Physical therapy
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Previous studies of Timed "Up & Go" Test (TUG) scores as a predictor of falls were based primarily on retrospective data, and no prospective studies of the TUG for predicting falls in people with hip fracture are available. The purpose of this study was to determine whether TUG scores obtained upon discharge from an acute orthopedic hip fracture unit can predict falls in people with hip fracture during a 6-month follow-up period. ⋯ The results suggest that the TUG is a sensitive measure for identifying people with hip fracture at risk for new falls, and it should be part of future outcome measures to decide for whom preventive measures against falls should be instituted.
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Clinical studies of transcutaneous electrical nerve stimulation (TENS) have used a variety of outcome measures to assess its effectiveness, with conflicting results. It is possible that TENS is effective on some measures of pain and not on others. The purpose of this study was to test the hypothesis that TENS reduces primary hyperalgesia of the knee induced by joint inflammation. ⋯ These data suggest that TENS inhibits primary hyperalgesia associated with inflammation in a time-dependent manner after inflammation has already developed during both acute and chronic stages.
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Case Reports Clinical Trial
Application of combined botulinum toxin type A and modified constraint-induced movement therapy for an individual with chronic upper-extremity spasticity after stroke.
Constraint-induced movement therapy (CIMT) is a promising intervention for retraining upper-extremity function after a stroke. The purpose of this case report is to describe the use of a combination of botulinum toxin type A (BtxA) and a modified CIMT program for a patient with severe spasticity who was unable to use his right upper extremity. ⋯ In a patient with severe flexor spasticity and nonuse of the dominant upper extremity after a stroke, a combined treatment of BtxA and modified CIMT may have resulted in improved upper-extremity use.
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Controlled Clinical Trial
Effects of physical training on functional status in patients with prolonged mechanical ventilation.
Patients requiring prolonged mechanical ventilation (PMV) are frequently deconditioned because of respiratory failure precipitated by the underlying disease, the adverse effects of medications, and a period of prolonged immobilization. The effects of 6 weeks of physical training on the strength of respiratory and limb muscles, on ventilator-free time, and on functional status in patients requiring PMV were examined. ⋯ The results show that a 6-week physical training program may improve limb muscle strength and ventilator-free time and thus improve functional outcomes in patients requiring PMV.
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Controlled Clinical Trial
Community-based tai chi and its effect on injurious falls, balance, gait, and fear of falling in older people.
It is important to determine the effect of adherence to a tai chi program on falls and related functional outcomes in older people. This study examined the effect of a community-based tai chi program on injurious falls, balance, gait, and fear of falling among people aged 65 years and older in Taiwan. ⋯ Tai chi can prevent a decline in functional balance and gait among older people. However, the reduction in injurious falls attained with tai chi did not reach statistical significance; the statistical inefficiency may have resulted partly from the large decline in injurious falls in control villagers. Finally, the unexpected effect of educational intervention on reducing injurious falls in different settings needs to be further examined.