Glen E. Gresham

Quantitative effects of physical therapy on muscular and functional performance in subjects with osteoarthritis of the knees

Osteoarthritis (OA) of the knees is a functionally limiting disability. Physical therapy (PT) is considered a useful treatment for OA, although evidence is qualitative. The purpose of this study was to quantitatively measure the effects of a 3-month PT program (n = 40; 20 men and 20 women) with knee OA. Muscle function and functional assessment parameters were measured. All data were analyzed by repeated measures analysis of variance (p < 0.05). There were no significant changes in handgrip strength and endurance, limb volume, or angular velocity after PT. Maximal muscle length was significantly increased. Muscle strength significantly increased for the hamstrings (9% and 19%) and quadriceps (8% and 24%) for the men and women, respectively. Endurance improved for the quadriceps (26% and 39%) and hamstrings (18% and 28%) for men and women, respectively. Functionally, there were significant improvements in the ability to climb stairs, rise from a chair, and walk. Walking time (50 ft) and the difficulty and pain of performing various activities decreased. Most improvements had occurred after 1 month of PT. For the first time, the effects of a PT program have been quantitatively measured for patients with knee OA.

Effects of a quantitative progressive rehabilitation program applied unilaterally to the osteoarthritic knee

Decreases in muscular strength, endurance, and angular velocity have previously been demonstrated in the elderly. Osteoarthritis (OA), especially of the knee, may cause further reductions in these parameters and lead to functional limitations. This study measured the effects of a quantitative progressive exercise muscle rehabilitation program (QPE) that was added to a physical therapy (PT) program. Forty subjects (20 men and 20 women) with OA of the knees were randomly selected from a group of volunteers (N = 437) for the 3-month program. Measurements of strength, endurance, angular velocity, and the Jette Functional Status Index were determined before and after 1, 2, and 3 months of the program. The QPE program was composed of isometric, isotonic, isotonic with resistance, endurance, and speed contractions prescribed in a progressive sequence. Muscle strength (14% and 29%) and endurance (38% and 43%) increased significantly (p < 0.05, ANOVA for repeated measures) for both the quadriceps and hamstrings, respectively, after rehabilitation. There were marked decreases in walking time and the difficulty and pain experienced during functional activities.

The quadriplegia index of function (QIF): sensitivity and reliability demonstrated in a study of thirty quadriplegic patients

The Quadriplegia Index of Function (QIF) was originally developed by the authors in 1980 because the popular Barthel Index was deemed too insensitive to document the small but significant functional gains made by quadriplegics (tetraplegics) during medical rehabilitation. The QIF has now been tested on a group of 30 complete quadriplegic patients at admission to and discharge from inpatient medical rehabilitation. Resultant scores were compared to those simultaneously obtained by the Barthel Index and the Kenny Self-Care Evaluation. The QIF was found to be more sensitive (46 per cent improvement as opposed to 30 per cent by the Kenny Self Care Evaluation and 20 per cent by the Barthel Index). The QIF was also tested for reliability. Ratings by three different nurses, working independently, were found to be significantly positively correlated for all sub-scores (p < .001). We conclude that the QIF provides a useful option in choosing a functional assessment instrument for use with quadriplegic patients.

Functional Assessment in Rehabilitation Medicine: Introduction and Brief Background

Medical rehabilitation addresses problems in the measurement of human function and health-related quality of life as well as problems in diagnosis and measurement of impairment. This article summarizes basic principles of measurement relevant to medical rehabilitation and presents examples of standards for development of measures and for their application in clinical practice. Measurement and clinical evaluation in medical rehabilitation need to be grounded in principles of validity and reliability. Improved measurement tools will secure the scientific basis of medical rehabilitation and enhance its long-term growth.

De effecten van een kwantitatief progressief behandelingsschema unilateraal toegepast op de knie bij patiënten met osteo-arthritis

Achteruitgang in spierkracht, uithoudingsvermogen en hoeksnelheid zijn aangetoond bij oudere mensen. Osteo-arthritis (oa), in het bijzonder van de knie, kan nog meer achteruitgang van deze parameters veroorzaken en leiden tot functionele beperkingen. In dit onderzoek worden de effecten gemeten van een kwantitatief progressief oefenprogramma voor spierherstel (kpo), dat werd gegeven naast een fysiotherapeutisch programma.