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Biomedical subjects

Richard W Bohannon

Publications and source records attributed to Richard W Bohannon.

At least 19 recordsLinked to original sources
PubMed2007

Muscle strength and muscle training after stroke.

For many individuals who have experienced a stroke, muscle weakness is the most prominent impairment. Both the theoretical and statistical relationships between muscle weakness and performance at functional activities suggest that weakness may be an appropriate target for therapeutic interventions. Researchers investigating the outcomes of strengthening regimens after stroke have routinely shown that resistance exercise leads to increased muscle strength, but that strength is typically measured using the same maneuvers that were used in training. Evidence supporting the use of strengthening regimens to reduce limitations in functional activity is equivocal.

Activities of Daily Living↗
PubMed2006

Test-retest reliability of the MicroFET 4 hand-grip dynamometer.

This study was conducted to determine the test-retest reliability of measurements of grip strength obtained with the MicroFET 4 dynamometer. Measurements did not differ significantly between days and had high intraclass correlation coefficients (>.970). The technical error of measurement was low (< or =22.7 newtons). On the basis of results from this convenience sample of nondisabled adults, it would appear that measurements obtained with the MicroFET 4 possess high test-retest reliability.

Adult↗
PubMed2006

Reference values for the timed up and go test: a descriptive meta-analysis.

BACKGROUND AND PURPOSE: The Timed Up and Go (TUG) test is widely employed in the examination of elders, but definitive normative reference values are lacking. This meta-analysis provided such values by consolidating data from multiple studies. METHODS: Studies reporting TUG times for apparently healthy elders were identified through the on-line search of bibliographic databases. Study specifics and data were consolidated and examined for homogeneity. RESULTS: Twenty-one studies were included in the meta-analysis. The mean (95% confidence interval) TUG time for individuals at least 60 years of age was 9.4 (8.9-9.9) seconds. Although the data contributing to this mean were homogeneous, data for individuals who could be categorized by age were more homogeneous. The mean (95% confidence intervals) for 3 age groups were: 8.1 (7.1-9.0) seconds for 60 to 69 year olds, 9.2 (8.2-10.2) seconds for 70 to 79 years, and 11.3 (10.0-12.7) seconds for 80 to 99 years. CONCLUSIONS: The reference values presented, though obtained from studies with clear differences, provide a standard to which patient performance can be compared. Patients whose performance exceeds the upper limit of reported confidence intervals can be considered to have worse than average performance.

Aged↗
PubMed2006

Reference values for the five-repetition sit-to-stand test: a descriptive meta-analysis of data from elders.

This meta-analysis was conducted to generate normative values for the 5-repetition sit-to-stand (STS) test suitable for application to individuals at least 60 years of age. A thorough review of the literature yielded 13 papers (14 studies) relevant to this purpose. After the exclusion of potentially unrepresentative data, meta-analysis of these 13 papers indicated that judgments about normal performance should be based on age. Analysis demonstrated that individuals with times for 5 repetitions of this test exceeding the following can be considered to have worse than average performance: 11.4 sec (60 to 69 years), 12.6 sec. (70 to 79 years), and 14.8 sec. (80 to 89 years).

Aged↗
PubMed2006

Hand-held dynamometry: adoption 1900-2005.

The purpose of this brief report is to describe the adoption of hand-held dynamometry, a procedure for documenting muscle strength. Between the early 1900s and the end of 2005, 478 research articles were published that documented use of hand-held dynamometry. The adoption of the procedure for research is consistent with the S-shaped curve described by Rogers. The extent to which hand-held dynamometry is used in clinical practice remains to be delineated.

Equipment Design↗
PubMed2005

Time spent moving is related to systolic blood pressure among older women.

Isolated systolic hypertension is present in the majority of older women. Exercise is an attractive antihypertensive lifestyle therapy for older women with isolated systolic hypertension, but the amount of exercise needed to reduce blood pressure (BP) is not clear. Evidence is accumulating that lower levels of physical exertion are associated with decreased BP. The authors sought to determine if BP was related to daily time spent moving. Participants were 109 women (mean +/- SD, 75.2+/-7.2 yr). A majority (63.3%) had hypertension, and 48.6% had isolated systolic hypertension. Systolic BP was lower among women moving > or =5 h/d (142.2+/-18.7 mm Hg) than those moving <5 h/d (149.8+/-19.0 mm Hg) (p=0.038). Multiple regression analysis indicated that the potentially strong confounding effects of antihypertensive medication use, adiposity, and age did not eliminate these favorable associations between daily time spent moving and systolic BP. Older women should be encouraged to regularly engage in physical activities typical of everyday life such as walking because of its BP benefits.

Aged↗
PubMed2005

Effectiveness of the easy-up handle in acute rehabilitation.

OBJECTIVE: The ability to attain standing without assistance is important to independent functioning. The objectives of this study, therefore, were to: (1) determine the effectiveness of the Easy-Up Handle for enabling otherwise dependent patients to attain standing from an armless chair and (2) establish whether knee extension force played a role in such effectiveness. DESIGN: Cross-sectional descriptive study and explicatory experiment. SETTING: Acute rehabilitation unit. SUBJECTS: A subset (n = 26) of 107 primarily elderly patients described in a previous study. The subjects were selected because of their inability to stand from an armless chair, even when using their upper limbs. MAIN MEASURES: The ability to stand from the same chair when using an Easy-Up Handle. Hand-held dynamometer measures of the combined strength of the lower extremities. RESULTS: Eight of 26 otherwise dependent patients were able to stand up independently with the Easy-Up Handle. Whether or not they were able to attain standing with the Easy-Up Handle was predicted by their combined knee extension force and by their combined force normalized against body weight. The Pearson correlations between stand-up independence (yes, no) and the forces were 0.496 and 0.543, respectively. CONCLUSIONS: The Easy-Up Handle can facilitate independence in chair rise for some patients otherwise unable to stand from sitting. Even with the Easy-Up Handle, however, a threshold of knee extension force is required.

Adult↗
PubMed2005

Manual muscle testing: does it meet the standards of an adequate screening test?

OBJECTIVE: To describe the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of manual muscle testing. DESIGN: Secondary analysis of cross-sectional strength data. SETTING: Acute rehabilitation unit. PARTICIPANTS: Convenience sample of 107 consecutive qualifying rehabilitation inpatients. INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: Knee extension forces measured by manual muscle testing and hand-held dynamometry. RESULTS: The ability of manual muscle testing to detect 15, 20, 25 and 30% between-side differences and deficits in knee extension force was described. Although the specificity of manual muscle testing was acceptable (mostly > 80%), its sensitivity to differences between sides and to deficits relative to normal never exceeded 75%. Its diagnostic accuracy was never greater than 78%. CONCLUSION: The results of this study cast doubt on the suitability of manual muscle testing as a screening test for strength impairments.

Adult↗
PubMed2005

Adiposity of elderly women and its relationship with self-reported and observed physical performance.

BACKGROUND AND PURPOSE: There is a societal trend toward increasing obesity and a natural tendency for physical performance to decrease with age. Our purpose was to describe the adiposity of elderly women participating in a health screening and to determine the relationship between their adiposity and both observed and self-reported physical performance. METHODS: Subjects were 104 communitydwelling elderly women (74.9+/-7.5 years). Their adiposity was described using body mass index (BMI), waist circumference, and waist to hip ratio. Physical performance was characterized using timed sit-to-stand, unilateral standing, 25-foot walk and the Physical Functioning subscale of the SF-36. Habitual activity was summarized as the number of daily hours patients estimated they spent moving about on their feet. RESULTS: The majority of women had excessive adiposity. Greater adiposity was associated with worse physical performance. Both Pearson correlations and multiple regression revealed BMI to be significantly predictive of all physical performance measures. Age added to the explanation of walking time and unilateral stance time. Time moving about contributed to the explanation of self-reported physical functioning. CONCLUSIONS: Adiposity should be documented as part of the physical therapist examination of elderly women. It may be an appropriate target of intervention if physical performance is limited.

Adipose Tissue↗
PubMed2005

Reliability and validity of three strength measures obtained from community-dwelling elderly persons.

The purpose of this study was to describe the reliability and validity of 3 strength measures obtained from community-dwelling elderly individuals. The strength of 10 elders was tested initially and 6 and 12 weeks later using the MicroFET 2 hand-held dynamometer (knee extension strength), the Jamar dynamometer (grip strength), and the sit-to-stand (STS) test. Mobility was tested using the timed up-and-go (TUG) test and a timed walk test. Intraclass correlation coefficients, which were used to characterize the reliability of the strength tests, ranged from 0.807 to 0.981. Pearson correlations between the lower extremity strength measures and the TUG and gait speed ranged from 0.635 to -0.943. Our examination of the 3 measures for 12 weeks extends previous evidence of the stability of these strength measures and justifies the use of hand-held dynamometry and the STS test when investigating limitations in mobility.

Aged↗
PubMed2005

Parallel comparison of grip strength measures obtained with a MicroFET 4 and a Jamar dynamometer.

Repeated measures of grip strength obtained bilaterally with a Jamar and a MicroFET 4 dynamometer were compared. Measurements obtained with the MicroFET 4 tended to be slightly (2.2-3.1 lb.) higher but were highly correlated (r > or = .96) with those obtained with the Jamar. Parallel reliability for the two devices was excellent (intraclass correlation coefficient > or = .96). Although clinicians should be cautious about using the devices interchangeably, the MicroFET 4 appears to be a legitimate alternative to the Jamar dynamometer.

Adult↗
PubMed2004

Mortality and readmission of the elderly one year after hospitalization for pneumonia.

BACKGROUND AND AIMS: Pneumonia, which is common among the elderly, is associated with untoward consequences. We sought, therefore, to describe the incidence of death and readmission, and to determine predictors of these variables during the year subsequent to index hospitalization. METHODS: This study involved the follow-up of 153 patients surviving an index hospitalization for pneumonia. Death and readmission were documented, and the relationship of selected variables with these outcomes was determined. RESULTS: Ninety-six (62.6%) of the patients had died or were readmitted. Only a count of comorbidities was correlated significantly with death, readmission, and either death or readmission. Using regression analysis, death alone was predicted by multiple variables. Grip strength and comorbidity counts correctly classified 75.2% of patients relative to that outcome. CONCLUSIONS: Untoward outcomes are likely among patients surviving acute hospitalization for pneumonia. These outcomes are related to variables that can be targeted in secondary prevention efforts.

Aged↗
PubMed2004

Association of physical functioning with same-hospital readmission after stroke.

OBJECTIVE: Readmission after hospitalization for stroke is an important outcome. We sought to document the frequency of same-hospital readmission and to determine the relative value of physical functioning as a predictor of the outcome. DESIGN: Consenting patients (n = 228) who were admitted for ischemic stroke were characterized according to demographics, stroke severity, and self-reported prestroke and postadmission physical functioning. The hospital's administrative database was used to track readmissions during the year after index hospitalization. RESULTS: Same-hospital readmissions were experienced by 37.3% of the patients. The readmissions usually occurred within 100 days of discharge. The most common readmission diagnosis was stroke (14.1%). Lower prestroke and postadmission physical functioning (as reflected by dichotomous Barthel index scores) were weak but significant predictors of readmission (r = -0.165 and -0.268, respectively). Regression analysis showed that once postadmission physical functioning was accounted for, neither prestroke functioning nor any other measured variable added to the explanation of same-hospital readmission. CONCLUSION: The importance of physical functioning goes beyond rehabilitation. It is a potentially modifiable variable with implications for readmission.

Activities of Daily Living↗
PubMed2004

Measurement properties of the short form (SF)-12 applied to patients with stroke.

The purpose of this study was to examine the reliability and validity of the Short Form (SF)-12 and to determine its ability to detect changes in health related quality of life (HRQOL) following stroke. The study involved a cohort of 90 patients admitted with an ischemic stroke to a hospital in the northeastern United States. The items of the SF-12 were found to be reliable (alpha=0.833-0.894) and to load on a physical and mental component. Three months post-stroke the physical component summary (PCS) scores of the SF-12 were significantly less than population norms. The PCS scores were also lower after stroke (3 month=42.5, 12 month=46.3) than before stroke (48.8). Mental component summary (MCS) scores did not differ significantly from population norms or across time (range=53.6 to 54.9). We conclude that the reliability and validity of the SF-12, as well as its brevity and capacity to document changes in the physical component of HRQOL, provide support for its use in patients with stroke.

Humans↗
PubMed2004

Test-retest reliability of short form (SF)-12 component scores of patients with stroke.

Although the Short Form (SF)-12 has been used previously to characterize the health related quality of life of patients with stroke, its test-retest reliability has not been described for such patients. We, therefore, examined this reliability in 31 patients (mean age=66.5 years) who experienced an ischemic stroke 3-12 months previously. Patients were contacted twice (mean interval=16.2 days) by telephone. Physical component and mental component scores were derived from the 12 SF items. Scores differed less than 1.5 points between tests and were not significantly different. Intraclass correlation coefficients surpassed 0.800. The findings support the test-retest reliability of physical and mental component scores of the SF-12 administered by telephone to post-stroke patients.

Adult↗