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H G Dickson

Publications and source records attributed to H G Dickson.

At least 19 recordsLinked to original sources
PubMed1996

Problems with the ICIDH definition of impairment.

This paper discusses problems with the definition of impairment in the International Classification of Impairments, Disabilities, and Handicaps, in particular the inclusion in the definition of the term 'psychological'.

Persons with Disabilities↗
PubMed1996

The multi-dimensionality of the FIM motor items precludes an interval scaling using Rasch analysis.

Rasch analysis scaling is said to produce an interval scale of Functional Independence Measure (FIM) motor function items. Rasch analysis requires that the data to be analysed represent the influence of a single underlying unidimensional variable. A unidimensional interval scale of activities of daily living means that a person who can perform the most difficult item on a scale can also perform the easiest item. For a FIM motor function interval scale, the ability to climb stairs would imply necessarily and ability to eat normally. As this need not be the case, the FIM motor items do not constitute an adequate interval scale. Eating and walking are different activities, and a unidimensional construct linking them is unsatisfactory. A principal components analysis of the admission FIM motor function items of 515 consecutive patients admitted to an inpatient rehabilitation unit revealed that more than one significant factor was necessary to explain the variance in scores. The counter-factual and statistical evidence argues that a unidimensional construct does not underly the FIM motor function items, and the use of Rasch analysis will not lead to a description of interval properties of the FIM motor function items.

Activities of Daily Living↗
PubMed1994

A longitudinal investigation into anxiety and depression in the first 2 years following a spinal cord injury.

This study is a 1 year extension of a controlled 1 year follow up study of spinal cord injured persons. The study assessed the extent of spinal cord injury (SCI) persons' depression and anxiety in comparison to an able bodied control group matched for age, sex, education and as far as possible, occupation. Psychological adjustment to SCI was assessed in terms of scores on the Trait Anxiety Inventory and the Beck Depression Inventory. Results obtained at the 2 year follow up were not significantly changed from those obtained over the first year. There was no significant improvement in anxiety and depression scores in the SCI group 2 years post injury. Examination of the SCI scores suggest that psychological morbidity was confined to a group of approximately 30% of persons, whilst the remaining persons were not severely anxious or depressed. Traditional stage models of adjustment to SCI which suggest that the passage of time is associated with better adjustment were not supported by the present data.

Adult↗
PubMed1994

Spinal cord injury: a search for determinants of depression two years after the event.

A prospective longitudinal study employing repeated measures was used to isolate factors which might predispose a person to depression two years after sustaining spinal cord injury (SCI). Thirty-one subjects who suffered acute spinal injuries resulting in permanent loss of movement, and who had no head injuries or any pre-existing psychopathology, were at least 17 years of age, and who were able to speak English, participated in the study. Using the Beck Depression Inventory (BDI) as a measure of depression, a regression analysis demonstrated that the experience of pain two years post-injury and feeling out of control of one's life prior to hospital discharge were predictive of depression two years post-injury. No demographic variables or injury characteristics such as level of lesion or completeness of lesion were related to long-term depression. Pain management and rehabilitation techniques that enhance the individual's belief of control over their lives are therefore recommended as interventions that could act to reduce depression in the long term in persons with spinal cord injury.

Adolescent↗
PubMed1994

Inpatient quality assurance by local analysis of uniform data set data.

We constructed a data base in order to examine the profile of patients admitted to a 24 bed inpatient rehabilitation unit at Fairfield Hospital. Data were collected according to the Uniform Data Set for Medical Rehabilitation, and collated and analysed using the Clinical Reporting System database software and the Statistical Package for Interactive Data Analysis statistical software. Outcome data collected included the patients domicile before and after admission, the duration of stay, medical diagnoses before admission to and during the stay in the Rehabilitation Unit, as well as the Functional Independence Measure item scores at admission and discharge. Analysis of the first 100 patients in the data base indicated a duration of stay of 43 +/- 34 days with a right skew distribution. Scatter plots of age and duration of stay, and age and functional improvement showed no bias in the Unit concerning these parameters. The Wilcoxon rank sum test indicated a highly significant difference (P = 0) between entry and exit Functional Independence Measure scores, indicating that patients improved functionally in the unit. Eighty three patients returned home on discharge and only five required admission to a nursing home. With the data base, the course of patients whose performance lies outside the range of normal for the unit can be examined and factors identified which produce a prolonged stay or failure to progress.

Age Factors↗
PubMed1993

Anxiety and depression over the first year of spinal cord injury: a longitudinal study.

The literature concerning the psychological consequences following spinal cord injury (SCI) indicates a discordance between clinical impressions and empirical research. Although many studies report that psychological morbidity is not an inevitable consequence of SCI, much of this research is characterised by methodological inadequacies and the conclusions are therefore tenuous. The present study assessed 41 persons with SCI for depression and anxiety using objective psychological measures on three occasions over the first year of SCI and compared them with 41 able bodied controls matched for age, sex, education and, as far as possible, occupation. Results demonstrated significant differences between the two groups, with the SCI group being more anxious and depressed. However, psychological morbidity was not an inevitable consequence of SCI, with group means reflecting mild levels of depression and anxiety. No significant differences were found across time and no interactions between groups and time were detected. Implications for the treatment of SCI are discussed.

Adolescent↗
PubMed1991

Task-dependent changes in the responses to low-threshold cutaneous afferent volleys in the human lower limb.

1. In seven human subjects who were standing without support the sural nerves were stimulated electrically using trains of non-painful stimuli (five pulses at 300 Hz), designed to activate afferents from cutaneous mechanoreceptors. The reflex effects of the stimulus train on different muscles of the ipsilateral and contralateral legs were sought in post-stimulus averages of rectified EMG. Changes in the pattern of reflex influence were investigated when the subjects maintained different postures. 2. Clear reflex responses were seen in ipsilateral tibialis anterior, soleus, biceps femoris and vastus lateralis, but only when the muscles were actively contracting. In each muscle, inhibition was the dominant reflex response within the first 100 ms. In four of the seven subjects, reflex changes were detectable in the contralateral tibialis anterior and soleus, the peak-to-peak modulation within the first 200 ms being 25-50% of that for the homologous ipsilateral muscle. 3. When subjects attempted to stand on a tilted platform, an unstable platform or on one leg with the other flexed, different combinations of muscles were active, involving both flexors and extensors or predominantly flexors or predominantly extensors. In each posture the reflex effects were demonstrable only in the active muscles. 4. With ipsilateral tibialis anterior, there were task-dependent changes in the short-latency components of the EMG response, approximately 60 ms and 80 ms after the stimulus. When seated performing voluntary contractions these components were difficult to define, and when standing on a platform tilted toe-up they were small. When the ipsilateral leg was flexed or when standing on an unstable base, these early components were more prominent in each subject. With contralateral tibialis anterior, the dominant reflex pattern was inhibition when seated and contracting voluntarily, and facilitation during bipedal stance tilted toe-up. These changes in reflex pattern could not be explained by different levels of background contraction. 5. It is concluded that cutaneous mechanoreceptors of the foot have widespread reflex actions on muscles throughout both limbs, particularly the ipsilateral limb, and that the reflex pattern in different muscles and within a single muscle may change dependent on the task that the subject is undertaking. These task-dependent changes indicate plasticity in the expression of cutaneous reflex activity, affecting both short-latency spinal as well as long-latency pathways.

Adult↗