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Biomedical subjects

H Alaranta

Publications and source records attributed to H Alaranta.

At least 55 records · Page 3Linked to original sources
PubMed1994

Long-term results of primary scalenotomy in the treatment of thoracic outlet syndrome.

A total of 107 patients with thoracic outlet syndrome were reviewed an average of 4.1 years (range 2-11 years) after primary scalenotomy. The sample included 86 women and 21 men, and the mean age at surgery was 41.9 years (range 16-59 years). The three most disturbing pre-operative symptoms were pain at rest (87%), numbness (66%) and lack of power (55%). The post-operative success rate diminished from 71% 1 month after operation to 63% at follow-up. The retirement frequency increased from 6% up to 33% during the follow-up time. It was highest among factory workers at 60%. Of the patients older than 45 years at surgery, 68% were retired at follow-up. The importance of careful selection for operation is emphasized, and also the need to consider vocational rehabilitation before resorting to surgical treatment of thoracic outlet syndrome. We recommend surgical treatment for this disabling disorder, especially for younger patients with clear evidence of thoracic outlet syndrome who are engaged in occupations demanding little repetitive work. The best results have occurred in this group.

Adolescent↗
PubMed1994

Subjective benefits of energy storing prostheses.

The energy storing (ES) prosthesis has been used in the Prosthetic Foundation's workshop since 1987. Subjective responses from 168 amputees (141 trans-tibial and 27 trans-femoral) fitted with the ES prosthesis were analysed. Ratings were generally favourable in comparison with those for conventional prostheses. The most pronounced advantages of the new prosthesis as shown by the ratings were in walking uphill or swift walking. The younger amputees had more benefit than the older ones. High body weight decreased the benefit of the ES prosthesis. The ES prosthesis does not seem to provide any major advantage for the less active amputee whose movements are mainly indoors.

Adult↗
PubMed1994

Flexibility of the spine: normative values of goniometric and tape measurements.

A sample of 508 male and female white-collar and blue-collar employees aged 35 to 54 years were examined clinically to determine the reliability of spinal flexibility measurements using inclinometers and a tape measure, and to determine the normal values of cervical sagittal movements, lateral flexion, lumbar flexion and extension, trunk rotation and sidebending. Spinal flexibility decreased with advancing age, particularly among the blue-collar workers. Male predominance was observed in lumbar flexion and rotation and female predominance in cervical flexion-extension-movement. Spinal flexibility was negatively related to the experience of disabling pain. The strongest connections were between cervical flexion-extension-movement and neck pain, and between trunk sidebending and low back pain during the preceding year. The interobserver reliabilities were found to be generally good for all these measurements, and trunk sidebending showed the highest reliability coefficients. The intraobserver reproducibility (checked at a one-year interval) was acceptable only for cervical flexion-extension movement, cervical sidebending and trunk sidebending.

Adult↗
PubMed1994

Non-dynamometric trunk performance tests: reliability and normative data.

A sample of 508 male and female white-collar and blue-collar employees aged 35 to 54 years was evaluated clinically to determine the reliability of repetitive sit-ups, repetitive arch-ups, repetitive squatting, and static back endurance tests, to determine the normal values of these tests and to detect determinants for trunk muscle performance. All of the given tests had fairly good or even excellent test-retest reliability. Muscular performance capacity decreased with advancing age, particularly among blue-collar workers. Men showed greater muscle endurance in all the muscle tests, and blue-collar workers lower values in all tests. The repetitive tests, in particular, showed reduced values in those with previous low-back pain. Normative values of back endurance, repetitive squatting, sit-up and arch-up tests for different age, sex and occupational groups are presented.

Adult↗
PubMed1994

Evaluating the outcome of vocational rehabilitation.

This paper presents an analysis of studies in which vocational rehabilitation was followed up during the 1980s and early 1990s. Its purpose is to clarify the outcome of vocational rehabilitation as well as the factors predicting that outcome. In these follow-up studies the variables by which the outcome is measured are closely linked with the subjects' employment opportunities, and are basically the same as those applied in earlier follow-up studies. Because of the study designs it is difficult to make any generalizations concerning the results. Little attention has been paid to the evaluation of psychological adaptation in most of these studies. Also, follow-up studies generally have not taken into account the employment situation. Whether those who have had rehabilitation are able to find employment depends essentially on employers' policies towards the handicapped and the disabled.

Female↗
PubMed1994

Correlation between neurological leg deficits and reaction time of upper limbs among low-back pain patients.

The purpose of the study was to examine how neurological deficits of the leg, i.e. sensory deficit, deficient reflexes and muscular weakness, correlate with reaction times of upper limbs in a group with chronic low-back pain. Thirty-two patients were studied. Three sets of measurements of simple reaction time and choice reaction time of upper limbs were conducted at one-week intervals. Neurological deficits of the leg were recorded by a physician and the subjects answered a questionnaire about the severity of their low-back symptoms (Oswestry's index). We also defined a neurological index which reflected the total sum of the three types of leg deficits experienced by each of the subjects. Sensory deficit of the leg and the neurological index correlated strongly with slower reaction times of upper limbs, while the other two neurological deficits did not reach a level of significance. Sensory deficits of the leg seem to be an indicator of much greater motor disability than has been thought so far. The motor disability not only appears distally from the lumbar radicular damage caused for example by an intervertebral herniation, it also seems to relate to psychomotor reaction more generally, even on upper limbs.

Adult↗
PubMed1994

Knee disorders in carpet and floor layers and painters. Part I. Isometric knee extension and flexion torques.

Knee morbidity, knee extension torque and knee flexion torque were examined among 168 actively working carpet and floor layers and 146 painters. The study included a questionnaire concerning knee disorders and knee symptoms, a clinical examination of the knees and measurement of isometric knee extension and flexion torque. Knee accidents were reported more frequently by carpet and floor layers than by painters. Tenderness of the knees was noted to an equal extent in the two groups. Knee extension torques gradually decreased by increasing age among carpet and floor layers, but not among painters. Body weight and thigh girth were not related to age among carpet and floor layers, but gradually increased with age among painters. Analysis of covariance showed that the torques were most consistently related to thigh girth and age. In addition, the right knee extension torque was related to occupation and tenderness of the patellofemoral joint; the left knee extension torque was related to the knee pain index. These results suggest that occupational kneeling and internal derangement of the knee affect thigh muscles among actively working house builders.

Adult↗
PubMed1993

Grip strength and hand position of the dynamometer in 204 Finnish adults.

A primary purpose of this study was to establish data on hand strength by Jamar dynamometer for normal Finnish adults aged 30 to 50 years. A second aim was to find out how five various breadths of grip affect the strength value. A sample of 103 male and 101 female adults, aged 19 to 62, from the southern part of Finland were tested using standardized positioning and instructions. Male and female subjects reached the highest grip strength using the third handle breadth of dynamometer, except females over 50 years. Female grip strength was 60% to 70% less than male grip strength. There was no significant difference in strength between dominant and non-dominant hands.

Adult↗
PubMed1993

The lumbar multifidus muscle five years after surgery for a lumbar intervertebral disc herniation.

Biopsy specimens of the lumbar multifidus were obtained from 18 patients with lumbar disc herniation at operation and after a postoperative follow-up period of 5 years. The structure and morphometry of the muscle fibers were analyzed and these data were compared with intraoperative biopsy results and the clinical outcome of the operation. The main findings were: 1) on the basis of occupational handicap score 10 patients belonged in the "positive" and 8 in the "negative" outcome group; 2) the intraoperatively recorded selective type 2 muscle fiber atrophy and the extent of pathologic inner structure changes both decreased in the "positive" outcome group, whereas they persisted in the "negative" group; 3) grouping as a definite sign of reinnervation was seen in only two versus four patients of the "positive" versus "negative" outcome group; 4) the relative amount of adipose tissue within the muscle decreased more markedly in the "positive" outcome group. The authors propose that both inactivity and axonal injury (mainly of neurapraxia type) contribute to the selective type 2 atrophy and inner structure changes in disc patients' multifidus muscle. These pathologic structural changes correlated well with the clinical outcome, and most importantly they are reversible and can be diminished by adequate therapy.

Adult↗
PubMed1993

Long psychomotor reaction time in patients with chronic low-back pain: preliminary report.

The hypothesis in this study was that slow psychomotor reaction time is related to low-back pain. A total of 73 people with chronic low-back pain (CLBP) were studied. Simple reaction time (SRT) and choice reaction time (CRT) were measured. CRT was also fractionated into decision and movement times. Each four variables measured were analyzed by using analysis variants and covariants with two grouping factors (CLBP and gender) with age and height serving as covariates. The CLBP group had longer SRT, decision time, and total CRT than the control group on average. The results did not conflict with our hypothesis. Slow psychomotor speed of reaction may be one factor in the development of CLBP, or slow reaction in CLBP may have resulted from fear responses, depression, or anxiety. Longitudinal studies are needed in the cause-and-effect evaluation of the relation between speed of reaction and CLBP.

Adult↗
PubMed1993

Spondylodesis augmented by transpedicular fixation in the treatment of olisthetic and degenerative conditions of the lumbar spine.

Fifty-one patients having lumbar or lumbosacral posterolateral fusion with pedicle screw internal fixation were reviewed retrospectively two years after the fusion by an independent observer. In 44 patients, the underlying condition was lytic or degenerative spondylolisthesis. The internal device was removed one year after the fusion. The fusion rate was 94%. The subjective disability was assessed using the Oswestry disability index. The mean Oswestry score was 38% preoperatively, and 24% two years after the fusion. Preoperatively, only every fifth patient was able to work; two years postoperatively, almost 60% held jobs. Complications due to internal fixation were recorded in 57% of the cases. Most of these, such as screw breakage and screw loosening in the sacrum, were of no clinical importance. The use of internal fixation seems to enhance the fusion rate but is associated with more complications than posterolateral fusion without implants.

Adult↗
PubMed1993

Lower-limb amputations.

The current epidemiological situation with regard to lower-limb amputations in southern Finland was analysed for the year 1989. Lower-limb amputations were performed on 268 patients. The amputation rate was 22.0 per 100,000 inhabitants, and the mean age of amputees was 70 years. Peripheral vascular disease was the main reason for amputation (79%). The most common level of amputation was above-knee (49%) followed by below-knee (29%). Two thirds (64%) of the patients lived over one year, and half (53%) over two years after the amputation. In the group of patients undergoing unilateral amputation and surviving over two months, 26% of the above-knee and 63% of the below-knee amputation patients received a prosthesis. The (average) time lag between surgery and fitting the prosthesis was 97 days. Incidence and mortality were decreased after 1985. The rate of prosthesis fitting was still low but the time lag between surgery and prosthetic fitting had decreased.

Adult↗
PubMed1993

Fat content of lumbar extensor muscles and low back disability: a radiographic and clinical comparison.

The fat content of the lumbar back extensor muscles was assessed from computed tomograms and correlated to self-reported disability in 39 consecutive chronic low back pain patients. The assessment for the quality of fat was done separately for the three lowest lumbar intervertebral levels. The Oswestry index was used to evaluate the low back disability. Analysis showed positive relationship between the fat content of the lumbar paraspinal muscles at lumbosacral level and self-reported disability in men. The relationship was weaker in women, and at higher lumbar levels it was not found in either sex.

Adipose Tissue↗
PubMed1992

Calcitonin treatment in lumbar spinal stenosis: a randomized, placebo-controlled, double-blind, cross-over study with one-year follow-up.

A randomized, placebo-controlled, double-blind, crossover study in 40 lumbar spinal stenosis patients with a 1-year follow-up showed that calcitonin had beneficial effects on the patients' symptoms without producing any notable side effects. Calcitonin had a clear analgesic effect. The mean of walking distance increased, but the crossover trend was not as good as the analgesic effect. Side effects such as erythema and nausea were usually mild and transient. Calcitonin therapy can be used as a conservative treatment in selected cases of lumbar spinal stenosis. When rest pain was mild or the walking distance was under 200-300 m because of neurogenic claudication, the effect of calcitonin seemed to be poor.

Adult↗