Biomedical subjects
V Wright
Publications and source records attributed to V Wright.
Gross motor performance measure for children with cerebral palsy: study design and preliminary findings.
This project investigated the validity, reliability and responsiveness of the Gross Motor Performance Measure (GMPM). The GMPM was developed as an observational instrument to measure changes in quality of movement in children with cerebral palsy. Physical therapists from 3 children's treatment centres assessed 107 children with CP, 18 children with head injury and 33 non-disabled children. Assessments were conducted on 2 occasions, 4 to 6 months apart. The measurement protocol included assessment with the GMPM and the Gross Motor Function Measure (GMFM). Validity was tested by comparing changes in GMPM scores to parent and therapist independent ratings of the children's motor performance. Also, a sample (n = 30) of paired assessments was videotaped for 'masked' evaluation by therapists. Inter-rater, intra-rater and test-retest reliability studies (n = 30) were conducted. Responsiveness to change was determined through parent and therapist ratings of the importance of observed changes in quality of movement. Data collection for this study has just been completed. Validation hypotheses have been postulated regarding correlations between changes in GMPM scores; GMFM scores; age of children; diagnosis; severity of condition; parent, therapist and 'masked' evaluator judgement of change. Correlation analysis, t-test and analysis of variance results will be presented. Reliability data for the GMPM and parent/therapist rating scales will be presented using intra-class correlation coefficients. Data supporting responsiveness of the GMPM will be presented using an analysis of variance model for 'stable' and 'responsive' groups.
On the postulated co-existence of rheumatoid arthritis and psoriatic arthritis.
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The best way to lecture in rheumatology. Different methods of teaching nurses were tested.
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A comparison of sleep in rheumatic and non-rheumatic patients.
The St. Mary's Hospital Sleep Questionnaire was used to investigate sleep in 439 hospitalized rheumatic and non-rheumatic patients. This questionnaire enabled an evaluation of both the level of sleep disturbance and the causes of such disturbance. The findings from this study indicated that there was little difference in the level of sleep disturbance between rheumatic and non-rheumatic patients. The sleep problem most frequently cited by rheumatic patients was pain. Noise appeared to be the worst environmental sleep problem in these patients. The only significant difference in the sleep problems reported by rheumatic and non-rheumatic patients, was that pain was cited more frequently in the rheumatic group. In order to determine whether sleep varied according to type of rheumatic disease, the rheumatic patients were divided into four diagnostic groups (rheumatoid arthritis; seronegative spondarthritis; osteoarthritis; other conditions). There were no significant differences between these groups in sleep disturbance or reported sleep problems.
Outcome measures and anti-rheumatoid drugs: a critical appraisal.
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Biomechanics background in the design of a total replacement knee prosthesis.
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A biochemical assessment of sulphasalazine in rheumatoid arthritis.
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A clinical and biochemical evaluation of Clozic, a novel disease modifying drug in rheumatoid arthritis.
We have compared two dose levels of Clozic, a novel agent with potential anti-rheumatoid activity, to D-penicillamine and aspirin in an observer blind randomised parallel group study of 56 patients with active rheumatoid arthritis. Eight clinical assessments and 26 laboratory assessments were performed on each patient at each visit over a six month period. Results were analysed by conventional methods and also by correlation matrices constructed between clinical and laboratory variables. Patients treated with D-penicillamine (500 mg/day) responded adequately and the control group on aspirin (up to 3.6 g of enteric coated formulation/day) performed well, though the withdrawal rate from this latter group was high, predominantly because of continued disease activity. Patients receiving Clozic (100 mg/day or 300 mg/day) improved more than patients receiving penicillamine, particularly at the higher dose. Comparison of methods of analysis validates the use of correlation matrices both for detecting anti-rheumatoid activity and for determining the optimum dose of a novel compound. This trial illustrates the problems of a study of this nature, with the powerful effect on patients of being enrolled in such a closely monitored investigation. It emphasises the greater value of biochemical changes in following disease changes.
Serum histidine in rheumatoid arthritis: changes induced by antirheumatic drug therapy.
Serum free histidine levels were studied in 15 patients with rheumatoid arthritis treated with D-penicillamine and 15 patients treated with hydroxychloroquine for 6 months. Both drugs produced improvement in the majority of patients, measured in terms of changes in 5 clinical parameters and plasma viscosity. A significant increase in serum histidine was observed only with D-penicillamine. This action, not seen with other specific antirheumatoid drugs may reflect a specific action of the drug.
Clinical studies in the aetiology of osteoarthrosis.
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The effect of sleep and nocturnal movement on stiffness, pain, and psychomotor performance in ankylosing spondylitis.
OBJECTIVE: This study was carried out in order to assess whether AS patients are adversely affected by a "good" night's sleep accompanied by little nocturnal movement. METHODS: Objective and subjective nocturnal movement, flexibility, stiffness, pain and psychomotor performance were measured in 22 subjects, 11 with ankylosing spondylitis and 11 controls. RESULTS: A better sleep integrity with little nocturnal movement was related to a decrease in lumbar flexibility. Difficulty in awakening and feeling tired and clumsy in the morning correlated with stiffness. Pain was correlated with a subjective difficulty in getting to sleep and a worse quality of sleep, but was also correlated with less objective sleep disruption. In the control group a better sleep integrity was correlated with an overnight decrease in psychomotor performance. In the spondylitic group a significant increase in performance occurred. Stiffness and pain did not correlate with performance. CONCLUSION: Sleep in ankylosing spondylitis differs from sleep in normals.
Management of NSAIDs-related dyspepsia in the community.
Little is known about how non-steroidal anti-inflammatory drugs (NSAIDs)-related dyspepsia is managed in general practice. A survey was conducted to ascertain the preferred methods of investigation and management of NSAIDs-related dyspepsia by GPs in the Leeds district in the summer of 1992. A total of 261/300 (87%) replied to the questionnaire. Most (87%) GPs discontinued NSAIDs, and 12% changed the drug. Only 42 (16%) suggested endoscopy.