Clarification on the use of silver-based purification systems.
Explore the source record for details and available documents.
Burns↗
Biomedical subjects
R F Edlich
Publications and source records attributed to R F Edlich.
A new barrier-free burn center.
This article describes a barrier-free burn center that is accessible to persons with disabilities and that complies with Title III of the Americans with Disabilities Act. The burn center has 3 separate components: patient rooms, patient support facilities, and staff support facilities. Thirteen rooms are used to care for 16 patients. Two of the 13 rooms are accessible to people with disabilities. These 2 rooms have wide doors that permit a wheelchair to pass through, and they have enough clear floor space for a wheelchair to make a 180 degrees turn. The rooms have a sink that is accessible from a wheelchair. The bathrooms have large, clear floor spaces that allow for the turning of a wheelchair, elevated toilets, grab bars, and showers that permit wheelchair access. Special wheelchairs that provide easier shower and commode access are available. The patient support services feature a large hydrotherapy room that contains a table-shower system that allows a person in a wheelchair to gain access to both sides of the shower table. A tub room has been constructed to provide compact patient bathing and hydromassage, and it is also accessible to people in wheelchairs. The staff support services include a locker room that has a shower accessible to people with disabilities so that staff members with mobility disorders can work in the burn center. Grade II braille writing marks all of the signs that designate the permanent rooms and spacing in the burn center and in the contiguous common use areas. The common use area has a restroom accessible to people with disabilities and a waiting room with a telephone communications system for people with mobility disorders or mobility impairment.
Architectural Accessibility↗
Comparison of continuous vs intermittent tube feedings in adult burn patients.
In an effort to determine an optimal method of utilizing the gastrointestinal tract to meet the nutritional need of burn patients, a comparison was made between continuous and intermittent delivery of lactose-free tube-fed diets in similar groups of burn-injured patients. It was found that significantly less stool frequency and time required to achieve the nutritional goal occurred in patients treated with continuous pump tube feeding over those fed intermittently.
Adolescent↗
Limited joint mobility in power lifters.
In this study we compared the flexibility of 10 power lifters with 10 age-matched nonpower lifters as controls. To do this, we used goniometric measurements, the behind the back reach test, and the sit and reach test. The sit and reach test was the only measurement that showed the flexibility of the power lifters to be greater than that of the nonpower lifters.
Adult↗
New assistive technology for passive standing.
The anesthetic skin of patients with spinal cord injuries makes these patients a high-risk population for burn injuries. Innovations in rehabilitation engineering can now provide the disabled with mechanical devices that allow for passive standing. Passive standing has been shown to counteract many of the effects of chronic immobilization and spinal cord injury, including bone demineralization, urinary calculi, cardiovascular instability, and reduced joint range of motion and muscular tone. This article will describe several unique assistive devices that allow for passive standing and an improvement in daily living for people with disabilities.
Activities of Daily Living↗
Technical considerations in the use of external condom catheter systems.
Since the advent of rehabilitation engineering new advances have been made that have revolutionized condom catheter drainage systems (CCDS). An innovative CCDS has been designed that ensures unobstructed urine flow. Its condom catheter has several unique design features. It has a double row of convolutions near the catheter tip that prevent kinking and twisting so that the pathway remains open. The condom catheter features a unique inner flap that fits snugly on the glans to prevent backflow of urine on the shaft. This condom catheter is connected to a vented leg bag that eliminates the development of a partial vacuum in the connecting tube. This vacuum can create siphoning, which in turn interferes with urine flow into the leg bag. In addition, a new rechargeable battery-operated clipper has been developed that makes nick-free hair removal from the genitals exceptionally easy. This atraumatic hair removal eliminates the pubic hair that becomes trapped under the condom catheter. The clinical impact of these new advances in CCDS requires further investigation.
Hair Removal↗
Psychometric assessment of psychologic factors influencing adult burn rehabilitation.
This article describes psychometric assessment instruments that are available for the screening of psychosocial problems that can interfere with patient rehabilitation. Structured assessment of patient depression, anxiety, substance abuse, social support, and willingness to take control and responsibility for health care is important throughout all stages of the patient's treatment. There are psychometrically sound, relatively brief, and nonintrusive measures with which to assess these variables. The hope is that the early and accurate identification of those patients who are in need of psychosocial services can lead to the implementation of services that will ameliorate psychosocial problems and facilitate total patient rehabilitation. Although many excellent measures exist, the most important assessment tool for the screening of psychosocial problems in patients with burns, which has emerged from this review, is the Psychological Adjustment to Illness Scale (PAIS). The PAIS integrates many of the relevant characteristics of psychologic screening and provides normative values that are specific to patients with burns. Ideally, this scale should be supplemented by an assessment of post-traumatic stress disorder, substance abuse, and personality and coping styles, because these critical factors are not adequately covered by the PAIS. Finally, the Burn Specific Health Scale shows promise for the assessment of health status and quality of life in patients with burns. Future clinical research will hopefully compare and contrast the efficacy and relevance of these measures. Furthermore, future clinical evaluation and research will need to relate the influence of psychosocial factors on the patient's total health functioning. Structured psychometric evaluation of the psychosocial and health characteristics will ensure that patients who have been burned will attain the most fulfilling quality of life that is available to them.
Burns↗
Adaptive communication systems for patients with mobility disorders.
An adaptive communication system has been developed for individuals with mobility disorders. It uses specialized computer software and hardware that compensate for this disability. For an individual with a motor-control impairment who is not able to use a keyboard effectively, a computer voice-recognition technology now removes this communication barrier. Speech-recognition systems consist of three basic components: speech processing, speech recognition, and speech understanding. The new Dragon Dictate (Dragon Systems, Inc., Newton, Mass.) is the first large-vocabulary speech recognition system in the personal computer industry that interactively learns a user's vocabulary and mode of speaking and responds to natural language rather than to limited sets of words. This speech-recognition system requires a microprocessor, a display monitor, a printer, and specific software packages, including word-processing and enhanced memory-management software. Important considerations in the use of this speech-recognition system include microphone positioning and training of the system. With the advent of this new voice-recognition computer system, another communication barrier between the disabled and society has been overcome.
Communication Devices for People with Disabilities↗
Computer analysis of the performance of the BTE Work Simulator.
The BTE Work Simulator (Baltimore, Therapeutic Equipment Co., Hanover, Md.) recreates the work environment by providing a rotatable shaft to which a variety of tools can be attached. The patient can simulate the coordinated muscle and joint movements involved in the work situation, exercising either isometrically or isotonically, and thereby increase the potential for return to work. The BTE Work Simulator has four major components: the exercise head to provide variable resistance, tools that attach to the exercise head, a control console containing a microprocessor that calculates work and power, and the Quest software package (Baltimore Therapeutic Equipment Co.). Quest provides four static/isometric and seven dynamic/isotonic tests that can be used to document the extent of a patient's impairment. In addition, it has daily treatment options and acts as an extensive data base capable of retrieving any stored test or treatment results. This software system greatly facilitates the use of the BTE Work Simulator by providing instant calculations of power and coefficients of variation, immediate patient feedback, graphic expansion of the data, and printed evaluation reports.
Computer Simulation↗
An overview of muscle strengthening.
This article gives an overview of muscle strengthening. In this review, we explore the underlying rationale, the process, and the physiologic adjustments that occur as muscles are trained to become stronger. Although controversy surrounds methods used to strengthen muscles, most agree that regular strength training exercises, regardless of the type, can be beneficial.
Body Composition↗
Water treatment of hydrotherapy exercise pools.
The major objectives of water treatment of hydrotherapy pools are to disinfect the water and to balance the water appropriately. A variety of disinfectant systems utilizing either halogens, ozone, or metals have been implemented in hydrotherapy pools. Regardless of the disinfectant system employed, continual and appropriate monitoring of the system is mandatory to prevent infection. Water balancing refers to the control of the water mineral concentration so that the water does not damage the pool. Five major factors that influence water balance are pH, total alkalinity, calcium hardness, total dissolved solids, and temperature. The extent to which these five factors affect water balance can be computed by the Langelier saturation index.
Chlorine↗
Design of hydrotherapy exercise pools.
Several hydrotherapy pools have been designed specifically for a variety of aquatic exercise. Aqua-Ark positions the exerciser in the center of the pool for deep-water exercise. Aqua-Trex is a shallow underwater treadmill system for water walking or jogging. Swim-Ex generates an adjustable laminar flow that permits swimming without turning. Musculoskeletal conditioning can be accomplished in the above-ground Arjo shallow-water exercise pool. A hydrotherapy pool also can be custom designed for musculoskeletal conditioning in its shallow part and cardiovascular conditioning in a deeper portion of the pool. Regardless of the type of exercise, there is general agreement that the specific exercise conducted in water requires significantly more energy expenditure than when the same exercise is performed on land.
Equipment Design↗
Evaluation of automatic disposable rotating cartridge skin staplers.
Burn surgeons commonly employ skin staples for the application of skin grafts and to secure dressings on donor site dressings and over skin grafts. Disposable skin staplers with rotating cartridges are ideally suited for wound closure because the position of their cartridges can be manually adjusted to facilitate placement of their staples. In response to the burgeoning interest in disposable automatic skin staplers with rotating cartridges, three different models are now commercially available. This report describes the design configuration and mechanical performance of these disposable automatic staplers and their staples. Mechanical performance of these staplers and staples has been assessed by standardized tests that can be replicated in any research laboratory. On the basis of these objective design and performance parameters, the Premium stapler is recommended for wound closure. This stapler provides maximal visualization of the wound as well as the staple during its formation. It delivers the staple into the skin or wound in a manner that the cross member of the staple is above the skin or wound surface. In addition, the Premium stapler has a prepositioning mechanism that can be controlled by the surgeon with minimal force. This mechanism allows the stapler to hold its staple securely, even when its pointed legs extend beyond the delivery end of the stapler. Force required to form its staples is so low that the surgeon can staple repetitively without fatigue. Finally, the Premium stapler delivers a staple that has a uniform geometry and sharp points that can easily penetrate tissue.
Adult↗
A new hydrofitness device for strengthening muscles of the upper extremity.
A new hydrofitness device has been devised for strengthening upper extremity muscles during aquatic exercise. It consists of a molded plastic fenestrated outer shell with an inner rotating disc that can be easily adjusted to alter the surface area of its frontal presentation. By changing the surface area of its frontal presentation a graded, individualized exercise program can be prescribed. A buoyant foam disc has been incorporated into the device to prevent it from sinking to the bottom of the pool. On the basis of this evaluation, performance of this device was judged to be superior to that of other devices for strengthening upper extremity muscles during aquatic exercise.
Arm Injuries↗
Evaluation of flotation devices for deep-water exercise.
Jogging and running in deep water (greater than or equal to 7 feet) appears to be a more efficient and safer means of aerobic exercise than jogging and running on land. Consequently, a variety of flotation devices have been developed to facilitate this deep-water exercise. A comprehensive evaluation of these devices revealed distinct performance limitations that interfered with this exercise. On the basis of the results of these studies, a new, improved flotation device has been conceptualized for individuals participating in deep-water exercise.
Adult↗
Hydrofitness devices for strengthening upper extremity muscles.
Our evaluation of hydrofitness devices for strengthening arm muscles has revealed several important determinants of their performance. Most importantly, the device's frontal projection should be in the shape of a paddle whose surface area can be varied to meet the individual exerciser's needs. Its weight should be light to minimize the inertial forces encountered in charging the velocity of paddle movement. Its handle should have a relatively large circumference without digital profiling. These optimal performance parameters have been recently incorporated into a new hydrofitness device that will be commercially available for aquatic exercise programs for strengthening upper extremity muscles.
Adult↗
A new hydrofitness device for leg musculoskeletal conditioning.
A new leg hydrofitness device has been designed for aquatic exercise. It consists of three separate rectangular-shaped buoyant floats that are positioned around the ankle. A clinical trial indicates its potential value for walking reeducation, strengthening leg muscles, and enhancing joint extensibility.
Biomechanical Phenomena↗