Committee on Strategic Initiatives: Strategic Planning Update, November 20, 2008

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Cardiac rehabilitation and psychological well-being

The aim of this chapter is to address psychological issues associated with effective multidimensional cardiac rehabilitation programmes. Cardiac rehabilitation is defined as: “the sum of activities required to influence favourably the underlying cause of the disease, as well as the best possible, physical, mental and social conditions, so that they (people) may, by their own efforts preserve or resume when lost, as normal a place as possible in the community. Rehabilitation cannot be regarded as an isolated form or stage of therapy but must be integrated within secondary prevention services of which it forms only one facet” (World Health Organisation, 1993). The chapter will: discuss the impact of CHD in the UK, provide an overview of the Government strategy for reducing the burden of cardiac disease and disability, and review quantitative evidence discussing the effectiveness of cardiac rehabilitation on the mental health and well-being of cardiac patients, with particular reference to anxiety and depression states. The final part of this chapter presents results of a qualitative study, previously reported in Hudson, Board, and, Lavallee (2001) that examined the psychosocial impact of cardiac disease and rehabilitation for patients attending one cardiac rehabilitation scheme in England

Foreword.

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Reliability of Kinematic Waveforms during Gait Analysis with Total Hip Arthroplasty Patients

Purpose: The aim of the study was to determine the test-retest reliability of lower limb kinematic waveforms derived from 3D gait analysis (3DGA) in patients following total hip arthroplasty (THA). Methods: Eight (7M:1F; age: 70 ± 7 years; height: 1.68 ± 0.11m; mass: 85 ± 20kg) adults with a unilateral THA attended test and retest sessions. 3DGA was undertaken with participants walking at a self-selected pace along a 7m walkway within each session. The standard error or the measurement (SEM) was calculated for hip, knee and ankle joint angles in all three planes, over the walking gait cycle. Results: The SEM ranged from 2.9 – 4.1°, 2.7 – 3.7° and 1.9 – 3.9°, in the sagittal, frontal and traverse planes at the hip. At the knee the SEM ranged from 1.6 – 4.2°, 1.0 – 1.9° and 1.3 – 2.9° in the sagittal, frontal and transverse planes, respectively. While the SEM ranged from 0.7 – 2.0°, 1.2 – 2.3° and 2.9 – 4.0° in the sagittal, frontal and transverse planes at the ankle. Conclusions: The findings demonstrate that 3DGA provides a reliable means of quantifying lower limb kinematics over the walking gait cycle in patients following THA, with all SEM values below the 5° threshold previously suggested to identify clinically meaningful differences. The SEM values reported may aid in the interpretation of changes in lower limb kinematics in patients following THA

Presidential Internationalization Advisory Committee, April 16, 2008

This PDF was downloaded from the website of the College of William and Mary Board of Visitors in December 2008

Testimony of Ambassador Carla A. Hills, United States Trade Representative, before the Subcommittee on Trade, Committee on Ways and Means, U.S. House of Representatives, June 14, 1990.

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Dedication.

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Dedication.

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