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Biomedical subjects

T E Rudy

Publications and source records attributed to T E Rudy.

34 records · Page 2Linked to original sources
PubMed1995

A dual-diagnostic approach assesses TMD patients.

The understanding and treatment of patients with temporomandibular disorders, or TMDs, have been impeded by the lack of a consensually agreed-on classification system on which to make a differential diagnosis. A number of classification systems for these patients have been proposed. Some are based primarily on whether symptoms are myogenic or arthralgic--somatically based; some investigators have suggested that patients be differentiated on the basis of psychological characteristics. It has been suggested recently that patients be classified along two dimensions--physical and psychological. This article summarizes research describing the development of a psychosocial classification of TMD patients that can be used with the physical axis of the recently proposed research diagnostic criteria for classification of TMD patients. It also presents preliminary evidence supporting the clinical utility of the psychosocial classification.

Dental Research↗
PubMed1993

Effects of intraoral appliance and biofeedback/stress management alone and in combination in treating pain and depression in patients with temporomandibular disorders.

To assess the differential efficacy of two commonly used treatments for temporomandibular disorders (TMD), intraoral appliances (IAs) and biofeedback (BF), separately and in combination, two studies were conducted. The first study directly compared IA treatment, a combination of biofeedback and stress management (BF/SM), and a waiting list control group in a sample of 80 TMD patients. Both treatments were determined to be equally credible to patients, ruling out this potential threat to the validity of the results obtained. The results demonstrated that the IA treatment was more effective than the BF/SM treatment in reducing pain after treatment, but at a 6-month follow-up the IA group significantly relapsed, especially in depression, whereas the BF/SM maintained improvements on both pain and depression and continued to improve. The second study examined the combination of IA and BF/SM in a sample of 30 TMD patients. The results of this study demonstrated that the combined treatment approach was more effective than either of the single treatments alone, particularly in pain reduction, at the 6-month follow-up. These results support the importance of using both dental and psychologic treatments to successfully treat TMD patients if treatment gains are to be maintained.

Adolescent↗
PubMed1990

Chronic pain in old and young patients: differences appear less important than similarities.

Two studies compared physical and psychosocial characteristics of elderly and younger chronic pain patients. No age differences were found during intake for the number of physical coping strategies. Elderly patients named fewer cognitive strategies. No age differences were detected in the percentage of patients offered treatment, who agreed to enter treatment, or who completed treatment. Although older patients more frequently had abnormal physical findings, there were no significant differences on measures of self-reported activity, pain severity, life interference, emotional or worry reactions in response to pain. Both age groups had comparable scores on measures of social support and perceptions of how others react to their pain. The present research suggests that there are relatively few factors distinguishing pain patients based on age. Moreover, age should not be a significant factor to consider when offering patients multidisciplinary treatment for chronic pain that focuses on psychological as well as physical modalities.

Activities of Daily Living↗
PubMed1987

Decreasing post-succinylcholine myalgia in outpatients.

The effectiveness of four pretreatment regimens in decreasing succinylcholine-induced myalgias was studied in healthy outpatients undergoing general anaesthesia for ambulatory surgery. Four hundred and forty adult females were randomly assigned to one of four pretreatment groups. Three hundred and ninety-five patients completed the study. One of the following pretreatments was given prior to injection of 1.5 mg X kg-1 of succinylcholine: normal saline IV three minutes and again immediately prior to succinylcholine; 0.06 mg X kg-1 d-tubo-curarine (dTc) IV three minutes prior and normal saline IV immediately prior; normal saline IV three minutes prior and 1.5 mg X kg-1 lidocaine IV immediately prior; 0.06 mg X kg-1 dTc IV three minutes prior and 1.5 mg X kg-1 lidocaine IV immediately prior. Fasciculations after injection of succinylcholine were observed and recorded. Patients were contacted by telephone 40-48 hours postoperatively and questioned about the presence of muscle pains. These pains, if present, were graded either mild or moderate to severe. The patients in the two dTc-containing groups exhibited less fasciculations than patients in the other two experimental groups. The dTc-lidocaine group had a lower incidence of moderate to severe fasciculations than in any of the other three groups. Patients in the dTc, lidocaine, and dTc-lidocaine experimental groups reported a higher incidence of absence of muscle pain and a lower incidence of moderate-severe pain than did patients in the saline group. The dTc-lidocaine group had more patients without myalgia and less patients with moderate to severe myalgias than any of the other groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Implicit models of illness.

This study was designed to be an initial investigation of implicit models of illness, that is, the dimensional structure that organizes an individual's common-sense illness schema. Nurses, college students, and diabetics rated the qualities of two different diseases, one that was personally salient (i.e., flu or diabetes) and one with which they were familiar but did not have direct experience (i.e., cancer), on a 38-item Implicit Models of Illness Questionnaire (IMIQ). An exploratory factor analysis revealed a four-dimensional structure of illnesses composed of Seriousness, Personal Responsibility, Controllability, and Changeability. The stability of this four-dimensional model was established using confirmatory factor analysis to test the fit of this structure to the IMIQ data of another sample of subjects drawn from the same populations. The structure of this implicit model proved stable for judgments of different diseases and across groups of subjects, even though they differed in their physical-health status and occupational roles. The dimensions identified in the present study were compared to those described in other papers. Our dimensions seemed to be both personally and psychologically meaningful. The implications of this preliminary "generic" implicit illness model for future work in the field of health cognition are discussed.

Adolescent↗
PubMed1985

Chronic pain: a multiple-setting comparison of patient characteristics.

Chronic pain patients attending four different pain management programs (N = 160) were compared on multiple variables encompassing demographics, the nature of the pain problem, and treatment history. Programs were selected because they differed on several dimensions (e.g., geographic location, general hospitals vs those serving veterans of Armed Services, university affiliated vs nonaffiliated) believed potentially to interact with treatment outcome. Results indicated differences between hospital programs serving veterans and general hospital programs (serving nonveterans) in terms of patients' age, percentage married, disability compensation, duration of pain symptoms, and treatment history. In addition, findings indicated that covariance among pain variables was dissimilar across the four types of pain programs, making it difficult to generalize from one type of setting to another regarding issues such as choice of optimal treatment.

Adult↗
PubMed1984

Health protection: attitudes and behaviors of LPNs, teachers, and college students.

Three groups of subjects, college students, high school teachers, and licensed practical nurses (LPNs), were asked to rate 30 health-protective activities in terms of (a) importance (attitude) and (b) the frequency with which they performed them (behavior). Correlational analyses revealed reasonably high consistency between attitudes and behaviors in all three groups. Multidimensional scaling procedures identified two basic dimensions of Health-Protective Behaviors (HPBs) accounting for 57% of the variance. The two dimensions were (a) degree of effectiveness and (b) amount of effort. Although students emphasized effectiveness in rating HPBs and teachers used both dimensions equally, the LPNs tended to consider only amount of effort. Additional analyses indicated that group differences were not related to age or gender but rather to health orientation. In sum, individuals' attitudes and behaviors related to health protection are stable, simply organized, and relatively consistent, but samples of health care providers (LPNs) and lay people (students and teachers) differentially weight the importance of effort and effectiveness when considering HPBs. The implications of these results for patient-provider communication, treatment adherence, as well as an understanding of health behavior are discussed.

Adolescent↗
PubMedDate not supplied

Effects of body mechanics training on performance of repetitive lifting.

OBJECTIVE: To measure the efficacy of body mechanics instruction (BMI) in patients with low back pain. METHOD: The effect of BMI was measured in four participants with back injuries using a standardized lifting protocol. Static strength, weight lifted, number of lifts completed, and motion analysis data to describe the body mechanics were measured before and after work hardening to evaluate treatment effects. The participants' performances were compared with 52 controls from an earlier study. RESULTS: Starting postures, characterized by degrees of hip and knee flexion, varied by participant but favored a squat lift in three participants when compared with the controls. Dynamic motion synchrony of the hip and knee joints was similar to controls in three of the four participants. Posttest data revealed significant changes in static strength, dynamic endurance, and lifting speed. CONCLUSION: Intensive instruction in body mechanics provided during the work-hardening treatment produced major changes in lifting styles, in terms of both starting postures and dynamic aspects of repetitive lifting. The computerized measurement procedures used in this study permitted more careful and detailed analyses of body mechanics, particularly dynamic aspects, than is possible with observational methods. This study demonstrated some of the inherent intricacies in isodynamic lifting and suggests additional areas of performance that may be important to address in BMI.

Adult↗
PubMedDate not supplied

Psychophysiological assessment in chronic orofacial pain.

Psychophysiological models of chronic pain conditions have emerged in recent years due, in part, to the inadequacy of structural models to explain the etiology, maintenance, exacerbation, and/or remediation of these conditions. Psychophysiological theories of temporomandibular disorders (TMD) and related research evidence are reviewed. It is concluded that a number of methodological problems in previous psychophysiological studies of TMD preclude reaching firm conclusions that psychological stress causes masticatory hypermuscle arousal in TMD patients. Recommendations and guidelines for future psychophysiological research in TMD are presented.

Chronic Disease↗