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Biomedical subjects

S F Wainapel

Publications and source records attributed to S F Wainapel.

At least 19 recordsLinked to original sources
PubMed1998

Use of alternative therapies by rehabilitation outpatients.

OBJECTIVE: To document the prevalence and patterns of use of alternative medical therapies as well as their perceived effectiveness by patients in a rehabilitation medicine outpatient practice. DESIGN: Cross-sectional survey by written questionnaire. SETTING: An urban rehabilitation medicine outpatient referral office. PATIENTS: A random sample of 103 patients referred for rehabilitation outpatient care, while waiting for their appointment, were given a questionnaire addressing their use of alternative therapies. MAIN OUTCOME MEASURES: Use of alternative therapies and their perceived effectiveness. RESULTS: One or more alternative medical therapies had been used by 29.1% of subjects in the past 12 months for their presenting problem. The most common therapies were massage, chiropractic, vitamin and mineral supplementation, and acupuncture. Musculoskeletal pain syndromes involving the spine and extremities were the most common problems for which patients sought both physiatric and alternative care. Of the patients who used alternative treatments 53% reported some degree of efficacy. CONCLUSIONS: A significant proportion of rehabilitation medicine patients use and frequently perceive a benefit from alternative therapies, particularly massage, chiropractic, vitamin and mineral supplementation, and acupuncture. Incorporating alternative therapies into physiatric practice is a desirable future direction for the specialty.

Adolescent↗
PubMed1998

Use of a motorized wheelchair in conjunction with a guide dog for the legally blind and physically disabled.

There is limited literature concerning use of wheelchairs by patients with combined visual impairment and neuromuscular diseases. This case report describes the use of a motorized wheelchair and guide dog by a legally blind patient with severe visual loss due to oculocutaneous albinism. He had concomitant decreased functional mobility from degenerative joint disease of both knees, which limited his ambulation capability. After careful consideration of risks and a successful trial of its use in the corridors of our institution, as well as successfully traveling with it outdoors, he was given a motorized wheelchair. He has continued to use it safely and successfully along with his guide dog. Combined visual and neuromuscular diseases will be encountered with increasing frequency because of the aging population, and it is therefore important for physiatrists to be able to provide assistive devices for such individuals. Vision loss is not an absolute contraindication to motorized wheelchair use.

Animals↗
PubMed1996

Dickens and disability.

The novels of Charles Dickens include many vivid portraits of individuals with physical disabilities or deformities, and these conditions are often used symbolically to highlight some of the author's recurring themes. Disabled children are depicted as innocent victims, while their older counterparts are most often viewed as corrupt victimizers whose physical deformities are outward manifestations of their inner depravity. Punishment for moral failings in non-disabled characters frequently takes the form of paralysis and/or aphasia resulting from a cerebrovascular accident. In this context the wheelchair becomes a potent metaphor of imprisonment as a form of retributive justice.

Persons with Disabilities↗
PubMed1989

Severe visual impairment on a rehabilitation unit: incidence and implications.

Eleven of the first 191 admissions (5.8%) to a rehabilitation inpatient unit met the criteria for legal blindness; two additional patients (1%) had severe visual impairment (visual acuity above 20/200 but less than 20/70 with corrective lenses). All but three of these patients were ambulatory with a walkerette or cane when discharged to their homes. The commonest causes of blindness were macular degeneration, cataract, glaucoma, and diabetic retinopathy. Despite being older (mean age 79.7 years compared to 70.4 years for all 191 admissions) and having visual impairment superimposed on their primary rehabilitation diagnosis, these patients' lengths of stay (LOS) were not prolonged (mean LOS = 33.1 days compared to 35.9 days for all 191 admissions). It is concluded that severe visual impairment is not uncommon among rehabilitation inpatients, particularly those aged 70 or older. Health care professionals working in rehabilitation should become more familiar with, and proficient in, the basic principles and treatment techniques used in the rehabilitation of visually impaired persons.

Adult↗
PubMed1987

The physically disabled physician.

This article reviews the available literature on physically disabled physicians and discusses the attitudinal, environmental, and political barriers they may encounter. Information on 215 physicians and 92 medical students with a wide range of disabilities was analyzed. Currently available personal and technological resources are outlined and special issues pertaining to medical education are highlighted. Greater awareness and acceptance by medical peers are essential for professional success.

Architectural Accessibility↗
PubMed1987

Physical disability among physicians: an analysis of 259 cases.

This article presents data on 259 physicians and medical students with a wide range of physical disabilities and specialty training. Three out of four were in active medical practice despite their disability, most often in the specialties of internal medicine, family practice, or psychiatry. Neurological disorders accounted for over half the sample, with spinal cord injury, multiple sclerosis, stroke, and post-polio weakness being the most commonly encountered diagnoses. These data indicate that physically disabled physicians are more numerous than the previous literature would suggest that they are capable of practising in many professional specialties.

Adult↗
PubMed1985

Stubby prostheses: an alternative to conventional prosthetic devices.

Stubby prostheses offer potential advantages over conventional prosthetic devices in terms of safety, stability, and energy efficiency. Although cosmesis is compromised in the process, these short nonarticulated pylon prostheses may be a viable option to consider in bilateral A-K or knee disarticulation amputee patients under the following circumstances: (1) as a training tool to determine whether progression to full-length articulated devices is feasible; (2) as permanent prostheses for the patient whose primary need for ambulation is within his own home; (3) for the elderly bilateral amputee in whom ambulation is feasible but safety and energy efficiency are of particular importance; and (4) as a definitive device in the patient who expresses a preference for them. Two patients who have become successful users of stubby prostheses are presented to illustrate these points.

Adult↗
PubMed1985

Electrotherapy for acceleration of wound healing: low intensity direct current.

Accelerated wound healing has been an observed effect of low intensity direct current (LIDC) in the range of 200 microA to 800 microA, but present electrotherapeutic equipment has been less than optimal in providing this range of stimulation. A small and portable LIDC stimulator was specially constructed and used in a study of the effects of LIDC on wound healing rates among inpatients here. Thirty patients with indolent ulcers located either below the knee or in the sacral area were randomly assigned to the LIDC protocol or to more conventional wound therapy. The patients in each treatment group were matched by age, diagnosis, wound size, and wound etiology. Comparison revealed 1.5 to 2.5 times faster healing in those receiving LIDC, which was statistically significant. The wounds treated with LIDC required less debridement and the healed scars were more resilient. Additionally, no wound infections occurred and patients reported less discomfort at the wound site. Low intensity direct current appears to be a convenient, reproducible, and effective method for improved healing of chronic open wounds and warrants more widespread use in the clinical setting.

Aged↗
PubMed1985

Ulnar nerve compression by heterotopic ossification in a head-injured patient.

Although heterotopic ossification (HO) at the elbow is a frequent occurrence following head injury, nerve compression by heterotopic bone is quite rare. We report the case of a 22-year-old woman with head injury and well-documented HO at the left elbow who developed signs and symptoms of an ulnar neuropathy four months after her original injury. Electrodiagnostic studies confirmed the presence of a severe ulnar nerve lesion at the level of the elbow. Anterior transposition of the left ulnar nerve showed the nerve to have been compressed by heterotopic bone.

Adult↗
PubMed1985

Statistical methods in rehabilitation research.

Of 128 articles in Volume 63 (1982) of the Archives of Physical Medicine and Rehabilitation 48 (37.5%) utilized some form of statistical methodology. The most commonly encountered methods were: mean (with or without standard deviation or standard error); analysis of variance (ANOVA); t-tests; simple correlation/linear regression; and chi-square analysis. A critical review of the analytic statistics used in 40 of these articles revealed that only 23 (57.5%) were considered satisfactory in descriptive and methodologic terms. The most frequently encountered deficiencies were: inadequate description of methods; misuse of t-tests; absence of appropriately complex statistical analysis. A greater understanding of and familiarity with biostatistics is essential for all readers of the Archives to allow critical evaluation of the rehabilitation literature.

Humans↗
PubMed1985

Paraplegia following epidural anesthesia. A case report and a literature review.

This article reports the case of a man who developed a pure motor paraplegia following epidural anesthesia with a pattern of slow recovery over subsequent months. Reviewing the available literature on post-epidural paraplegia we noted a number of potential etiologies and analyzed their role in its causation. On the basis of this analysis we have identified five distinct clinical groups and a constellation of factors which can lead to an increased risk of post-epidural paraplegia in susceptible surgical patients.

Aged↗
PubMed1984

Rehabilitation of the blind stroke patient.

Over a two-year period 220 consecutive stroke admissions to a rehabilitation medicine inpatient service were reviewed. There were nine admissions (4.1%) involving seven separate patients who were also legally blind. The characteristics, outcomes, and special problems of these patients are reviewed. Despite their advanced age and double disability almost all became ambulatory and a majority of them were able to be discharged to their homes. Visual loss was often the primary limiting factor in functional outcome. A striking finding was the lack of perceptual problems in those right brain damaged patients with the greatest degree of visual impairment.

Activities of Daily Living↗