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Biomedical subjects

J L Poole

Publications and source records attributed to J L Poole.

17 recordsLinked to original sources
PubMed2005

Factors related to oral hygiene in persons with scleroderma.

OBJECTIVES: The purpose of this study was to assess potential risk factors for the development of poor oral hygiene and increased dental caries in individuals with scleroderma. METHODS: Twenty-two subjects with scleroderma participated in this study. All subjects were examined with the Patient Hygiene Performance (PHP) Index, which assesses the extent of plaque and debris over a tooth surface. In addition, oral aperature, xerostomia and dominant upper extremity strength, motion, skin thickness, and dexterity were measured. RESULTS: None of the subjects had good or excellent hygiene. Fifteen subjects had fair oral hygiene and seven subjects had poor oral hygiene as measured by the PHP Index. Significant differences were seen between these two groups for oral aperture, percentage of teeth with caries, skin thickness, dexterity and finger flexion. Dexterity and joint motion correlated significantly with the number of decayed surfaces and number of caries. Oral aperture correlated with the PHP Index and the number of dental caries. CONCLUSIONS: Subjects with poor oral hygiene required more time to complete manual dexterity task and had decreased hand strength and joint motion. Moreover, these same subjects had more contractures, scars, ulcers, and higher skin scores (more disease activity) than subjects in the fair hygiene group. In addition to frequent dental exam and routine cleaning, dental personnel may want to consider exercises to increase oral aperature and investigate toothbrush and dental floss selection used by persons with scleroderma.

Dental Caries↗
PubMed2000

Reliability and validity of the Arthritis Hand Function Test in adults with systemic sclerosis (scleroderma).

OBJECTIVE: To determine the interrater and test-retest reliability and validity of the Arthritis Hand Function Test (AHFT) in persons with systemic sclerosis. METHODS: Interrater reliability of the AHFT was established by two raters independently scoring the performances of 20 women with systemic sclerosis. The same group of subjects was tested again 7-10 days later to determine test-retest reliability. Concurrent validity was established by the subjects' self-reports of their abilities to perform activities of daily living as measured by the Health Assessment Questionnaire and the Arthritis Impact Measurement Scales 2 (AIMS2). RESULTS: All of the items had excellent interrater intraclass correlation coefficients (ICC = 0.99-1.00). The ICCs for test-retest reliability were in the excellent (ICC = 0.80-0.97) range for most of the items and moderate (ICC = 0.57-0.73) for the others. Most of the items were moderately correlated with items on the AIMS2 (r = 0.45-0.69). CONCLUSION: The results from this study suggest that the AHFT is a reliable and valid test to measure hand function in persons with systemic sclerosis.

Activities of Daily Living↗
PubMed1998

A review of balance instruments for older adults.

OBJECTIVE: The purpose of this article is to review balance instruments developed within the past 10 years that can be used in the clinic or home environment. The use of such instruments may assist in identifying older adults who are at risk for falling, a major problem that can result in impaired function and loss of independence. METHOD: Six instruments were reviewed: the Berg Balance Scale (Berg), the Clinical Test of Sensory Interaction and Balance (CTSIB), the Functional Reach Test, the Tinetti Balance Test of the Performance-Oriented Assessment of Mobility Problems (Tinetti), the Timed "Up and Go" Test (TU&GT), and the Physical Performance Test (PPT). Considered were what aspects of balance are assessed, time needed to administer the instrument, tools or equipment needed, evidence of reliability and validity, advantages and disadvantages, and the target population. RESULTS: The Berg, Tinetti, and PPT measure a variety of aspects of balance, whereas the Functional Reach, TU&GT, and CTSIB measure more narrow aspects of balance. All six instruments have been used with older adults and do not require much equipment. The instruments differ in their reliability and validity. CONCLUSION: Familiarity with balance instruments can be helpful in selecting the one most appropriate for clinical setting and clients in order to institute appropriate prevention programs, such as environmental modifications and lifestyle adaptations.

Accidental Falls↗
PubMed1997

The mechanisms for adult-onset apraxia and developmental dyspraxia: an examination and comparison of error patterns.

OBJECTIVES: The purpose of this study was to determine whether persons with developmental dyspraxia and apraxia make similar errors during the performance of four types of tasks. METHOD: Three groups of subjects with dyspraxia or apraxia (i.e., children with learning disabilities and dyspraxia, young adults with learning disabilities and dyspraxia, older adults with left-hemisphere brain damage with apraxia) and three groups of age-matched control subjects (i.e., children, young adults, older adults) were observed performing transitive, intransitive, verbal command, and imitation tasks. Performance was scored on the basis of the types of errors made. Errors were classified as conceptual (nonrelated, unrecognizable, sequencing) or production (omission, perseveration, related, internal configuration, external configuration, incorrect movement, body part as object). RESULTS: No significant difference was found between conceptual and production error patterns for any group. In addition, there was no significant difference between the dyspraxia and apraxia groups or among the control groups on the specific types of production errors made. However, the dyspraxia and apraxia groups differed in the type of conceptual error made on the intransitive task. The body-part-as-object error was the most frequently made error on the transitive, verbal command, and imitation tasks, whereas the movement error was the most frequently made error on the intransitive task. CONCLUSION: Subjects with dyspraxia or apraxia make similar errors, suggesting that the praxis behaviors are similar.

Adult↗
PubMed1995

Concurrent validity of the Health Assessment Questionnaire Disability Index in Scleroderma.

OBJECTIVE: To establish the concurrent validity of the Health Assessment Questionnaire (HAQ) Disability Index in systemic sclerosis (SSc; scleroderma). METHODS: Eighty subjects with SSc completed the HAQ Disability Index questionnaire. An occupational therapist, who was blind to the subjects' responses, observed each subject's performance on 10 of the items. RESULTS: Paired t-tests showed significant differences between the observer and subjects' responses for tying shoes, buttoning, gripping, and walking. Intra-class correlations between observer and subjects ranged from 0.38 to 0.76. CONCLUSION: The results support the validity of the HAQ Disability Index in patients with systemic sclerosis.

Activities of Daily Living↗
PubMed1994

Developmental differences in praxis in learning-disabled and normal children and adults.

Gestures made on tasks in response to verbal command or to imitation and on tasks involving axial and distal movements were compared for groups of learning-disabled and normal children and adults. The 15 learning-disabled children and 15 adults scored lower than the 15 normal children and 15 adults on all tasks. All groups scored higher on imitation than on verbal command and scored similarly on the axial and distal tasks. The findings from this study suggest that it would be worthwhile to test the hypothesis that dyspraxic behaviors may persist into adulthood.

Adolescent↗
PubMed1994

Grasp pattern variations seen in the scleroderma hand.

OBJECTIVES: Therapists generally describe a person's grasp in terms of normal prehension patterns that have been discussed in the literature. However, the grasp pattern used by a person with a hand impairment may not fit into these patterns. The purpose of this study was to describe, with qualitative classification systems, static grasp patterns used by hands impaired by scleroderma and to determine the relationship between hand impairment and variations in grasp. METHODS: Seventeen subjects with scleroderma were observed grasping a key, a coin, a glass, and a saucepan. Their grasp patterns were recorded on the basis of which fingers were used to grasp the object, the surface areas of the fingers in contact with the object, and the position of the joints of the fingers. In addition, range of motion, grip and pinch strength, skin thickening, digital ulcers, calcium deposits, and tendon friction rubs were assessed. RESULTS: More variations in grasp were seen with the coin, glass, and saucepan than with the key. The presence of digital sores indicated more difficulty holding a coin, whereas the presence of calcium deposits indicated more difficulty holding a coin, glass, and saucepan. The number of fingers with contractures correlated with the ability to hold all four objects. CONCLUSIONS: Persons with scleroderma show qualitative differences in grasp as compared to normal prehension patterns. These differences are influenced by impairments in the scleroderma hand. Qualitative descriptions of grasp patterns may provide therapists with additional means to document change after surgical or therapeutic intervention.

Adult↗
PubMed1991

The use of the Health Assessment Questionnaire (HAQ) to determine physical disability in systemic sclerosis.

The health assessment questionnaire (HAQ), a self-administered instrument to determine physical disability, was completed by 211 patients with systemic sclerosis who subsequently received scleroderma examinations. The mean HAQ disability index for the entire group was 0.92. Patients with high skin scores had significantly higher disability indices as compared to patients with low skin scores (p < 0.001). Higher disability indices were found for patients with joint pain, tendon rubs, and contractures. However, the presence of ulcers on the digital tip did not interfere with patients' abilities to function as measured by this scale. Intensive hand evaluations were performed on a subset of these 211 patients with systemic sclerosis (n = 80). Grip strength, thumb abduction, wrist extension, and motion of the index and middle fingers significantly correlated with the HAQ scores (p < 0.01). The findings from this study suggest that patients with systemic sclerosis have significant physical disability. Furthermore, the HAQ appears to be useful in assisting health professionals in quantitating this disability.

Activities of Daily Living↗
PubMed1991

Application of motor learning principles in occupational therapy.

The processes underlying skill acquisition depend on the nature of the task and the stage of the learner. In addition, feedback and practice are two potent learning variables when used appropriately in the instruction of motor tasks. Occupational therapists involved in the training and retraining of motor skills can benefit from knowledge of instructional methods used by coaches and physical educators. This paper reviews commonly accepted principles of motor learning and applies these principles to occupational therapy treatment. The stage of the learner, type of task, feedback, practice, and facilitation of skill acquisition are emphasized. Specific examples of how occupational therapists can use motor learning principles in treatment are given.

Biofeedback, Psychology↗
PubMed1988

Motor assessment scale for stroke patients: concurrent validity and interrater reliability.

This study was conducted to establish the concurrent validity and interrater reliability of the Motor Assessment Scale (MAS) for stroke patients. Thirty hemiplegic subjects were tested with the MAS and the Fugl-Meyer Assessment (FMA), a reliable and validated test of motor function in stroke patients. The high correlations obtained between the total scores on the MAS and the FMA (r = .88) and between specific item scores (except sitting balance) (r = .28 to .92) provide support for the concurrent validity of the MAS. Interrater reliability coefficients for the total MAS score and individual items on the MAS (except tone) were also high and significant.

Adult↗
PubMed1982

Subclavian venous catheterisation in small children using the Seldinger technique.

Subclavian venous catheterisation, using a Seldinger technique, was attempted in 25 children weighing less than 10 kg (mean 6.4 kg). Catheterisation was successful in 24 cases. Initial catheter position was satisfactory in 19 of the 24 cases (79%) and with repositioning it was possible to obtain satisfactory flow and pressure-wave recordings in all 24 patients. The technique is simple and provides reliable access to the central circulation in small infants. There was no serious morbidity attributable to the technique.

Body Weight↗
PubMed1981

Electroencephalographic changes with hypothermia and cardiopulmonary bypass in children.

Our experience of EEG changes associated with hypothermia, induced predominantly by core cooling, is presented. Easily recognizable, repeatable patterns emerge and four different types of changes are seen, from generalized slowing and loss of faster rhythms progressing to discontinuous activity, burst suppression activity, and finally loss of all cerebral potentials. These patterns were not altered significantly by anesthetic agents or by patient age or weight differences. Abnormalities of various kinds can be distinguished from the hypothermic changes. In particular, continuous epileptiform activity can be recognized and therefore abolished.

Adolescent↗
PubMed1980

Subclavian vein catheterisation for cardiac surgery in children.

Infraclavicular subclavian vein catheterisation is a useful means of measuring central venous pressure and establishing a central infusion line in children undergoing open heart surgery. In 48 children ranging in age from 15 months to 13 years, there was a high success rate and no morbidity.

Adolescent↗