In vivo contact stresses at the radiocarpal joint using a finite element method of the complete wrist joint

A small number of cadaveric studies have been carried out looking at the force transmission through the radiocarpal joint. In this study subject specific finite element models were created of the whole wrist joint using measured biomechanical data to capture the forces acting on the wrist with the hand generating a maximum gripping force

Predicting outcome in acute low back pain using different models of patient profiling

Study Design: Prospective observational study of prognostic indicators, utilising data from a randomised, controlled trial of physiotherapy care of acute low back pain (ALBP) with follow up at 6 weeks, 3 months and 6 months. Objective: To evaluate which patient profile offers the most useful guide to long-term outcome in ALBP. Summary of Background Data: The evidence used to inform prognostic decision-making is derived largely from studies where baseline data is used to predict future status. Clinicians often see patients on multiple occasions so may profile patients in a variety of ways. It is worth considering if better prognostic decisions can be made from alternative profiles. Methods: Clinical, psychological and demographic data were collected from a sample of 54 ALBP patients. Three clinical profiles were developed from information collected at baseline, information collected at 6 weeks, and the change in status between these two time points. A series of regression models were used to determine the independent and relative contributions of these profiles to the prediction of chronic pain and disability. Results: The baseline profile predicted long-term pain only. The 6-week profile predicted both long-term pain and disability. The change profile only predicted long-term disability (p \u3c 0.01). When predicting long-term pain, after the baseline profile had been added to the model, the 6-week profile did not add significantly when forced in at the second step (p \u3e 0.05). A similar result was obtained when the order of entry was reversed. When predicting long-term disability, after the 6-week profile was entered at the first step, the change profile was not significant when forced in at the second step. However, when the change profile was entered at the first step and the 6-week clinical profile was forced in at the second step, a significant contribution of the 6-week profile was found. Conclusions: The profile derived from information collected at 6 weeks provided the best guide to long-term pain and disability. The baseline profile and change in status offered less predictive value

International low back pain guidelines: A comparison of two research based models of care for the management of acute low back pain.

Evidence based guidelines for the management of acute low back pain (ALBP) have been formulated by numerous countries. There are discrepancies between guidelines regarding physiotherapy treatment. The aim of this study was to compare two research based models derived from international LBP guidelines. A single-blind randomised controlled trial was undertaken in a physiotherapy outpatients department. Subjects with ALBP were randomly allocated to an ‘assess/advise/treat’ group (n = 50) or an ‘assess/advise/wait’ group (n = 52). The primary outcome measure was the Roland and Morris Disability Questionnaire (RMDQ). Secondary outcome measures of pain (VAS, usual pain intensity) depressive symptoms (MZSRDS) somatic distress (MSPQ) anxiety (STAIS) quality of life (SF36) and general health (EuroQol) were also obtained. Outcomes were assessed at 6-weeks, 3-months and 6-months. At 6-weeks subjects in the assess/advise/treat group demonstrated less LBP related disability (p = 0.02) and depressive symptoms (p = 0.01), as well as better general health (p = 0.006, p = 0.05), vitality (p \u3c 0.001), social functioning (p = 0.004) and mental health (p = 0.002). At long-term assessment (3 and 6 months) subjects in the assess/advise/treat group were less distressed (p = 0.004), anxious (p = 0.01) and had fewer depressive symptoms (p = 0.001), as well as reporting better general health (p = 0.009, p = 0.05), emotional role (p = 0.03) and mental health (p = 0.04). Active physiotherapy produces better short-term outcomes than advice. Delaying treatment has no long-term consequences on pain or disability, but affects the development of psychosocial features

Peg O\u27 My Heart : Waltzes

https://digitalcommons.library.umaine.edu/mmb-ps/2529/thumbnail.jp

A Comparative Study of the Oral Language of Students in Basal-Based and Whole Language Kindergartens.

Concern has existed for several years over the classroom practices relating to the whole language approach as opposed to the basal-based approach relative to literacy development, especially with respect to the appropriateness of each method for use with minority and lower socioeconomic groups of children entering kindergarten. This study describes the oral language of both African American and European American kindergarten children from low and middle socioeconomic status families who are attending public school kindergartens, one using whole language and one a basal-based approach. The language during centertime of seventeen children from these two classrooms was audiotaped using wireless microphones over a period of six weeks in the spring of the school term. Qualitative research methodologies following techniques for both participant and nonpartcipant observations were implemented. Transcriptions were used to analyze the language according to the functions (Halliday, 1973), strategies (Tough, 1983), the Situational, Discourse, Semantic Model (Norris & Hoffman, 1993), and other recognized measures. Data analyses are presented in both descriptive and tabular form. Oral language of all groups classified was found to be in accord with the expectations of analytical models; virtually all the children studied were expressing themselves at the anticipated levels for their age. Even though there were recognizable differences in performance at particular points of measurement and levels of maturity, similar, somewhat parallel patterns were common to all groups. Contrary to what might have been expected by some educators, African American, lower socioeconomic status children actually performed at higher levels than European American, middle socioeconomic children in enough instances to suggest there was a similarity between the groups, particularly in the whole language classroom. There is evidence to suggest that, in some areas, the whole language approach encouraged a more mature, richer use of language than did the basal-based approach. This observation applies to both middle socioeconomic European American children and lower socioeconomic African American children. When children are given the freedom to express themselves in carefully planned, developmentally appropriate (Bredekamp, 1987) centertime activities, regardless of their racial or socioeconomic status, they will interact in a manner that advances their oral language capabilities