured patients during rehabilitation.

Adolescent↗

PubMed1988

Stroke rehabilitation outcome: impact of coronary artery disease.

The frequency of clinically significant coronary artery disease (CAD) among stroke patients and the impact of CAD on stroke rehabilitation were studied in 132 patients with first thrombotic or embolic stroke who participated in comprehensive rehabilitation. Sixty-one patients (46%) had a history of CAD, and 16 of the 61 also had congestive heart failure (CAD-CHF). Patients with CAD, and especially those with CAD-CHF, had significantly longer intervals from stroke onset to rehabilitation admission (p less than 0.001), and once in rehabilitation they experienced three times as many cardiac complications (p less than 0.001). While all patient groups improved function during rehabilitation, those with CAD and CAD-CHF improved significantly less than did those without CAD (p less than 0.01). Patients with CAD did least well with rolling, moving in bed, transferring from a wheelchair to bed, and walking. CHF not only adversely influenced overall function and mobility task performance but also affected the potential for achieving functional gains. These data suggest that specific measures of function and rehabilitation are affected by CAD and that the levels of achievement for patients with CAD-CHF are limited.

Aged↗

PubMed1988

Functional skills after spinal cord injury rehabilitation: three-year longitudinal follow-up.

Reports that spinal cord injury (SCI) patients maintain or improve functional abilities after initial rehabilitation have been limited by small sample size, inadequate functional measures, cross-sectional assessment at only one point in time, and lack of detailed statistical analysis. This study evaluated the follow-up functional status levels of 236 patients with traumatic SCI who completed comprehensive inpatient rehabilitation and were also followed for three years. The sample population was 83% men, with a mean age of 27.0 years. The 100-point Modified Barthel Index (MBI) was used to assess functional abilities. The 75 patients with complete quadriplegia had mean MBI scores of 30.3 at rehabilitation discharge and 37.8 at three-year follow-up. The 53 patients with incomplete quadriplegia were discharged with a mean MBI score of 53.8, and scored 68.3 at three-year follow up. The mean MBI scores for the 66 patients with complete paraplegia were 72.0 at discharge and 75.6 at three-year follow-up. The 42 patients with incomplete paraplegia had mean MBI scores of 77.0 at discharge and 86.1 at three-year follow-up. Each of the four groups demonstrated stability or increases in the proportions of patients who were independent in performance of each of the 14 MBI component tasks from discharge to follow-up. The finding that SCI patients, in this large series, maintained or improved functional levels for three years after discharge is consistent with previous studies and is reassuring to rehabilitation providers.

Adult↗

PubMed1987

Benefits of rehabilitation for traumatic spinal cord injury. Multivariate analysis in 711 patients.

The functional outcomes of 711 patients with traumatic spinal cord injuries who were admitted to a rehabilitation hospital during an eight-year period were studied. The modified Barthel index, a 100-point scale, was used to assess ability to perform self-care and mobility skills at rehabilitation admission and discharge. There were statistically significant improvements in self-care and mobility subscores of the modified Barthel index. Mean total modified Barthel index scores increased from 13.8 at admission to 46.1 at discharge for patients with quadriplegia, and from 37.7 to 74.4 for patients with paraplegia. Functional gains made by patients with incomplete spinal lesions were greater than those made by patients with complete lesions. This study documents improvement in ability to perform self-care and mobility skills among patients with spinal cord injuries who participate in comprehensive rehabilitation.

Adult↗

PubMed1987

Multivariate analysis of improvement and outcome following stroke rehabilitation.

This study documented the status of 432 patients and characteristics of functional improvements and outcomes achieved by 163 patients who participated in comprehensive stroke rehabilitation. Scores on the 100-point Activities of Daily Living Index improved from hospital admission to discharge and declined slightly at follow-up. An average Activities of Daily Living Index point gain of 0.6 per day was found that was unrelated to age, sex, side of hemiparesis, or admission functional status. Seventy-nine percent of the patients were discharged home; 85% were home at follow-up. Eleven percent of the patients were working at follow-up. Patients traveled outside their homes an average of 24.6 days during the three months immediately following discharge. A significant number of patients achieved favorable functional housing, employment, and social outcomes. This study supported referral for rehabilitation services regardless of age, side of hemiparesis, or degree of impairment.

Activities of Daily Living↗

PubMed1984

Selection, Isolation, and Characterization of Cadmium-Resistant Datura innoxia Suspension Cultures.

Datura innoxia cells from suspension cultures were selected for their ability to grow and divide rapidly in normally lethal concentrations of cadmium. Cells resistant to 12.5, 25, 50, 100, 160, 200, and 250 micromolar cadmium chloride were isolated and utilized to initiate cell suspension cultures resistant to this toxic metal ion. Variant cell lines retained their ability to grow in cadmium after being grown in its absence for more than 400 generations. Resistance to cadmium was correlated with the synthesis of low molecular weight, cysteine-rich, cadium-binding proteins. Synthesis of these proteins was induced rapidly in cadmium-resistant cells in response to a challenge of cadmium. Induction was detectable within one hour after exposure of the cells to the metal ion. Accumulation of protein bound cadmium reached a maximum eight to twelve hours following exposure. Metal-binding proteins were not detectable in the cadmium sensitive D. innoxia cells from which resistant cells were derived.

Journal Article↗

PubMedDate not supplied

Hemiplegic gait. Relationships between walking speed and other temporal parameters.

It has been asserted that speed alone is an effective indicator of the degree of gait abnormality. To determine the validity of this assertion, relationships between velocity and 18 other temporal gait parameters were determined in 25 patients with a first hemispheric stroke resulting in hemiplegia or hemiparesis of at least one month duration. Gait characteristics were recorded using footswitchs connected to a portable computerized monitoring device. Velocity was found to be significantly correlated with cadence, mean cycle duration, mean cycle length, hemiplegic limb stance phase duration, nonhemiplegic limb stance phase duration and percent, nonhemiplegic limb swing phase percent, double support phase duration and percent, hemiplegic limb swing/stance phase ratio, nonhemiplegic limb swing/stance phase ratio, and swing phase symmetry ratio but not with the hemiplegic limb stance phase percent, hemiplegic limb swing phase duration and percent, nonhemiplegic limb swing phase duration, stance phase symmetry ratio, and overall asymmetry ratio. Velocity is related to most, but not all, of the other temporal measures of hemiplegic gait. A comprehensive gait evaluation should also include characterization of the degree of asymmetry and descriptions of individual phase durations and proportions (particularly hemiplegic stance and swing percentages).

Adult↗

PubMedDate not supplied

Ventilatory function in cervical and high thoracic spinal cord injury. Relationship to level of injury and tone.

Weakness and spasticity of chest wall muscles are known to adversely affect pulmonary function in spinal cord-injured patients. To test the assertion that impaired strength and increased tone contribute to ventilation deficits, 52 patients with recent acute traumatic cervical and high thoracic spinal cord injury underwent complete pulmonary function testing. Regression analyses were performed to determine relationships between spinal cord injury level and pulmonary function test results and between Ashworth scale tone ratings and pulmonary function test results. Level of injury was found to be significantly correlated with expiratory reserve volume (and percent predicted expiratory reserve volume), residual volume/total lung capacity ratio, and negative inspiratory pressure but not with vital capacity, forced expiratory volume in one second, forced expiratory volume in one second/vital capacity ratio, inspiratory capacity, total lung capacity, functional residual capacity, residual volume, or positive expiratory pressure. There were significant correlations between Ashworth Scale tone ratings and negative inspiratory pressure but not between tone ratings and any of the other pulmonary function test results. It appears that muscle strength may be a more important factor than muscle tone in determining pulmonary function in spinal cord-injured patients and that both strength and tone are closely related to negative inspiratory pressure.

Adolescent↗

PubMedDate not supplied

Comparison of sperm quantity and quality in antegrade V retrograde ejaculates obtained by vibratory penile stimulation in males with spinal cord injury.

Reduced fertility in men with spinal cord injury results from the inability to ejaculate and poor semen quality. Vibratory penile stimulation can induce ejaculation in many men with spinal cord injuries, but few studies have reported the effects of repeated vibratory stimulation on quantitative semen analysis tests. Fourteen spinal cord-injured males were enrolled in a prospective study to develop a quantitative profile of antegrade and retrograde ejaculate specimens collected during repeated vibratory stimulation. Antegrade specimens were obtained in 51 (84%) and retrograde specimens were obtained in all of the 61 trials (100%). Sperm were present in 70% and 64% of the antegrade and retrograde samples, respectively. Of the patients who underwent repeated vibratory stimulation attempts, three showed marked improvement in sperm counts and characteristics with repeated vibration and five showed normal fluctuation or no change in semen quality. Overall, there was a trend toward higher sperm counts in the antegrade samples (mean, 74.1 million) than in the retrograde samples (mean, 40 million), but no statistical significance was found. Mean sperm motility, sperm progressive motility, and percent normal sperm morphology were not significantly different between antegrade and retrograde specimens. Fructose and zinc, semen markers that reflect the presence of a true ejaculate, were present in all antegrade and retrograde specimens. In conclusion, (1) both antegrade and retrograde ejaculation occur with vibratory penile stimulation, with antegrade samples containing greater numbers of sperm but retrograde samples also having significant sperm counts, (2) repeated vibration may increase sperm concentration or may result in only minimal changes reflective of normal fluctuations, and (3) vibratory stimulation results in true ejaculation, as evidenced by semen markers.

Adult↗

PubMedDate not supplied

The timer-logger-communicator gait monitor: recording temporal gait parameters using a portable computerized device.

A portable microprocessor-based device, the timer-logger-communicator (TLC), was adapted and connected to footswitches to monitor and record temporal gait parameters in 25 hemiplegic and 30 normal subjects. Controls walked at 1.36 m/s with symmetric gait. Hemiplegic subjects had a mean walking speed of 0.43 m/s, asymmetric gait, and varying proportions of time spent in each phase, consistent with previously reported gait parameters. Trends in objective gait measures more closely paralleled trends in functional ambulation classification than in Brunnstrom motor recovery stages. The TLC gait monitor is a useful instrument to measure temporal parameters of gait in the clinical setting.

Adult↗