Activities of daily living in patients with Duchenne muscular dystrophy are related to age and muscle strength, and manual muscle testing grade 3 is an important cut-off point to predict their disability.
This preliminary study suggests that our newly modified washing toilet seat with a monitoring system could be a useful alternative for bowel management in patients with SCI.
Study design: Case series. Objectve: The objective was to study the effect of phenol blocks to the motor points of the subscapularis muscle in patients with cervical cord injury (CCI). Setting: Spinal cord injury units of a national hospital in Tokyo. Methods: The participants were seven patients with traumatic CCI, mean age 55.8 years (SD4.0), whose injury level were at the fifth cervical level and the American Spinal Injury Association (ASIA) impairment scale was A in 2, C in 1 and D in 4. They were at least 5 months post-acute injury, and complained of pain and limited range of motion (ROM) of their shoulder joint that were unresponsive to usual rehabilitative interventions and medications. Before and after the phenol block to the motor points of the subscapularis muscle, we compared passive and active ROM of the shoulder (flexion, abduction and external rotation), spasticity of the subscapularis as assessed with the modified Ashworth scale, pain as evaluated with a visual analog scale, and eating item of the Functional Independence Measure. Results: There were significant improvements in passive ROM in flexion (23.71), abduction (19.41) and external rotation (16.81; Po0.05). Visual analog scale for shoulder pain was reduced from 6.0 to 3.4 (Po0.05). The modified Ashworth scale for shoulder spasticity, however, did not significantly change. The eating Functional Independence Measure item score improved significantly (Po0.05). Conclusions: This study suggests that subscapularis motor point block for pain and limited ROM with spastic shoulder is a useful technique in patients with CCI.
), and determined the difficulty order of the FIM SM items with the percentage of patients who were independent (6 or 7) for each FIM item (% independence). Results: The ADL of patients with DMD had an order in terms of difficulty. For the motor subscale, the most difficult item was stairs, and the easiest item was locomotion. On the cognitive subscale, problem solving was the most difficult item. When we compared item difficulty between patients <15 years of age and those ≥ 15 years, the % independence was lower in the older age group for all motor items. The decrease in the % independence of the eating item with age was significant; however bladder management was well maintained. Conclusions: ADL of patients with DMD has a specific difficulty order. The order of difficulty is based on the relative level of independence/dependence. The difficulty order was maintained, although the structure of ADL changed with age. (Keio J Med 58 (4) : 223 -226, December 2009)
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