Biomedical subjects

J Vachon

Publications and source records attributed to J Vachon.

13 recordsLinked to original sources

PubMed1999

Muscle strength changes as measured by dynamometry following functional rehabilitation in individuals with spinal cord injury.

OBJECTIVE: To objectively quantify muscle strength changes over the course of functional rehabilitation and up to 15 months postdischarge in individuals with spinal cord injury (SCI). METHOD: Hand-held dynamometry was used to evaluate the strength of six muscle groups in 31 individuals after acute SCI (tetraplegia, n = 13, paraplegia, n = 18). Assessment was performed by a single research therapist at admittance and discharge from functional rehabilitation and 3 months and 15 months after discharge. RESULTS: There were significant increases of mean strength values for all muscle groups between admittance and discharge in individuals with parapalegia (median value between 13% and 22%) and tetraplegia (median value between 33% and 83%). Three months after discharge, only individuals with tetraplegia continued to significantly improve their mean strength for four muscle groups (elbow flexors-extensors and shoulder flexors-extensors). One year later, elbow flexors were significantly improved in both paraplegic and tetraplegic persons, while shoulder extensors showed significant gains only in individuals with paraplegia. Study results showed a large variability in the individual profiles of upper limb strength recovery, particularly in tetraplegic individuals. Although some individuals showed strength gains exceeding 200%, some strength decreases were noted. CONCLUSION: Recovery of muscle strength in individuals with tetraplegia over individuals with parapalegia continues for a longer period since it depends initially on recovery of muscle innervation. This study quantified strength improvements during rehabilitation and clearly showed that these gains can be maintained or even increased when the person returns to community living.

Activities of Daily Living↗

PubMed1999

Productivity outcomes of individuals with spinal cord injury.

STUDY DESIGN: Cross-sectional study by mail survey of participation in productive activities of individuals who sustained a spinal cord injury (SCI) in Quebec from 1970 to 1993. OBJECTIVES: To determine the level of productivity outcomes of a representative sample and to determine the relationship between the productivity outcomes and some personal and environmental variables. SETTINGS: Quebec, Canada. METHODS: Four hundred and eighteen subjects (mean of age=42.1+/-11. 8) were included in this study. Overall productivity was assessed by the participation into five categories of activities (gainful employment, studies, homemaking and family activities, community organizations and leisure activities). RESULTS: Depending on the severity of injury, 30% to 51% of the variance in productivity outcomes can be explained by a set of ten variables: education, ability to drive a car vehicle, other transportation indices, age related variables and type of locomotion. A discriminant analysis was undertaken to classify the subjects into three levels of productivity (low, moderate and high). The percentage of subjects correctly classified was moderate (54% to 71%) to high (72% to 81%) depending on the productivity levels. CONCLUSION: The results confirm the significant contribution of education and transportation to explain the productivity outcomes. SPONSORSHIP: This project was funded by the 'Société d'Assurance Automobile du Québec', the 'Commission de la Santé et de la Sécurité du Travail' and the 'Fondation André Senécal'.

Adolescent↗

PubMed1998

Comparison of three methods to assess muscular strength in individuals with spinal cord injury.

The aim of the project was to compare three methods for measuring muscle strength in individuals with SCI: the manual muscle test (MMT), the hand-held myometry and the isokinetic dynamometry (Cybex). Thirty-eight (38) subjects, 31 men and seven women (age range = 14-63; lesion from C5 to L3) were included in this project. Muscle strength assessment of upper limbs was performed at admittance and discharge using MMT and myometry for the left and right side, and using Cybex dynamometer for the stronger side. The testing sessions were at least a day apart and performed by a single evaluator (trained physiotherapist). Significant and non-significant differences of myometry mean strength values were observed between consecutive levels of MMT. However, the range of myometry scores within each MMT grade led to significant overlaps between two adjacent MMT grades of each muscle group. Variables correlations were observed between the strength values measured by MMT and myometry with paraplegia (0.26 < or = r < or = 0.67) and tetraplegia (0.50 < or = r < or = 0.95). Similar results were observed when compared MMT and Cybex with the stronger side. Moderate to strong correlations were observed between the strength values measured by myometry and Cybex with paraplegia (0.70 < or = r < or = 0.90) and tetraplegia (0.57 < or = r < or = 0.96). These results suggest that the MMT method does not seem to be sufficiently sensitive to assess muscle strength, at least for grade 4 and higher and to detect small or moderate increases of strength over the course of rehabilitation. Since outcome measures is an important issue in rehabilitation, objective measurements of strength should be used in clinical settings. Considering cost and assessment time, the myometry technique seems to be highly valuable.

Adolescent↗

PubMed1990

In-flight stabilization of oxygen saturation by control of altitude for severe respiratory insufficiency.

A 4,907-mile medical air transport recently took place between Vancouver, Canada, and London, England. The patient was a 6-year-old boy with multiple pleural, pulmonary, and pericardial hemangiomata who required heart-lung transplant. Because his respiratory function was so poor (including oxygen-induced hypercarbia and sleep-induced hypoxia), a Lear 35 was used. The aircraft made a low altitude flight possible, allowing adjustment of cabin pressure to overcome the child's sensitivity to any significant reduction in partial pressure and to minimize his need for supplemental oxygen. Clinical observation and monitoring using oximetry and transcutaneous blood gas measurements were carried out en route to warn of excessive altitude effects. Sequential increases in altitude were made once oxygenation had stabilized at each cabin pressure. Cabin pressure was not allowed to rise above 3,700 ft to ensure an oxygen saturation level of at least 80%. The transport was accomplished successfully with no requirement for intervention. This approach to in-flight management has applications for other aero-medical transports.

Acute Disease↗

PubMed1978

[Angina pectoris and muscular bridges on the anterior interventricular artery. Apropos of 3 operated cases].

A relationship between ischaemia of the myocardium and a muscular bridge over the anterios descending artery has now been demonstrated. The authors report three cases in which the severity of the clinical features was sufficient to justify surgical division of the muscular bridge without touching the underlying artery. Progress remained satisfactory after a follow-up period of 1.5 to 3 years. The opportunity is taken to discuss the role of the muscle bridge in causing pathology in the coronary arterial system.

Adult↗

PubMed1972