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Biomedical subjects

S Leggett

Publications and source records attributed to S Leggett.

8 recordsLinked to original sources
PubMed1999

Restorative exercise for clinical low back pain. A prospective two-center study with 1-year follow-up.

STUDY DESIGN: A comparison of treatment of 412 patients with chronic back pain at two separate centers using the same treatment protocols and outcome measures. Outcome was defined by specific strength testing; Short Form-36 scores at intake, discharge, and 1-year follow-up; self-appraisal of improvement at discharge and in a 1-year follow-up; and reuse of health care services after discharge. OBJECTIVES: To investigate the efficacy of standardized treatment methods using isolated lumbar strength testing and strengthening based on progressive protocols using specific equipment. Comparison of results should clarify the effect of the treatment center versus the efficacy of standardized protocols. SUMMARY OF BACKGROUND DATA: There has been little support in the scientific literature for exercise programs based on standardized protocols. The use of specialized equipment to achieve intense specific exercise also has been poorly supported. Overall health benefit has not often been related to specific improvement in strength. METHODS: More than 400 individuals with chronic back pain were evaluated at the initiation of treatment, discharge, and 1 year after discharge. Measures of efficacy were based on Short Form-36 scores, self-appraisal of improvement, and reuse of health care services after discharge. Study participants were patients with chronic back pain consecutively referred to each treatment site and underwritten by a variety of payers, including workers' compensation, Medicare, and private insurance. RESULTS: Overall response during the course of the program and at 1-year follow-up was similar between the two centers. Similar proportions of participants at each site demonstrated improvement in SF-36 scores, self-appraisal of improvement, and reuse of health care services. CONCLUSIONS: Standardized protocols using specific strength and measurement equipment can achieve similar benefits at different sites.

Adult↗
PubMed1997

Relationships between myoelectric activity, strength, and MRI of lumbar extensor muscles in back pain patients and normal subjects.

Eight normal individuals and eight patients with chronic back pain were evaluated. They undertook a treatment program lasting 8 weeks, with two exercise sessions each week. Myoelectric activity, lumbar extensor strength, and cross-sectional magnetic resonance imaging appearance of the lumbar paraspinal extensor muscles was assessed at the beginning and end of the program. Initial baseline and final extensor strength measurements were done isometrically at seven points through full range. Surface myoelectric activity was monitored during both flexion and extension exercise. Subsequently, electromyographic (EMG) signals were analyzed for mean frequency (MPF) and amplitude (RMS). An average functional improvement of 65% and reduction of pain complaint of 41% occurred in the eight patients with chronic low back pain. Extensor strength improved an average of 48% contrasted to 6% for the normal subjects. Four patients who showed severe fatty infiltration in the extensors had a decrease in the degree of infiltration and no change in muscle mass. Changes in fatty infiltration did not correlate with strength changes. The dynamic EMG changes documented a decrease in amplitude (RMS) and a smaller decrease in frequency (MPF) for the same resistance when used at the beginning and end of the program. Structural changes in the muscles are not always needed to achieve strength gains or symptomatic improvement.

Back Pain↗
PubMed1996

Relationship of lumbar strength in shipyard workers to workplace injury claims.

STUDY DESIGN: Strength testing of lumbar extensors of shipyard workers without back injury claims was accomplished to compare isolated lumbar strength with the severity of their workplace physical demands and the incidence of workplace back injury during a 2-year period. OBJECTIVES: To determine if strength is a predictor of workplace injury and if there is a relationship between the physical demands of the job and strength. SUMMARY OF BACKGROUND DATA: The role of preplacement strength testing has not been clarified as a potential means for predicting workplace injury. It has not been clarified whether work activity affects the strength of the worker. METHODS: One hundred fifty-two shipyard workers were strength tested for isometric lumbar extensor strength. They had been classified as to the severity of their job demands according to the Physical Demand Characteristics. All workers at this industry were likewise classified. Those workers who were tested were followed for 2 years to evaluate for claims of back injury. RESULTS: There was a higher incidence of low back injuries in the heavy and very heavy classification. There was, however, no difference in strength among those workers classified in medium, heavy, and very heavy work. Nine percent of those workers tested had back pains during the following 2 years. All but two had higher-than-average strength. CONCLUSIONS: There is no evidence that preplacement back strength testing would predict workplace claims of injury.

Adult↗
PubMed1996

Comparison of female geriatric lumbar-extension strength: asymptotic versus chronic low back pain patients and their response to active rehabilitation.

We compared lumbar-extension strength between healthy asymptomatic geriatric females (HEAL) and symptomatic geriatric females (INJ) seeking medical attention for chronic low back pain. The INJ group used the MedX lumbar-extension machine to perform isotonic exercises two times per week and were eventually reduced to one time per week. Range of motion (ROM) and strength were significantly different between groups before beginning the program. After the program, ROM and strength improved significantly and were not different from those of the HEAL group. The average length of treatment was 97 days and 20 visits. Subjective pain ratings were significantly reduced (60%) and exercise weights significantly increased (71%). This reconfirms the notion that many back pain sufferers have weaker lumbar-extension strength and that some symptomatic geriatric women can increase strength with progressive resistance exercise, which leads to a decrease in low back pain.

Aged↗
PubMed1995

A test to measure lift capacity of physically impaired adults. Part 2--Reactivity in a patient sample.

STUDY DESIGN: Test reactivity is the based on the idea that experience with a test may affect performance on subsequent tests, independent of what the test purports to measure. The reactivity of a test of lift capacity was studied in a single-blind randomized clinical trial was studied in a single-blind randomized clinical trial in which subjects were assigned to one or two groups. One group received lift testing before and after a therapeutic trial, while the other group received lift testing only at the conclusion of the therapeutic trial. OBJECTIVE: To measure the reactivity of a lift capacity test over the course of treatment. SUMMARY OF BACKGROUND DATA: The reactivity of a test is an important criterion by which an outcome measure must be judged. Change in response to treatment is assumed to be independent of changes resulting from the evaluee's experience with the test, although this is rarely addressed. METHODS: The EPIC Lift Capacity test was administered to 55 patients with low back pain in a treatment program after they were randomized into a pre-test/post-test and a post-test only group. Additional measures were taken on a pre-test/post-test basis for all subjects. RESULTS: Analyses of variance demonstrated no difference between the randomized groups after treatment. However, the pre-test/post-test group demonstrated significant improvement over the course of treatment. Other measures of outcome were similarly affected. CONCLUSION: The reactivity of the EPIC Lift Capacity test was negligible over an 8-week treatment regimen that did not include lifting tasks.

Adult↗
PubMed1985

Evaluation of a QRS scoring system for estimating myocardial infarct size. V. Specificity and method of application of the complete system.

The specificity of a previously developed 57-criteria/32-point QRS scoring system for estimating myocardial infarct (MI) size is evaluated in an extensive control population and the method of application of this system for determining a QRS score from a standard 12-lead electrocardiogram is described. Points are accumulated from Q- and R-wave durations, R- and S-wave amplitudes, R/Q- or R/S-amplitude ratios and the presence of R-wave notching, with each point representing approximately 3% of the left ventricle. The subjects were selected because of the minimal likelihood of their having had myocardial infarcts or other sources of QRS modification. There were 500 consecutively selected normal Caucasian subjects, aged 20 to 69 years, with 50 women and 50 men in each of the 5 decades. Specificity for the 57 individual criteria ranged from 89 to 100%. Fifty-one criteria met the required standard of at least 95% specificity; of the 6 that failed, 3 were successfully modified to achieve this standard and 3 were eliminated. In the resultant 54-criteria/32-point complete system, the total population, as well as both women and men, required more than 3 points to attain at least 95% specificity. Subjects in each of the 5 decades met the specificity standard either at or below the level of more than 3 points. The point score at which 95% or greater specificity was attained for the 10 age/sex subsets varied.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗