Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Handicapped”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 523 records · Page 29Linked to original sources
PubMed1981

Genetic counselling for handicapped school leavers.

A total of 287 school leavers with 299 unassociated handicaps from seven special schools for physically handicapped, visually handicapped, and deaf children were given genetic counselling from 1973 to 1979. The practical aspects of running this project are described. The risks needed were those of having an affected child: 54 (18.8%) were given a high risk (greater than 1 in 10), 89 (31.0%) were given a moderate risk (1 in 10 to 1 in 40), 69 (24.0%) were given a low risk (less than 1 in 40), and 83 (28.5%) were told that risk was the same as that of general population. Of the 299 total handicaps, 25 (8.4%) were thought to be autosomal dominant conditions, 38 (12.7%) to be autosomal recessive conditions, and 8 (2.7%) to be X linked conditions. Empirical risks were given for 145 (48.5%) diagnoses, and general population risks for the remaining 83 (27.7%).

Adolescent↗
PubMed1995

Impairment, disability, or handicap in peripheral neuropathy: analysis of the use of outcome measures in clinical trials in patients with peripheral neuropathies.

Outcome measures can be classified into measures of impairment, disability, and handicap. To investigate the biological effect of treatment, measures of impairment are appropriate. Studies investigating whether patients benefit from treatment in terms of improvement of functional health, however, require disability or handicap measures. In a review of the medical literature between 1978 and 1993, 73 controlled intervention studies in patients with peripheral neuropathies were found. Disability or handicap measures were used in two of 54 studies in patients with diabetic neuropathy, in two of six studies in patients with chronic inflammatory demyelinating polyneuropathy, in none of five studies in a mixed group of patients, and in all eight studies in patients with Guillain-Barré syndrome. The limited use of disability and handicap measures in patients with diabetic and mixed neuropathies can be explained by the experimental nature of most studies. In four of six studies, however, in patients with chronic inflammatory demyelinating polyneuropathy or neuropathy associated with monoclonal gammopathy that were designed to assess effectiveness of treatment, the choice of outcome measures was not appropriate. It is concluded that in the design of intervention studies in patients with peripheral neuropathy more attention should be paid to a proper choice of suitable outcome measures to assess the effectiveness of treatment.

Activities of Daily Living↗
PubMedDate not supplied

Muscular tension and body posture in relation to voice handicap and voice quality in teachers with persistent voice complaints.

The aim of this study was to investigate the relationship between extrinsic laryngeal muscular hypertonicity and deviant body posture on the one hand and voice handicap and voice quality on the other hand in teachers with persistent voice complaints and a history of voice-related absenteeism. The study group consisted of 25 female teachers. A voice therapist assessed extrinsic laryngeal muscular tension and a physical therapist assessed body posture. The assessed parameters were clustered in categories. The parameters in the different categories represent the same function. Further a tension/posture index was created, which is the summation of the different parameters. The different parameters and the index were related to the Voice Handicap Index (VHI) and the Dysphonia Severity Index (DSI). The scores of the VHI and the individual parameters differ significantly except for the posterior weight bearing and tension of the sternocleidomastoid muscle. There was also a significant difference between the individual parameters and the DSI, except for tension of the cricothyroid muscle and posterior weight bearing. The score of the tension/posture index correlates significantly with both the VHI and the DSI. In a linear regression analysis, the combination of hypertonicity of the sternocleidomastoid, the geniohyoid muscles and posterior weight bearing is the most important predictor for a high voice handicap. The combination of hypertonicity of the geniohyoid muscle, posterior weight bearing, high position of the hyoid bone, hypertonicity of the cricothyroid muscle and anteroposition of the head is the most important predictor for a low DSI score. The results of this study show the higher the score of the index, the higher the score of the voice handicap and the worse the voice quality is. Moreover, the results are indicative for the importance of assessment of muscular tension and body posture in the diagnosis of voice disorders.

Adult↗
PubMed2006

Utility of the Type D Scale 16 and Voice Handicap Index to assist voice care in student teachers and teachers.

An epidemiological cross-sectional survey study was performed among female student teachers and teachers for primary education, using a general questionnaire, the Type D Scale 16 (DS16) and Voice Handicap Index (VHI). Type D personality is the combination of high 'negative affectivity' and high 'social inhibition', and the DS16 has been considered to be a reliable and valid measure of these two stable personality traits. The objectives of the study were to assess the VHI of type D subjects in comparison to non-type-D subjects, to explore the utility of the DS16 and the VHI to assess whether subjects with a type D personality were more handicapped due to their voice complaints, and whether they behaved differently in seeking voice care. It was investigated whether subjects of the type D group in comparison to the non-type-D group had a voice handicap even when they did not report voice complaints. The type D group did not report more voice complaints than the non-type-D group. However, the type D group had higher VHI scores compared to the non-type-D group. Furthermore, significantly more type D subjects had a VHI score greater than the 75th percentile than the non-type-D subjects, and they sought less voice care than the non-type-D subjects. Also among subjects who reported voice complaints, the type D group sought less care than the non-type-D group. Even among the subjects who did not report voice complaints, significantly more type D than non-type-D subjects had VHI scores higher than the 75th percentile. The findings indicated that type D subjects were apparently more bothered by their voice than the non-type-D subjects (high VHI scores); however, they did not report more voice complaints, and they also sought less voice care. The DS16 used along with the VHI was useful to identify subjects of the type D trait with a voice handicap. This enables specific voice care, encompassing not only physical, but also psychosocial aspects of vocal health.

Adult↗
PubMed1995

Reliability of the assessment of impairments, disabilities and handicaps in survey research on speech therapy.

An important aspect to the practice of speech therapy is the diagnostic assessment. This assessment is complementary to the medical diagnosis. The International Classification of Impairments, Disabilities and Handicaps (ICIDH) is regarded as a good starting point for the classification of speech therapy assessments. Based on the ICIDH, a form was developed for the registration of impairments, disabilities and handicaps in survey research on speech therapy. The aim of this study was to evaluate the reliability of the assessment of impairments, disabilities and handicaps based on clinical observations and examinations by speech therapists. On the basis of the percentage of agreement and kappa values it is concluded that the reliability of the assessment of the impairments, disabilities and handicaps was satisfactory to excellent for most of the categories.

Adolescent↗
PubMed1988

Interobserver agreement for the assessment of handicap in stroke patients.

Interobserver agreement for the assessment of handicap in stroke patients was investigated in a group of 10 senior neurologists and 24 residents from two centers. One hundred patients were separately interviewed by two physicians in different combinations. The degree of handicap was recorded by each observer on the modified Rankin scale, which has six grades (0-5). The agreement rates were corrected for chance (kappa statistics). Both physicians agreed on the degree of handicap in 65 patients; they differed by one grade in 32 patients and by two grades in 3 patients. Kappa for all pairwise observations was 0.56; the value for weighted kappa (with quadratic disagreement weights) was 0.91. Our results confirm the value of the modified Rankin scale in the assessment of handicap in stroke patients; nevertheless, further improvements are possible.

Activities of Daily Living↗
PubMed1989

Honig v. Doe: the suspension and expulsion of handicapped students.

Public Law 94-142 provides for a free appropriate public education for all handicapped children, but does not address the issue of disciplining handicapped students. The result has been confusion and uncertainty, particularly concerning expulsion and suspension. The courts have been forced into this vacuum, acting as arbiters. The Supreme Court's ruling in Honig v. Doe will help to delineate the proper role of educators in the suspension and expulsion of handicapped students. This article examines that role and offers recommendations for school policies regarding the discipline of handicapped students.

Dangerous Behavior↗
PubMed1986

Do learning handicaps and headache cluster?

Children who are brought to medical attention because of frequently recurring or disabling headaches appear to have an increased prevalence of learning handicaps. Some of this increase might reflect Berkson's principle--the selection bias of an overrepresentation of patients with two disorders. Consideration is given to five models that show a relationship between learning handicap and headache. Two of the models are dismissed as too simple. Studies are needed to determine whether learning handicap and headache are indeed associated, and, if so, how. Clinicians are advised not to wait until these studies have been completed before implementing therapeutic programs that might prove helpful to those children with both headache and learning handicap.

Child↗
PubMed2002

The willingness of general dental practitioners to treat people with handicapping conditions: the Hong Kong experience.

A study was carried out to assess the willingness of general dental practitioners in Hong Kong to treat patients with handicaps. A questionnaire and practitioner scale were developed and circulated to 400 general dental practitioners of which 250 responded giving a response rate of 62.5%. The majority of practitioners (59.6%) saw between one and five patients with handicaps per year, 15.6% saw none at all. The mean score was 33.68 (SD = 9.19) on a scale with a range from 0 to 60. The observed mean score, which was just over the halfway mark, indicated a slightly positive feeling for treating people with handicaps. Cronbach's alpha for the scale was 0.67 for the raw variables. Cronbach's alpha was sufficiently high to indicate a reliable scale for the population under investigation. It was found that although general dental practitioners were relatively enthusiastic about treating people with handicaps they felt it was not economically viable to do so. There was also a strong feeling that government should play a more prominent role in provision of dental care for this group.

Attitude of Health Personnel↗
PubMed2005

Quality of life, functional outcome, and voice handicap index in partial laryngectomy patients for early glottic cancer.

BACKGROUND: In this study, we aim to gather information about the quality of life issues, functional outcomes and voice problems facing early glottic cancer patients treated with the surgical techniques such as laryngofissure cordectomy, fronto-lateral laryngectomy, or cricohyoidopexi. In particular, consistency of life and voice quality issues with the laryngeal tissue excised during surgery is examined. In addition, the effects of arytenoidectomy to the life and voice quality are also studied. METHODS: 29 male patients were enrolled voluntarily in the study. The average age was 53.9 years. Three out of 10 patients with laryngofissure cordectomy also had arytenoidectomy. 11 patients had fronto-lateral laryngectomy with Tucker reconstruction, two of which also had arytenoidectomy. There were eight patients with cricohyoidopexi and bilateral functional neck dissection. Three of these patients also had arytenoidectomy. In bilateral functional neck dissection cases, spinal accessory nerve was preserved and level V of the neck was not dissected. None of the patients had neither radiotherapy nor voice therapy. Cordectomy patients never had a temporary tracheotomy or were connected to a feeding tube. Data was collected for 13 months for the cordectomy group, 14 months for fronto-lateral laryngectomy and cricohyoidopexi groups on average post-operatively. Statistical analysis in this study was carried out using the one-way analysis of variance, and the Post-Hoc group comparisons were made after Bonferroni and Scheffe-procedures.In order to determine the effects of arytenoidectomy, a regression analysis is carried out to see if there are statistical differences in answers given to the survey questions among patients who were arytenoidectomized during their surgeries. RESULTS: There was a statistically significant difference between cordectomy and cricohyoidopexi group in answers to the University of Washington- Quality of Life- Revised survey part 1. (p = 0). A statistically significant difference was also established between cordectomy and fronto-lateral laryngectomy groups, as well as between cordectomy and cricohyoidopexi groups in answers to the University of Washington- Quality of Life- Revised survey part 2. (p = 0,036 and p = 0.009, respectively). Cricohyoidopexi group has given the lowest scores and the cordectomy group has given the highest scores in three survey questions representing the quality of life, performances and new voices. These ranges are also consistent with the laryngeal tissue excised during surgery (cricohyoidopexi > fronto-lateral laryngectomy > cordectomy). There was no statistically significant difference between groups in Performance Status Scale for Head and Neck cancer patients instrument. The difference between the Voice Handicap Index and Voice Handicap Index (functional); Voice Handicap Index (physical) and Voice Handicap Index (emotional) scores in three patient groups was not significant either. All of the patients evaluated that their new voices have similar functional, physical and emotional impact on their life. Decanulation and oral feeding times of cricohyoidopexi and fronto-lateral laryngectomy patients are found to be significantly longer than cordectomy patients. Lastly, the removal of arytenoid does not have any significant adverse effects on the quality of life, the functional outcomes, or the quality of voice. CONCLUSION: In the present study, all patients with early glottic cancer, treated with different surgical technics reported fairly good quality of life outcomes, functional results and voice qualities. This study also finds that the removal of arytenoid does not have any adverse effects on the quality of life and voice from the patients' point of view.

Journal Article↗
PubMed2003

Falls in community-dwelling older persons followinig hip fracture: impact on self-efficacy, balance and handicap.

OBJECTIVE: To compare the four-month outcomes of fallers and nonfallers as well as those with slow gait speed in patients with hip fracture successfully discharged back to the community. DESIGN: Prospective study with four-month follow-up data. SETTING: Community sample of survivors of hip fracture who have completed their rehabilitation programme. SUBJECTS: A consecutive sample of 73 community-dwelling, cognitively intact older adults admitted to hospital following a fall-related hip fracture and available to complete a follow-up assessment at four months. MAIN OUTCOME MEASURES: At baseline, data collection consisted of the Modified Barthel Index (MBI), Mini Mental State Examination (MMSE), sociodemographics and medical history. At four months follow-up, data collection consisted of the MBI, London Handicap Scale (LHS), Berg Balance Scale (BBS), a 10-metre timed walk test, Falls Efficacy Scale (FES) and the Activities Balance Confidence (ABC) scale. Participants were also asked to recall if they had fallen in the four months since their fracture. RESULTS: Seventy-three participants had complete data for evaluation. There was minimal disability with a mean MBI of 91.2 but there was some residual handicap with a mean LHS of 0.67. Those who had fallen had lower self-efficacy (FES) and greater handicap (LHS). Those with slower gait speed were more handicapped (LHS), had lower self-efficacy (FES and ABC) and lower balance scores (BBS). CONCLUSIONS: Measuring ADL disability alone loses valuable information in community-dwelling survivors of hip fracture. Falls after hip fracture should be a target for treatment and our data give some weight to the idea of a fall fracture cycle. Gait speed, which may reflect lower limb strength, is also a target for therapeutic interventions. These measures should be included in clinical practice.

Accidental Falls↗
PubMed2005

Spiroergometric and spirometric parameters in patients with multiple sclerosis: are there any links between these parameters and fatigue, depression, neurological impairment, disability, handicap and quality of life in multiple sclerosis?

One-hundred and twelve patients with multiple sclerosis were selected as population-based sample and examined on impairment (Expanded Disability Status Scale), disability (Barthel Index), handicap (Environment Status Scale), the quality of life (Multiple Sclerosis Quality of Life), fatigue (Modified Fatigue Impact Scale), depression (Beck Depression Inventory Score), respiratory function (spirometric parameters on spirometry) and physical fitness (spiroergometric parameters on a bicycle ergometer). The aim of the study was to examine and analyse (descriptive statistics) spiroergometric and spirometric parameters in patients with multiple sclerosis. Firstly, we tested the hypothesis whether spiroergometric and spirometric parameters are decreased and whether there are any correlations between these parameters and measures of impairment, depression, disability, handicap and quality of life. Secondly, we tested the hypothesis whether there is any correlation between a possible deconditioning and fatigue, and between a possible respiratory dysfunction and fatigue in multiple sclerosis. It results from this study that many spiroergometric parameters in patients with multiple sclerosis are significantly lowered in comparison to the population norm. A link can be found between some spiroergometric parameters and neurological impairment, disability, handicap and quality of life. It is not possible to prove any correlation between spiroergometric parameters and depression. From the spirometric parameters, these are expiratory flows that are significantly lowered in MS patients. It is not possible to prove any correlation between spirometric parameters and fatigue, depression, neurological impairment, duration of the disease, disability, handicap and quality of life in multiple sclerosis.

Adult↗
PubMed1976

New long-stay patients in a hospital for mental handicap.

Better Services for the Mentally Handicapped (1971) forecasts a diminution in the number of beds in hospitals for mental handicap. It can be achieved only by the admission of fewer new long-stay patients. This paper considers 50 new long-stay cases admitted to a hospital for mentally handicapped in the five years 1970 to 1974. Of these admissions 42% were children, and of all the admissions 54% had Wechsler intelligence quotients under 25. Further, 62% of the admissions were for behaviour problems and 38% were for physical infirmity and helplessness. It is concluded that there are some mentally handicapped people who have problems with which only a hospital can cope. The high nursing dependency and the profound mental retardation of a majority of the new long-stay patients present a formidable challenge.

Adolescent↗
PubMed1984

Changing sociological and clinical patterns in mental handicap. The 1983 Blake Marsh lecture.

The historical development of official provision for the care and training of the mentally handicapped--both adults and children--is outlined, to show the changes between Local Authority and Government. Changes in emphasis between compulsory and voluntary admissions to institutions are discussed with particular reference to changes in the law and the administration of the services. Demographic changes due to longer survival, falling birth rate, and prevention, diagnosis and treatment of individual causes of mental handicap are discussed. Particular reference is made to Down's syndrome and to the fragile X syndrome. The need for psychiatrists in mental handicap is mentioned along with the benefit of early intervention. The numbers of the mentally handicapped needing specialist care and training are not diminishing, but the manner of provision is changing, and partly reverting to ways tried long ago.

Adolescent↗
PubMed1988

Pica as a cause of death in three mentally handicapped men.

In Prudhoe Hospital, a large mental-handicap hospital of 1000 residents, it was found that of the 94 deaths that occurred between 1982 and 1986, three were closely associated with the habit of pica. These deaths occurred in severely and profoundly handicapped males, whose average age was 32, compared with an average age of death of 58 for the combined groups of severely and profoundly mentally handicapped patients (22 cases), and an average age of death of 60 for all degrees of handicap (94 cases). It seems likely that the habit of pica constitutes a cause of considerable morbidity and mortality in certain institutionalised patients.

Adult↗
PubMed2001

Handicap after acute whiplash injury: a 1-year prospective study of risk factors.

BACKGROUND: Exposure to a whiplash injury implies a risk for development of chronic disability and handicap, with reported frequencies ranging from 0% to 50% in follow-up studies. The exact risk for development of chronic whiplash syndrome is not known. OBJECTIVE: To prospectively determine the sensitivity and specificity of five possible predictors for handicap following a whiplash injury. METHODS: In a 1-year prospective study of persons with acute whiplash injury (n = 141) and control subjects who had acute ankle distortion (n = 40), pain intensity, number of nonpainful neurologic complaints, cervical mobility, workload during extension and flexion of the neck, and results of psychometric assessment were recorded. The consecutively sampled injured persons were assessed with structured and semistructured questionnaires, and underwent neurologic examination after 1 week and 1, 3, 6, and 12 months. After 3 to 4 years, participants with whiplash injury were questioned about legal issues. RESULTS: After 1 year, 11 (7.8%) persons with whiplash injury had not returned to usual level of activity or work. The best single estimator of handicap was the cervical range-of-motion test, which had a sensitivity of 73% and a specificity of 91% (p < 0.01, Cox regression analysis). Accuracy and specificity increased to 94% and 99% when combined with pain intensity and other complaints. This increase was gained at the expense of a reduced sensitivity. Initiation of lawsuit within first month after injury did not influence recovery. CONCLUSION: The cervical range-of-motion test has a high sensitivity in prediction of handicap after acute whiplash injury. The value of cervical range-of-motion test is further improved by additional recording of symptoms and pain intensity.

Adult↗
PubMed2000

Convergent validity of the tinnitus handicap inventory and the tinnitus questionnaire.

For research into tinnitus to be robust and credible, the use of well-validated instruments of self-perceived tinnitus handicap as outcome measures is essential. The tinnitus handicap inventory (THI) and the tinnitus questionnaire (TQ) are two such instruments which are in widespread use. Both questionnaires were administered by mail to 100 consecutive new patients of the Cambridge Tinnitus Clinic, and completed in randomized order. These patients had been referred by the otolaryngology team and had not undergone any tinnitus therapy. The response rate was 78 per cent, neither questionnaire being more acceptable to patients than the other. The convergent validity of the instruments was high, with total and subscale scores all being significantly correlated at the five per cent level (Spearman correlation coefficients). A number of subscale scores were not significantly correlated at the one per cent level however. In particular, the sleep disturbance element of the TQ was demonstrated to have some discriminant validity from the THI and from other elements of the TQ at the one per cent significance level. The THI and TQ have been demonstrated to have high convergent validity and are both suitable for tinnitus outcome studies involving the quantification of self-perceived tinnitus handicap. For research that aims to determine the specific effect of an intervention on tinnitus-related sleep disturbance, the TQ sleep subscale has potential utility. The hypothetical constructs of tinnitus handicap underlying the psychologist-developed TQ and the audiologist-developed THI have been shown to be convergent.

Adolescent↗
PubMed1986

[Health problems among workers engaged in the education of handicapped children. Status of daily care and trends in physical complaints].

Workers engaged in compulsory education and training of severely handicapped children have a high prevalence of neck pain, shoulder pain, low back pain and general fatigue. These complaints are mainly due to heavy physical burden placed on these workers in caring for a large number of handicapped children who are unable to satisfy by themselves daily needs such as excretion, putting on and off their clothes, and eating. To prevent these physical disturbances, it was found effective to reduce the number of assigned handicapped children, to introduce physical exercise especially designed for low back pain prevention, and to provide individual guidance to workers through health examination. Though these measures are expensive, they are considered necessary in preventing disturbances and in executing the government's program of providing compulsory education and training to all handicapped children in the country.

Adult↗