Biomedical subjects

Stephen J Page

Publications and source records attributed to Stephen J Page.

23 records · Page 2Linked to original sources

PubMed2002

Modified constraint-induced therapy in subacute stroke: a case report.

OBJECTIVE: To determine the efficacy of a modified constraint-induced therapy (CIT) protocol administered to a patient with subacute stroke. DESIGN: Multiple-baseline, before-after trial. SETTING: Subacute outpatient clinic. PATIENT: A 68-year-old woman who had a left anterior cerebral artery infarct 5 months before study entry and who exhibited learned nonuse of the affected upper limb. INTERVENTION: Thirty minutes of structured physical therapy and 30 minutes of occupational therapy 3 times a week for 10 weeks, each session emphasizing affected arm use. During the same period, her unaffected arm and hand were restrained 5d/wk during 5 hours initially identified as a time of frequent use. MAIN OUTCOME MEASURES: The Fugl-Meyer Assessment of Motor Recovery (FMA), Action Research Arm Test (ARA), Wolf Motor Function Test (WMFT), and Motor Activity Log (MAL). RESULTS: The patient exhibited substantial improvements on the FMA and ARA. She also improved on the WMFT in her ability to perform tasks and in the time taken to complete the tasks. Amount and quality of arm use also improved, as measured by the MAL. CONCLUSIONS: Modified CIT may be an efficacious method of improving function and use of the affected arms of patients with learned nonuse.

Activities of Daily Living↗

PubMed2002

Scaling of the revised Oswestry low back pain questionnaire.

OBJECTIVE: To evaluate the measurement properties of the Revised Oswestry Disability Questionnaire (RODQ) by using rating scale analyses. DESIGN: Calibration of item responses by using a data set. SETTING: Four outpatient therapy clinics in the northeastern United States. PATIENTS: Convenience sample of 95 community-dwelling adults exhibiting mild to severe low back pain-related disability (LBP-D). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: The RODQ. RESULTS: Several Rasch analyses were performed, with 1 item deleted and 2 response categories collapsed, creating a better test without increased error. A schema for item administration and evaluation was also developed. CONCLUSIONS: By using the abbreviated scale, suggested item order, and predicted responses, abbreviated versions of the instrument can be applied to measure LBP-D more efficiently.

Activities of Daily Living↗

PubMed2002

Modified constraint-induced therapy in chronic stroke.

Although efficacious, constraint-induced therapy may be difficult to implement in some outpatient settings. This case study examined the effectiveness of modified constraint-induced therapy administered to a patient with chronic stroke, learned nonuse, and a stable motor deficit in his dominant upper limb. The Fugl-Meyer Assessment of Motor Recovery and Action Research Arm Test were administered twice before intervention, and the Motor Activity Log and actigraphy were administered once. The patient then participated in half-hour, structured physical and occupational therapy sessions, emphasizing affected arm use, three times per week for 10 wk. It was concluded that modified constraint-induced therapy may be an effective method of improving affected arm function and use in chronic stroke patients exhibiting learned nonuse.

Aged↗

PubMed2002

Modified constraint-induced therapy after subacute stroke: a preliminary study.

OBJECTIVE: To determine the efficacy of a modified constraint-induced therapy (mCIT) administered to patients with subacute stroke. DESIGN: Prospective, multiple-baseline, before-after, randomized clinical trial. SETTING: Subacute outpatient clinic. SUBJECTS: Fourteen patients with subacute stroke who exhibited learned nonuse and stable motor deficits in their affected upper limbs. INTERVENTION: Four patients participated in half-hour, structured physical and occupational therapy sessions that emphasized affected arm use in valued functional activities, 3 times per week for 10 weeks. Their less affected upper limbs were restrained 5 days per week during 5 hours identified as times of frequent use (mCIT). Five patients received regular therapy (TR) with similar therapeutic contact time to mCIT and 5 patients received no therapy (CON). MAIN OUTCOME MEASURES: The Fugl-Meyer Assessment of Motor Recovery (Fugl), Action Research Arm (ARA) test, and Motor Activity Log (MAL). RESULTS: After intervention, Fugl, ARA, and MAL scores remained virtually the same for TR and CON groups; scores improved by 11.4 and 11.5points, respectively, on the Fugl and ARA for the mCIT group. Amount and quality of arm use, as measured by the MAL, also improvedfor mCIT patients (2.49 and 0.47, respectively). CONCLUSIONS: mCIT may be an efficacious method of improving affected arm function and use in stroke patients exhibiting learned nonuse.

Aged↗

PubMed2002

Stroke patients' and therapists' opinions of constraint-induced movement therapy.

OBJECTIVE: To determine the opinions of patients with stroke and therapists about constraint-induced movement therapy (CIT). SUBJECTS AND INTERVENTION: Two hundred and eight patients with stroke in the northeastern USA responded to a self-report questionnaire administered through the mail and via telephone interviews. A similar questionnaire was administered to 85 physical and occupational therapists in the northeastern USA during their clinical staff meetings. The questionnaire described CIT to participants using excerpts from a recently published CIT study. Subjects then responded to various statements concerning their opinions of the protocol and supplied rationale for their opinions. RESULTS: Sixty-eight per cent of patients said they were not interested in participating in CIT, citing concerns with the practice schedule and the restrictive device schedule. Therapists cited concerns about patient adherence and safety, and speculated that facilities may not have the clinical resources to provide CIT. CONCLUSIONS: Patients with stroke and therapists in some environments may hold sceptical views about the utility of CIT. Although it has been shown to be effective in laboratory research, CIT may have low clinical practicality in some environments.

Adolescent↗