Standard goniometry is the most commonly used method of assessing the range of motion (ROM) in patients with burn scar contracture. However, standard goniometry was founded on arthrokinematic principles and doesn’t consider the cutaneous biomechanical influence between adjacent joint positions and skin pliability to accommodate motion. Therefore, the use of standard goniometry to measure burn scar contracture is called into question. This prospective, multicenter, comparative study investigated the difference between standard goniometry, based on arthrokinematics and a revised goniometry protocol, based on principles of cutaneokinematics and functional positions to measure ROM outcome in burn survivors. Data were collected for 174 joints from 66 subjects at seven burn centers totaling 1044 measurements for comparison. ROM findings using the revised protocol demonstrated significantly more limitation in motion 38.8 ± 15.2% than the standard protocol 32.1 ± 13.4% (p < .0001). Individual analyses of the motions likewise showed significantly more limitation with revised goniometry compared with standard goniometry for 9/11 joint motions. Pearson’s correlation showed a significant positive correlation between the percentage of cutaneous functional units scarred and ROM outcome for the revised protocol (R2 = .05, p = .0008) and the Δ between the revised and standard protocols (R2 = .04, p = .0025) but no correlation was found with the standard goniometric protocol (R2 = .015, p = .065). The results of this study support the hypothesis that standard goniometry underestimates the ROM impairment for individuals whose motion is limited by burn scars. Having measurement methods that consider the unique characteristics of skin impairment and the impact on functional positions is an important priority for both clinical reporting and future research in burn rehabilitation.
To quantify or estimate the environmental and radiological impacts h m man-made sources of radioactive effluents, certain dose assessment procedures were developed by various government and regulatory agencies. Some of these procedures encourage the use of computer simulations (models) to calculate air dispersion, environmental transport, and subsequent human exposure to radioactivity. Such assessment procedures are fiequently used to demonstrate compliance with Department of Energy (DOE) and U. S. Environmental Protection Agency (USEPA) regulations. howledge of the density and distribution of the population surrounding a source is an essential component in assessing the impacts fiom radioactive effluents. Also, as an aid to calculating the dose to a given population, agricultural data relevant to the dose assessment procedure (or computer model) is often required. This report provides such population and agricultural data fbr the area surrounding Los Alamos National Laboratory.
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