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Biomedical subjects

R L Waters

Publications and source records attributed to R L Waters.

At least 109 records · Page 6Linked to original sources
PubMed1979

Positional feedback and electrical stimulation: an automated treatment for the hemiplegic wrist.

Positional feedback (PF) and electrical stimulation were combined in a new treatment modality for facilitating wrist extension in stroke patients. Thirty adult hemiparetic patients lacking normal voluntary wrist extension were randomly placed in control and study groups. The control group received conventional therapy while the study group received positional feedback stimulation training (PFST) in addition to conventional treatment. At the end of the 4-week program, study patients showed a 280% increase in isometric extension torque when the wrist was positioned in 30 degrees of extension and 70% increase when positioned in 30 degrees of flexion. Control patients showed no significant changes in torque. Study patients made an average 200% gain in selective range of motion over their starting levels while controls made only a 50% increase. Treatment using automated PFST equipment allows controlled repetitive isotonic exercise and facilitation of wrist extension without continuous one-on-one therapist/patient supervision.

Automation↗
PubMed1976

Metabolic energy cost of unrestrained walking.

Physiologic factors of metabolic energy cost as well as selected mechanical characteristics of gait are described in a group of 40 presumably normal men and women between the ages of 20 and 60 years. Special emphasis was placed on unrestrained (free cadence) walking to provide a reliable baseline for comparison to persons with physical gait impairments. Velocity of walking was the most important factor in determining oxygen uptake and was independent of age or sex. An empirical equation was established relating oxygen uptake to the speed of walking. The average velocity for men in unrestrained walking trials was 89 meters per minute; for women 74 meters per minute. These differences were related to the greater stride length in men. The average cadence selected by both sexes was 116 steps per minute. None of these factors was age dependent. Of the physiologic measures only systolic blood pressure was age dependent predictably rising with age. The mean heart rate was 103 beats per minute and did not vary significantly between men and women. The mean respiratory rate was 19 per minute; the mean respiratory quotient, 0.85, neither being age or sex dependent. Oxygen uptake values averaged 12.95 ml/kg-min for the population studied and again were neither age nor sex dependent.

Adult↗
PubMed1976

Energy cost of walking of amputees: the influence of level of amputation.

A comparison of selected gait parameters and the energy cost of prosthetic walking was made in seventy patients with unilateral traumatic and vascular amputations. Amputations above the knee, below the knee, and at the Syme's level were compared in both groups of amputees, and a control group of forty normal subjects also studied. In both groups of amputees performance was significantly better the lower the level of the amputation. When preservation of function is the chief concern, amputation should be performed at the lowest possible level.

Adult↗
PubMed1976

Electrical stimulation and feedback training: effects on the voluntary control of paretic muscles.

The carry-over effect of gait-synchronized stimulation of the peroneal nerve on voluntary dorsiflexion of the paretic foot was evaluated in hemiplegic patients. The influence of providing audiovisual feedback of performance on voluntary control was also evaluated. Each patient received three test sessions separated at least one week apart. In each session, measurement of isometric torque from voluntary effort was repeated four times: before, and at 0, 30 and 60 minutes after a 20-minute walk period. Session 2 involved both peroneal stimulation during walking and performance feedback during voluntary efforts. Session 1 had stimulation only. Session 3 had feedback only. The results were inconsistent among the patients. Where increase of voluntary dorsiflexion was obtained, it was more a consequence of performance feedback than peroneal stimulation. General problems of using isometric torque produced by voluntary dorsiflexion as a measure of the carry-over effect are discussed.

Adult↗
PubMed1975

Peroneal nerve conduction velocity after chronic electrical stimulation.

The effects of electric stimulation on nerve conduction velocity of the peroneal nerve via surgically implanted electrodes was evaluated in a group of nine hemiplegic patients. After a mean duration of 25 months nerve conduction velocity averaged 47.3 meters/sec in the uninvolved and 46.1 meters/sec in the stimulated (paretic) extremity. In a control group of ten hemiplegic subjects who did not receive stimulation, nerve conduction velocity averaged 43.1 meters/sec in the hemiplegic leg, and 41.3 meters/sec in the uninvolved leg. These differences were not statistically significant. Maximum dorsiflexion strength was increased in all patients following chronic stimulation.

Ankle↗
PubMed1975

Experimental correction of footdrop by electrical stimulation of the peroneal nerve.

Footdrop was corrected in thirteen of sixteen patients with centrally paralyzed ankle dorsiflexor muscles who were treated by electrical stimulation of the peroneal nerve by means of surgically implanted electrodes. Four patients required surgical revision before a good result was obtained. After follow-ups of more than three years there was no evidence of any nerve damage caused by chronic electrical stimulation of the peroneal nerve.

Action Potentials↗
PubMedDate not supplied

Occipito-cervico-thoracic spine fusion in a patient with occipito-cervical dislocation and survival.

A 16-year-old man with occipito-cervical dislocation and survival was treated at Rancho Los Amigos Medical Center. The patient had ligamentous instability between the occiput and the cervical spine. His neurologic level was complete at the C1 level, and he was dependent on a mechanical respirator. Sternocleidomastoid and other neck musculature were not functional. A fusion of the occiput to cervical spine and cervical spine to thoracic spine was performed to obviate the need for external neck support. The patient went on to fuse and is now independently mobile with a tongue-switch driven wheelchair with a respirator trailer 2 years after injury. The patient has no need for external support as a result of his fusion.

Adolescent↗
PubMedDate not supplied

Acute subdural haematoma mimicking an epidural haematoma on a CT scan.

This paper reports an acute subdural haematoma mimicking an epidural haematoma as seen on a non-enhanced computerized tomography (CT) scan of the head in a patient who had sustained a traumatic head injury. The patient had undergone a craniotomy 4 years prior to the injury described here.

Adult↗
PubMedDate not supplied

Moving forward.

Explore the source record for details and available documents.

Cerebrovascular Disorders↗
PubMedDate not supplied

Dorsal myelotomy for relief of spasticity in spinal injury patients.

Seven male patients, five complete quadriplegic and two complete high thoracic paraplegic, were treated by dorsal longitudinal myelotomy to relieve intractable spasticity of the lower extremities. All had intact neurogenic bladders before surgery. All patients had initial relief of spasticity but had recurrence of spasticity in varying degrees at two to three months postoperation. One patient had repeat myelotomy with similar results. One patient had successful relief of spasticity but lost neurogenic bladder function. Three patients required surgical releases of spastic contractures after surgery. Only one patient was satisfied with the procedure but required additional procedures for relief of spasticity. None of the procedures was considered successful. Dorsal longitudinal myelotomy is not successful in the treatment of spasticity in the spinal-injured patient.

Adult↗
PubMedDate not supplied

Surgical morbidity in patients with neurologic dysfunction.

Mortality and morbidity data were collected on 388 patients treated by operations to correct extremity deformities caused by stroke, head trauma and neurologic disease. A total of 613 procedures were performed, requiring 524 general, 2 spinal and 16 regional anesthesias. There were no postoperative deaths. None of the patients showed further neurologic deterioration. The incidence of medical complications was 6.4% and all patients responded to medical treatment. Sixteen wound complications responded to routine care. Age appeared to be the primary risk factor to postoperative morbidity. It is generally safe to perform elective orthopedic surgery to correct extremity deformities in the neurologically involved patient.

Age Factors↗