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Biomedical subjects

J F Kramer

Publications and source records attributed to J F Kramer.

47 records · Page 3Linked to original sources
PubMed1984

Ultrasound: evaluation of its mechanical and thermal effects.

Despite the frequent clinical use of ultrasound (US), neither its effect on nerve conduction nor the explanation for these changes have been agreed upon. This study differentiated between the thermal and mechanical effects of US by using continuous US to provide combined mechanical and heating effects, pulsed US to provide an equivalent mechanical effect, placebo US to duplicate the pulsed US treatment, and infrared radiation to provide a heating effect only. Ten subjects were randomly assigned to each of four treatment groups and the distal humeral segment of the ulnar nerve was treated. Statistically significant changes in both nerve conduction velocity (NCV) and subcutaneous tissue temperature were associated with each treatment. Continuous US and infrared radiation treatments were associated with increased temperatures (0.8C) and increased velocities (3.75 and 3.08m/sec, respectively). Pulsed and placebo US treatments were associated with decreased temperatures (2.2C and 3.1C, respectively) and decreased velocities (2.79 and 5.38m/sec, respectively). Similar levels and patterns for NCV and subcutaneous tissue temperature were observed for the continuous US and the infrared groups, and for the pulsed US and the placebo US groups. Additionally, placebo US and infrared radiation treatments produced opposite temperature and velocity changes, while not contributing any mechanical effects. It was concluded that the mechanical effects of US were not significantly operative in this study. The increased velocities associated with continuous US and infrared radiation treatments were attributed to a thermal-heating effect, and the decreased velocities associated with placebo and pulsed US treatments were attributed to a thermal-cooling effect of the US transmission gel.

Adult↗
PubMed1982

A one-year follow-up of participants in a smoke stoppers program.

A follow-up study of Smoke Stoppers participants was conducted at least one year after participation to determine the effectiveness of this approach and to identify the characteristics of those who had remained nonsmokers. The overall program success rate was determined to be 40% at best, but no worse than 32%, depending on the denominator. The following characteristics did not show a statistically significant correlation with stopping smoking: age, education, number of attempts to stop smoking, reasons for wanting to stop, total life stressors, moral support for quitting, companions with whom participants attended classes, number of cigarettes smoked, number of years smoking has continued, and employment with the hospital. Those who stopped smoking had attended significantly more classes and had a greater proclivity to gain weight than did those who resumed smoking, although large weight gains were not a problem.

Data Collection↗
PubMedDate not supplied

An upper body musculoskeletal assessment instrument for patients with work-related musculoskeletal disorders: a pilot study.

OBJECTIVES: To examine the reliability and validity of a new outcome measure, the Upper Body Musculoskeletal Assessment (UBMA). DESIGN: Twenty subjects physician-diagnosed as having work-related musculoskeletal disorders (WRMD) and ten healthy subjects were assessed using the UBMA on three separate occasions. All subjects with WRMD attributed their injury to equipment use on their job. RESULTS: The WRMD group had significantly higher UBMA scores on the side of equipment use than on the other side (p <0.01), whereas the healthy group had similar scores on both sides (p> 0.05). UBMA scores for the WRMD group were significantly greater on both sides of the body than scores for the healthy group (p<0.01). Only one test occasion was required to produce excellent reliability coefficients (ICCs>0.88). Although group reliability was excellent, changes of 24% for patients with WRMD and 44% for healthy subjects would be required for confidence that UBMA scores for individual patients on the side of equipment use had changed from baseline. CONCLUSIONS: Although testing on one occasion produced reliable UBMA scores, healthy subjects could be distinguished from patients with WRMD, and the side of equipment use could be distinguished from the other side in patients with WRMD, prediction of individual UBMA scores was poor. In its present form, the UBMA is useful for making decisions about groups but not about individual patients. Modifications of the current UBMA are required to reduce measurement error.

Adult↗
PubMedDate not supplied

Interrater reliability of pinch and grip strength measurements in patients with cumulative trauma disorders.

The purposes of this study were to examine the interrater reliabilities of grip, lateral pinch, and tripod pinch measurements in patients with cumulative trauma disorders. Thirty-eight patients with unilateral (n = 28) or bilateral (n = 10) cumulative trauma disorders were tested independently by two hand therapists, during a one-hour period. The tests were completed in a normal hand clinic environment using the standard protocol recommended by the American Society of Hand Therapists. Interrater reliability coefficients for the scores obtained using either a single repetition or the mean of three repetitions were very high (intraclass correlation coefficient [ICC] > 0.87) for all strength measurements. As a result, strength determination in this patient group, when performed by different hand therapists, may be considered reliable.

Evaluation Studies as Topic↗
PubMedDate not supplied

Decision making in detecting abnormal Semmes-Weinstein monofilament thresholds in carpal tunnel syndrome.

Both hands of 39 patients who had symptoms of pain and/or numbness in one or both hands were tested by two hand therapists using the full kit of Semmes-Weinstein monofilaments (SWMFs). The SWMF thresholds were obtained for the thumb, the index finger, and the long and small fingers. These thresholds were classified as normal or abnormal based on four decision rules and two criterion measures. Decision rules were based on whether SWMF 2.83 or 3.22 would be the best limit of normality, and whether the small finger should be used for within-subject comparisons. The criterion measures were the highest threshold of all three radial digits and the highest threshold of the long finger alone. Intertherapist agreement on normality was fair to moderate (kappa = 0.22-0.51), varying according to decision rules and criterion measures. Reliability was higher when the additional comparison with the small finger was omitted. High accuracy in identifying cases of carpal tunnel syndrome (CTS) was possible, but accuracy varied moderately between testers and greatly according to decision rules and criterion measurements. The best overall accuracy (81%-82% sensitivity and 57%-86% specificity) was achieved when SWMF 2.83 was used as the upper limit of normality and the small finger was used for within-subject comparison, and when data from the long finger alone were used for decision making.

Adult↗
PubMedDate not supplied

Reliability of a patient-rated forearm evaluation questionnaire for patients with lateral epicondylitis.

PURPOSE: To determine the reliability of a questionnaire designed to assess forearm pain and function in patients with lateral epicondylitis. METHODS: Forty-seven patients with unilateral lateral epicondylitis completed a patient-related forearm evaluation questionnaire (PRFEQ) on two occasions. Intraclass correlation coefficients (ICC 2,1), standard error of measurement (SEM), and 95% confidence intervals (CIs) were determined for the whole group and for three subgroup comparisons of male vs. female subjects, subacute vs. chronic lateral epicondylitis, and work-related vs. non-work-related lateral epicondylitis. RESULTS: The test-retest reliability for the overall PRFEQ (ICC, 0.89), and its pain (ICC, 0.89) and function (ICC, 0.83) subscales was excellent. Test-retest reliability for patients with work-related lateral epicondylitis (ICC, 0.80) was significantly (p = 0.018) less than for patients with non-work-related lateral epicondylitis (ICC, 0.94). CONCLUSIONS: The PRFEQ can provide a simple, quick, and reliable estimate of arm pain and function in patients with lateral epicondylitis. However, large SEM and 95% CIs limit its ability to accurately predict individual scores.

Female↗
PubMedDate not supplied

Training of head control in the sitting and semi-prone positions.

The purpose of this study was to compare the semi-prone (SP) and sitting (SIT) training positions with respect to head control in children with cerebral palsy, before and after 5 weeks biofeedback training using a head position trainer (HPT). Four children were randomly assigned to each of two training groups: (a) SP on a prone board inclined 45 degrees above the horizontal and (b) SIT in their personal wheelchair and orthotic device. The HPT, secured to the child's head, controlled a video-cassette player, turning it off when the head deviated beyond 25 degrees from the vertical (termed an error). The time in error and the number of errors during test periods of 3 minutes, without feedback and completed in both the SP and the SIT positions, were determined immediately before and after, and at 16 weeks after training. The SIT trained group performed significantly better immediately post-training in three of four comparisons (P < 0.01), but the groups performed similarly in the other eight comparisons--four immediately pre-training and four at 16 weeks post-training (P > 0.05). Post-training scores for the total group (n = 8) were significantly improved over pre-training scores, regardless of the test position or the criterion measurement (P < 0.05). Biofeedback training with a HPT can be effective in either the SIT or the SP positions, with improvement lasting at least 16 weeks after training is discontinued.

Biofeedback, Psychology↗
PubMedDate not supplied

Effect of a neoprene sleeve on knee joint position sense during sitting open kinetic chain and supine closed kinetic chain tests.

The primary objective of the present study was to compare the effect of a neoprene sleeve on knee joint position sense during a sitting open kinetic chain test and a supine closed kinetic chain test. Young (24 +/- 2 years old), healthy subjects (18 men and 18 women) performed knee joint angle replication tests during open kinetic chain knee extension (sitting) and closed kinetic chain leg press (supine with an axial load of 15% body weight) before and after application of a neoprene sleeve over the dominant knee. The improvement in ability to replicate joint angles after application of the sleeve (sleeve effect) was significantly less during the supine closed kinetic chain test (0.3 degree +/- 1.4 degrees) than during the sitting open kinetic chain test (1.2 degrees +/- 1.1 degrees). The sleeve effect was inversely related to subjects' performance without the sleeve during both the sitting open kinetic chain and supine closed kinetic chain tests, suggesting that some people may derive greater benefit from the sleeve than others. Although the sleeve effects were small, particularly during the supine closed kinetic chain test, 72% of subjects felt that the sleeve improved their overall test performance. Future research is needed to establish the functional relevance of the small sleeve effects observed and to identify the characteristics of people who might derive greatest benefit from sleeve use.

Adult↗
PubMedDate not supplied

Forearm pronation and supination: reliability of absolute torques and nondominant/dominant ratios.

This study examined the reliability of pronation and supination measurements expressed in absolute units (newton-meters [Nm]) and nondominant/dominant ratios (%), and determined isometrically using the BTE (WS20) and the Cybex (340) dynamometers. Twenty-one healthy men and 22 healthy women were tested twice on each machine, within 14 days. Twelve of 16 reliability coefficients for absolute torques were considered acceptable (> 0.75) when determined as the reliability of two repetitions on one occasion, while 14 of 16 coefficients were acceptable when determined as the reliability of two repetitions on each of two occasions. However, reliability coefficients for the nondominant/dominant ratios were not acceptable on one (0 of 8 coefficients > 0.75) or two (2 of 8 coefficients > 0.75) occasions. Ratio data were also characterized by larger standard errors of measurement (SEMs) and wider 95% confidence intervals, relative to the sample mean and standard deviation. Overall, reliability coefficients, SEMs, and 95% confidence intervals were similar for men and women, pronation and supination movements, and the BTE and Cybex dynamometers. The authors suggest that absolute scores be used when possible, as these data tend to provide more reliable measurements--especially when the clinician has only limited test occasions to establish baseline scores.

Bias↗