Exercise for special populations, sensory research, factors impacting rehabilitation top issues

This study demonstrates that individuals with a spinal cord injury (SCI) who exercise twice a week report having less pain, stress, and depression than individuals who do not exercise regularly. Study participants completed written questionnaires that assessed pain, stress, and depression at 0, 3, 6, and 9 months. The findings suggest that the beneficial effects of exercise on stress and depression are the result of two chain reactions. Exercise led to a change in pain that led to a change in stress and, in turn, a change in stress that led to a change in depression.

This study compares the physical function of sedentary and physically active older veterans to the physical function of their civilian peers. Forty-four participants in an outpatient exercise program for older veterans were evaluated for lower-body strength and cardiorespiratory endurance. Test results were then compared to published national norms. Sedentary veterans scored significantly lower than exercising veterans and the national averages. This study emphasizes the positive associations between regular exercise and maintenance of physical functioning to maintain independent living.

This study evaluates the effectiveness of a 6-month exercise program on functional performance, mental health, and depression in seniors who live in a nursing home. After the 6-month program, seniors who participated in the exercise program showed significant improvement in knee extension strength, were less depressed, and demonstrated more functional ability than seniors who did not exercise. At the end of the 6-month study, seniors who did not exercise showed significant decreases in functional ability, walking speed, and mental health. Data confirm the physical and psychological benefits of exercise for elderly persons who live in nursing homes.

This study assesses the prevalence and significance of visual and hearing impairments in patients hospitalized for rehabilitation following hip fracture. Eight hundred and ninety-six patients were studied prospectively. Visual impairment was found in 210 patients (23.4%) and hearing impairment was found in 231 patients (25.8%). Both visual and hearing impairments were seen in 72 patients (8%). Rehabilitation effectiveness was significantly lower in patients with visual impairment compared to those without, and in patients with hearing impairment compared to those without. Visual impairment was independently associated with efficacy of rehabilitation. Investigators suggest that during the first phase of rehabilitation an effort should be made to correct patients' vision impairments.

This study compares the gait (walking) of individuals with lower-limb amputations with healthy volunteers. Investigators examined the performance of a prototype knee compared with prosthetic knees currently used. The stance duration, knee flexion at the early stance and in the swing phase, and hip extension and flexion were measured to compare the different knees. Although prosthetic gait with the prototype showed no significant variation in individuals at different speeds, volunteers had increased stability and ease of swing with the prototype.

This research determines how much a residual limb changes volume and shape after prosthesis removal. A custom optical scanner was used to image the residual limbs of six volunteers with below knee amputations. Results showed that changes in volume over a 35-minute interval after prosthesis removal were greater than those experienced over a two-week interval. In four of the six volunteers, 95% of the volume increase was reached within eight minutes after prosthesis removal. Results from this study provide a base from which to investigate fluid movement responsible for the shape changes in residual limbs.

This study assesses the validity and reliability of the Q-TFA (Questionnaire for Persons with a Transfemoral Amputation), a new self-report outcome measure designed to reflect current prosthetic use, mobility, problems, and health in nonelderly persons with an above-the-knee amputation. The Q-TFA also measures outcome when changing from a conventional socket prosthesis to a direct bone-anchored prosthesis (osseointegration). Study results support adequate measurement properties of the Q-TFA on persons using an above-the-knee socket prosthesis.

This study reports the analysis of a new, simple, low-cost sling for the lower limb, compared to a common ankle-foot orthosis (AFO). Gait with no orthosis, with AFO, and the sling were evaluated using a movement analysis system, in a volunteer with hemiplegia (paralysis of one side of the body). The sling and traditional AFO provided similar support to the affected ankle. The sling was better at improving some gait variables than the AFO. Data from study may provide a background for future studies evaluating the clinical application of the sling in the early phases of rehabilitation of patients with hemiplegia.

This study defines a more biomechanically appropriate measure of balance than is currently available. Investigators demonstrate that the new balance index has a better relationship with sway angle for some populations than a more commonly used clinical balance measure. This is important because the larger the sway angle, the more likely a person could fall. The new Postural Stability Index (PSI) is described, and the relationship of PSI to average sway angle is discussed. The new measure provides a more sensitive index of balance for clinical use in rehabilitation clinics.

This study investigates the effects of ultrasound and laser therapies on wound healing in rats. Investigators found that ultrasound and laser therapies reduced inflammation and growth in wounds. Laser treatment was more effective than ultrasound in the inflammatory and proliferation phases. In addition to conventional therapies such as debridment and daily wound care, laser and ultrasound can effectively treat bedsores and chronic wounds. The finding is important because problems related to wound healing, such as infection, are a significant cause of morbidity and mortality for patients who have a spinal cord injury, are bed-ridden, or have chronic wounds.

This study identifies the current methods of evaluation and instruction used in VA blind rehabilitation centers and vision impairment center to optimize remaining sight (VICTORS) programs. A questionnaire was mailed to all VA blind rehabilitation centers and VICTORS programs. Although all programs report providing eccentric viewing training, use of alternative areas of healthy peripheral retina, time spent in instruction and the techniques used for both evaluation and training varied considerably. Investigators conclude that research studies are needed to determine which patients will benefit from eccentric viewing training and the specific procedures to use for best results.

This study explores how well automatic speech recognition (ASR) systems meet the needs of users with physical disabilities. The top reason for using ASR is to reduce fatigue and pain associated with manual input. A main concern with ASR is inconsistent recognition. The average satisfaction with ASR was greater than neutral, but not overwhelmingly positive. Results suggest that a typical user may enter about 16 wpm with ASR, but speeds as low as 3 wpm and as high as 32 wpm were observed. Users who manually type faster than 15 wpm may be less likely to enjoy a speed enhancement through the use of ASR.

About the Journal
JRRD has been a leading research journal in the field of rehabilitation medicine and technology for 40 years. JRRD, a peer-reviewed, scientifically indexed journal, publishes original research papers, review articles, as well as clinical and technical commentary from U.S. and international researchers on all rehabilitation research disciplines. JRRD's mission is to responsibly evaluate and disseminate scientific research findings impacting the rehabilitative healthcare community. For more information about JRRD, visit www.vard.org.