Thigh muscle strength and endurance in patients with COPD compared with healthy controls

SummaryThe aim of this study was to evaluate thigh muscle strength and endurance in patients with COPD compared with healthy controls. Forty-two patients (26 women; 16 men) with moderate to severe COPD and 53 (29 women; 24 men) age-matched healthy controls participated in the study. The subjects were tested for maximum voluntary contractions (MVC), endurance and fatigue of the thigh muscles on an isokinetic dynamometer (KinCom®). Endurance was expressed as the number of attained repetitions of knee extension and muscle fatigue as a fatigue index (FI).MVC in knee extension was 17% lower in female patients (P=0.017) but no difference was found in male patients (P=0.56) compared to controls. MVC in knee flexion was lower both in female (51%) (P<0.001) and male patients (40%) (P<0.001) compared to controls. Both female and male patients had significantly lower muscle endurance compared to controls. Female patients had a higher FI (22.5%) than female controls (10%) (P=0.001) while no difference was found regarding FI between male patients (15%) and male controls (10%) (P=0.103). The level of self-reported everyday physical activity did not differ between groups.The results showed impaired skeletal muscle function in COPD, except for MVC in knee extension in male patients. Female patients seemed to be more prone to decrease in thigh muscle function. More focus on improving muscle strength and muscle endurance should be considered when designing pulmonary rehabilitation programs. Patients with preserved level of physical activity can be included in exercise programs and gender-related differences should be taken into account

An observational study of two rehabilitation strategies for patients with chronic pain, focusing on sick leave at one-year follow-up

OBJECTIVE: To follow up 2 rehabilitation strategies for patients with chronic pain: a 2-day interdisciplinary team assessment followed by either (i) a 4-week outpatient multimodal rehabilitation programme, or (ii) a subsequent rehabilitation plan. METHODS: After a 2-day interdisciplinary team assessment at our pain rehabilitation clinic, 296 consecutive patients were selected to undergo either multimodal rehabilitation programme (n = 76) or rehabilitation plan (n = 220). They completed questionnaires regarding beliefs about the future (only at assessment), Multidimensional Pain Inventory and sick leave, both at assessment, and at 1-year follow-up. RESULTS: Both the rehabilitation plan and multimodal rehabilitation programme groups improved significantly as regards decreased sick leave and the Multidimensional Pain Inventory scales Pain severity, Interference, and Support. The multimodal rehabilitation programme group also improved significantly regarding Life control and Affective distress. For men, low disability level and for women a positive expectation about work was associated with no sick leave at follow-up. CONCLUSION: The multimodal rehabilitation programme had long-term positive effects on sick leave and all Multidimensional Pain Inventory scales. However, a less intense intervention (rehabilitation plan) with follow-up in primary care can decrease levels of sick leave and improve some Multidimensional Pain Inventory scales. An interdisciplinary team assessment of patients with chronic pain seems to be useful for selecting which patients should undergo different rehabilitation interventions

Reach performance and postural adjustments in children with severe spastic diplegia wearing Dafos

Godkänd; 2007; Bibliografisk uppgift: Titel på proceedings: Abstraktbok Sjukgymnastdagarna 10-12 oktober 2007 Sider: 4; 20071019 (andbra

One-year follow-up of two different rehabilitation strategies for patients with chronic pain

Objective: To determine outcomes for 2 rehabilitation strategies for patients with chronic pain: a 2-day interdisciplinary team assessment followed by either: (i) a 4-week outpatient multimodal rehabilitation programme, or (ii) a subsequent rehabilitation plan. Methods: After a 2-day interdisciplinary team assessment at our pain rehabilitation clinic 296 consecutive patients were selected to either multimodal rehabilitation (n = 76) or rehabilitation plan (n = 220). They completed questionnaires regarding pain intensity (Visual Analogue Scale), disability (Disability Rating Index), life satisfaction (LiSat-11), anxiety and depression (Hospital Anxiety and Depression Scale) at assessment and again at 1-year follow-up. Results: Both groups showed significant improvements at 1-year follow-up regarding pain intensity. In addition, the multimodal rehabilitation group improved in the disability items ("light work" and "heavy work"), depression and life satisfaction ("leisure", "somatic health", and "psychological health"). In the rehabilitation plan group "somatic health" improved, although not statistically significant. Conclusion: This study indicates that multimodal rehabilitation may have long-term positive effects on pain, disability, depression and domains of life satisfaction. However, a minor intervention, rehabilitation plan with follow-up in primary care, can improve pain and "somatic health". Based on the biopsychosocial approach, an interdisciplinary assessment of patients with chronic pain seems to be of value for selecting patients to different rehabilitation interventions.Published in manuscript form in Daniel Merricks thesis.</p

Traumatic spinal cord injury in the north-east Tanzania : describing incidence, etiology and clinical outcomes retrospectively

Background: Causes, magnitude and consequences of traumatic spinal cord injury depend largely on geography, infrastructure, socioeconomic and cultural activities of a given region. There is a scarcity of literature on profile of traumatic spinal cord injury to inform prevention and rehabilitation of this health condition in African rural settings, particularly Tanzania. Objective: To describe the incidence, etiology and clinical outcomes of traumatic spinal cord injury and issues related to retrospective study in underdeveloped setting. Methods: Records for patients with traumatic spinal cord injury for five consecutive years (2010–2014) were obtained retrospectively from the admission wards and health records archives of the Kilimanjaro Christian Medical Center. Sociodemographic, cause, complications and patients’ condition on discharge were recorded and analyzed descriptively. Results: The admission books in the wards registered 288 new traumatic spinal cord injury cases from January 2010 to December 2014. Of the 288 cases registered in the books, 224 were males and 64 females with mean age 39.1(39.1 ± 16.3) years and the majority of individuals 196(68.1%) were aged between 16 and 45 years. A search of the hospital archives provided 213 full patient records in which the leading cause of injury was falls 104(48.8%) followed by road traffic accidents 73(34.3%). Cervical 81(39.9%) and lumbar 71(34.74%) spinal levels were the most affected. The annual incidence for the Kilimanjaro region (population 1,640,087) was estimated at more than 26 persons per million population. The most docu- mented complications were pressure ulcers 42(19.7%), respiratory complications 32(15.0%) and multiple complications 28(13.1%). The mean length of hospital stay was 64.2 ± 54.3 days and the mortality rate was 24.4%. Conclusion: Prevention of traumatic spinal cord injury in North-east Tanzania should consider falls (particularly from height) as the leading cause, targeting male teenagers and young adults. Pressure ulcers, respiratory complications, in-hospital mortality and availability of wheelchairs should be addressed.

The characteristics of stroke and its rehabilitation in Northern Tanzania

Background: Stroke causes great suffering and severe disability worldwide, and rehabilitation following a stroke seeks to restore lost functions. The extent to which stroke patients get access to rehabilitation in Tanzania is not well estimated, and drawing a current picture of the rehabilitation services for these persons is the first step in developing a more effective rehabilitation model in the country. Objective: The objective of this study was to establish the characteristics of stroke and its rehabilitation at the Kilimanjaro Christian Medical Centre (KCMC), a consultant referral hospital in northern Tanzania. Methods: This was a records-based descriptive study in which demographic, clinical, and rehabilitation information of stroke patients admitted to the KCMC between January 2012 and December 2015 was collected and audited. The means, percentages, and proportions were used to summarise the demographic, clinical, and rehabilitation patterns using SPSS version 24.0 software. The chi-squared statistic was used to examine the relationships between categorical variables, and a p-value&lt;0.05 was considered statistically significant. Results: Of the 17,975 patients admitted to the KCMC during the period of the study, 753 (4.2%) had suffered a stroke, with a mean age of 68.8 ± 16.4 years. The predominant cause of stroke was hypertension, which accounted for 546 (72.5%) patients. A total of 357 (47.4%) patients had various forms of rehabilitation during the admission to hospital. Following a discharge home 240 (31.9%) patients did not return to the hospital for the continuation of rehabilitation. Conclusion: Stroke patients at the KCMC lack access to rehabilitation therapies. Insufficient access to rehabilitation therapies may warrant the need to explore alternative approaches such as tele-rehabilitation technologies in Tanzania