Neuroprothesis reduces secondary complications of spinal cord injury, pg 241
Study discusses recipients' perceptions of a surgically implanted neuroprosthesis on system performance, satisfaction, clinical complications, health benefits, and use patterns. Participants included those with low cervical or thoracic spinal cord injury (SCI) with more than 12 months of experience with an implanted standing neuroprosthesis. All implant recipients noted improvement in health, incidence of pressure sores, leg spasms, and urinary tract infections. Subjects were moderately to very satisfied with system performance and were unanimously willing to repeat the surgery and rehabilitation to obtain similar clinical outcomes. All implant recipients reported the system to be safe, reliable, and easy to use.
Equinometer holds promise to aid physicians care for equinus contracture patients, pg 235
Investigators describe the development of an equinometer, a device that allows the measurement of ankle motion under controlled conditions. Equinus contracture (EC), restricted movement of the ankle, is associated with several foot disorders. EC may impair foot function and is difficult to evaluate. Data suggest the equinometer provides accurate and reliable measurements of ankle motion. The equinometer may help physicians make appropriate clinical decisions in patients with equinus contracture.
EEG traces link between computer-brain rehabilitation therapies, pg 225
Article compared the brain areas represented by the "readiness potential," which may cause purposeful movement by "turning on" the spinal cord and the supplemental motor area. Sixteen patients with spinal cord injury (SCI) and ten subjects without SCI received 128-channel electroencephalograms (EEG). The EEG was recorded while the subjects were moving a finger (active movement) and when the same finger was passively moved. The EEG showed a change in the location of active brain areas in SCI patients compared to normal controls, both with active and passive movement. For patients with SCI, the ability to manipulate objects in their environment directly via a brain-computer interface could immediately improve the quality of their lives.
Telemedicine and the delivery of health services to veterans with multiple sclerosis, pg 265
The current state of telemedicine and its use in the Veterans Health Administration (VHA) are discussed in this review of literature. Telemedicine has the potential to reduce costs, increase access to healthcare, and improve the quality of care for people with disabilities. The application of telemedicine to the care of veterans with multiple sclerosis has support in the medical literature. VHA has a rich telemedicine network. While telemedicine is presently used, its capacity has only begun to be tapped. Veterans are increasingly receiving care via telemedicine technology in the VHA. As clinicians increase their knowledge of telemedicine, more veterans will have access to this emerging health care technology.
ER-4B Canal PhoneTM earphones and reliability of hearing thresholds, pg 253
The reliability of hearing thresholds in cochlear-impaired listeners using computer-automated tinnitus matching technique and Etymotic ER-4B Canal Phone TM insert earphones were tested. Repeated testing resulted in improved hearing thresholds for the normal-hearing group, but not for the cochlear-loss group. The normal-hearing group showed better response reliability, both within and between sessions, than the cochlear hearing-loss group. Reliable threshold responses can be obtained using automated testing technique, which has particular application for tinnitus testing and for ototoxicity monitoring. The ER-4B insert earphones offer an important advantage over other earphones, both insert and supra-aural, as they can be used to test both conventional and high frequencies.
Neck movement impacts ability to use computer head controls for people with disabilities, pg 199
Computer head controls provide an alternative means of computer access for people with disabilities. Study explored whether limited neck movement reduces performance with head controls and identified cursor movement features that could help assess computer access limitations. Neck movement limitations were associated with reduced performance in computer tasks with the use of head controls. If a person is unable to use head controls as an alternative access method, he or she may have to resort to slower, more inefficient methods, reducing his or her employment options. Models such as those derived in this work may allow head controls to adapt to a user's needs, accommodating difficulties resulting from neck range of motion limitations.
Smoking may increase risk for pressure ulcers, pg 283
Smoking, a known risk factor in the development of pressure ulcers, is investigated to determine its effect on blood flow in skin. The increase in blood flow following removal of a pressure load was measured in the skin above the tailbone in healthy female smokers and matched nonsmokers. The total response was significantly less in the smokers, mainly because of a failure to maintain the increased blood flow. Study demonstrated that differences in blood flow can be measured at skin sites at risk of pressure damage in an at risk group. These preliminary studies may allow the development of an objective measurement of risk and identify factors associated with pressure ulcer development.
Postoperative care for transtibial amputations based on local practice, skill, and intuition, pg 213
Paper presents a critical review of over 60 published studies to compare measures of safety, efficacy, and clinical outcomes. Analysis of 10 controlled studies supported only 4 of 14 claims cited in uncontrolled descriptive studies. The literature supports the hypothesis that rigid plaster cast dressings result in significantly accelerated rehabilitation times and significantly less edema compared to soft gauze dressings. Prefabricated pneumatic prostheses were found to have significantly fewer postsurgical complications and required fewer revisions compared to soft gauze dressings. No reports compared all types of dressings within one study. Postamputation management is an important determinant of recovery from amputation. Published evidence is primarily antidotal and insufficient to determine optimum clinical guidelines.
JRRD is a peer-reviewed, scientifically indexed publication covering all rehabilitation research disciplines: neurology, orthopedics, engineering, audiology, ophthalmology and optometry, outcomes, restorative, prosthetics, geriatrics, psychiatrics, and community reintegration. Formerly the Bulletin of Prosthetics Research, JRRD debuted in 1983 to include cross-disciplinary findings in rehabilitation. JRRD accepts original research papers, review articles, as well as clinical and technical commentary from U.S. and international researchers who investigate disability rehabilitation.
Journal
The Journal of Rehabilitation Research and Development