Stephen F Figoni - Academia.edu (original) (raw)
Papers by Stephen F Figoni
Clinical …, 2003
The purpose of this study was to assess the reliability and validity of a mobility obstacle cours... more The purpose of this study was to assess the reliability and validity of a mobility obstacle course for women with mobility impairments. Participants included 72 adult women with permanent physical disabilities including arthritis, orthopedic conditions, paraplegia, and others. The 60-m course consisted of carpeted runways and turns, ramps, a doorway, a transfer, and object manipulation. Pa1ticipants completed two trials, walking or wheeling through the course as quickly as possible, safely and without running. Total course time and peak hemt rate data were con•elated with SF-36 health survey subscales. Overall, peak heart rate was significantly (p < .05) con-elated with physical functioning (r =-.328), limitations due to physical functioning (r = .261), and pain (r = .296). Total course time was significantly conelated with physical functioning. These findings indicate very high reliability and preliminary evidence of validity.
![Research paper thumbnail of [114] Evaluation of FES techniques for exercise](https://attachments.academia-assets.com/85810461/thumbnails/1.jpg)
](Journal of Rehabilitation Research and Development, 1991
Cost. Access. Quality. These are three objectives that must drive a responsible discussion regard... more Cost. Access. Quality. These are three objectives that must drive a responsible discussion regarding reform of the delivery of health care in this country, and specifically, decreasing (or at least controlling) cost while increasing access and quality. A fool's errand? Maybe. A zero-sum game, with any reduction in cost leading to a concomitant decrease in access and quality? Not necessarily. Why is reform needed? Quite simply, because the health care system of the United States is falling short in the areas of cost,' access 2 and, by certain measures, even quality.' This year the Law Review of Mississippi College School of Law dedicated its annual symposium to bringing together scholars to discuss these and other difficult issues surrounding health care reform. As the articles and essays in this symposium issue demonstrate, it succeeded. The symposium was held on Friday, February 26, 2010, just one day after President Obama's "failed" 4 summit on February 25, and less than a month prior to the President signing the historic Patient Protection and Affordable Care Act (PPACA) on March 23. There is timely, and then there is timely!
Peptides have great potential as therapeutic agents, however, their clinic applications are sever... more Peptides have great potential as therapeutic agents, however, their clinic applications are severely hampered by their instability and short circulation half-life. Zero-order release carriers could not only extend the circulation lifetime of peptides, but also maintain the plasma drug level constant, and thus maximize their therapeutic efficacy and minimize their toxic effect. Here using PEGylated salmon calcitonin (PEG-sCT)/tannic acid (TA) film as an example, we demonstrated that hydrogen-bonded layer-by-layer films of a PEGylated peptide and a polyphenol could be a platform for zero-order peptide release. The films were fabricated under mild conditions. The second component, TA, is a natural product and presents potential therapeutic activities itself. Unlike common carriers, the new carrier releases the peptide via gradual disintegration of the film because of its dynamic nature. The release of PEG-sCT follows a perfect zero-order kinetics without initial burst release. In addition the release rate could be tuned via external stimuli, such as pH and temperature. When implanted in rats, the films could remain the plasma level of PEG-sCT constant over an extended period. Accordingly, the serum calcium level was reduced and maintained constant over the same period, suggesting an improved therapeutic efficacy of the released drug. The tremendous advances in biotechnology are introducing more and more peptide therapeutics for the treatment of various diseases, particularly metabolic diseases and cancers 1-3. Unfortunately, their intrinsic weaknesses, e.g. poor chemical and physical stability and therefore a short circulating plasma half-life, severely limited their clinical applications 4. One method to extend circulation lifetimes is via PEGylation 5. It was well documented that PEG conjugation could protect the fragile drug from enzymatic digestion, slow its filtration by the kidneys, and thus increase its retention in the circulation 6. Another important approach is the using of drug carrier. Encapsulation of peptide therapeutic in a carrier could not only protect the drug against degradation but also allow its sustained release, leading to prolonged systemic exposure to the drug. Up to now, many carriers were designed for peptide release, including biodegradable microparticles (particularly poly(D,L-lactide-co-glycolide) (PLGA) microparticles) 7, 8 , micelles 9 , and hydrogels 10. PEG conjugations can be regarded as a type of drug carriers too, in which the drug is chemically bound, instead of physically encapsulated 11. Although significant progress has been achieved in the development of drug carriers for peptide release, some challenges still remain. Particularly the carriers usually release the drug in a "fast-then-slow" manner. The rapid release at the initial stage will result in a high plasma drug level, which will pose a serious toxicity threat for the patients 8. For example, biodegradable microspheres, which were extensively investigated for peptide release, usually suffer from a significant initial burst release 8, 12. Initial burst was also observed in peptide releasing hydrogels both in vitro and in vivo, and is considered a limiting factor for their applications 10. At the late stage of release, however, as the release rate slows down gradually, the plasma drug level will finally drop to a level not high enough to achieve therapeutic effects 13. As a result, only a small portion of the precious drug will exert its therapeutic effects.
Medicine & Science in Sports & Exercise, 1995
Journal of Biomechanics, 1992
Our knowledge about the wear mechanisms occurring in synovial joints is still very poor. The effe... more Our knowledge about the wear mechanisms occurring in synovial joints is still very poor. The effects of various operating parameters such as surface speeds, chemical and physical disruptions to the articular surface on consequent wear have not yet been studied in detail. On the other hand the information about the wear processes taking place in synovial joints is critical to the proper functioning of joints and the development of joint diseases. There are obvious technical problems in conducting wear studies of synovial joints in in-vivo conditions. A joint simulator that would very closely reproduce a working cycle of a synovial joint to enable study of the wear of synovial joints under laboratory conditions was designed and built. The simulator has been specifically designed to reproduce very closely the working cycle of a natural joint. The information resulting from the tests conducted will hopefully yield information on the mechanisms of wear occurring in synovial joints, the effects of various operating conditions on wear and joint performance and the development of degenerative joint diseases. Sheep joints were used for initial testing in the simulator. The operating principles of the simulator and initial test results are described in this paper.
Archives of Physical Medicine and Rehabilitation, 2002
Objective: To evaluate the construct validity of a new 13-item physical activity survey designed ... more Objective: To evaluate the construct validity of a new 13-item physical activity survey designed to assess physical activity in individuals with physical disabilities. Design: Mail survey requesting information on physical activity, basic demographic characteristics, self-rated health, and self-rated physical activity. Setting: In February 2000, surveys were sent to 1176 individuals who had used rehabilitative services at a major midwestern university between 1950 and 1999. Participants: Two hundred twenty-seven men and 145 women with disabilities responded to the mail survey (80%, spinal cord or other locomotor injuries; 13%, visual and auditory injuries; 7%, other; 92%, white; mean age Ϯ standard deviation, 49.8 Ϯ 12.9y; mean length of disability, 36.9 Ϯ 14.9y). Interventions: Not applicable. Main Outcome Measures: Physical activity was assessed with the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD). The PASIPD requests the number of days a week and hours daily (categories) of participation in recreational, household, and occupational activities over the past 7 days. Total scores were calculated as the average hours daily times a metabolic equivalent value and summed over items. Results: Pearson correlations between each survey item and the total PASIPD score were all statistically significant (P Ͻ .05) and Ն .20 (range, .20-.67). Factor analysis with principal component extraction and varimax orthogonal rotations revealed 5 latent factors (eigenvalues Ն 1, factor loadings Ն .40): home repair and lawn and garden, housework, vigorous sport and recreation, light sport and recreation, and occupation and transportation. These 5 factors accounted for 63% of the total variance. Cronbach ␣ coefficients ranged from .37 to .65, indicating low-to-moderate internal consistency within factors. Those who reported being "active/highly active" had higher total and subcategory scores compared with those "not active at all." Those in "excellent" health had higher total, vigorous sport and recreation, and occupation and transportation subcat-egory scores compared with those who rated their health "fair/ poor" (all P Ͻ .05). Conclusion: These results provide preliminary support for the construct validity of the PASIPD. Additional validation studies using an external criterion and in more generalizable samples are warranted.
Journal of Rehabilitation Research and Development, 1991
Medicine and Science in Sports and Exercise, 1980
The Journal of the American Paraplegia Society, 1990
The purposes of this study were three-fold: (a) to determine acute physiologic responses of spina... more The purposes of this study were three-fold: (a) to determine acute physiologic responses of spinal cord injured (SCI) subjects to peak levels of leg cycle ergometry utilizing functional neuromuscular stimulation (FNS) of paralyzed leg muscles, (b) to determine the relative contributions of passive and active components of FNS cycling to the peak physiologic responses, and (c) to compare these physiologic responses between persons who have quadriplegia and those who have paraplegia. Thirty SCI subjects (17 quadriplegics and 13 paraplegics) performed a discontinuous graded FNS exercise test from rest to fatigue on an ERGYS 1 ergometer. Steady-state physiologic responses were determined by open-circuit spirometry, impedance cardiography with ECG, and auscultation. In the combined statistics of both groups, it was noted that peak FNS cycling significantly increased (from rest levels) mean oxygen uptake by 255%, arteriovenous O2 difference VO2 and VE, Q and a-vO2 and VCO by 69%, and stro...
Journal of rehabilitation research and development
We studied 31 subjects with severe leg ischemia and 29 age-matched nonischemic control subjects t... more We studied 31 subjects with severe leg ischemia and 29 age-matched nonischemic control subjects to compare preamputation assessments of leg ischemia using laser Doppler imaging (LDI), transcutaneous partial pressure of oxygen (TcPO(2)), and transcutaneous partial pressure of carbon dioxide (TcPCO(2)). TcPO(2) and TcPCO(2) were evaluated with Novametrix Medical Systems, Inc, monitors (Wallingford, Connecticut) and perfusion (flux) of skin topically heated to 44 degrees C, and adjacent nonheated areas were evaluated with a Moor Laser Doppler Imager (Moor Instruments, Ltd; Devon, England). LDI flux of heated areas, its ratio to nonheated areas, and TcPO(2) (not TcPCO(2)) were lower in ischemic subjects than in control subjects. LDI flux ratio performed better than TcPO(2) in identifying ischemia, with fewer false positive and false negative results. Moreover, LDI flux of heated skin detected a proximal to a distal gradient of perfusion in ischemic subjects, while TcPO(2) did not. LDI w...
The Journal of Spinal Cord Medicine
Cardiopulmonary Physical Therapy Journal
ABSTRACT
The Journal of orthopaedic and sports physical therapy, 2017
Synopsis Claudication from peripheral artery disease (PAD) may mimic or coexist with musculoskele... more Synopsis Claudication from peripheral artery disease (PAD) may mimic or coexist with musculoskeletal conditions and represents an important diagnostic consideration in patients over 50 years of age. Physical therapists are optimally positioned to recognize this condition by incorporating a vascular history and physical examination in appropriately selected patients. Recognition of PAD is important both from the standpoint of addressing the ischemic risk to the limb and because PAD is associated with high cerebrovascular and cardiovascular risk. Therefore, multidisciplinary management of patients with PAD is essential. Extensive evidence supports treatment of PAD-related claudication with supervised exercise, and physical therapists are well positioned to play an important role in this treatment. J Orthop Sports Phys Ther 2017;47(12):957-964. Epub 9 Oct 2017. doi:10.2519/jospt.2017.7442.
PM&R, 2016
Physicians have difficulty predicting patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;am... more Physicians have difficulty predicting patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; occupational limitations, abilities, and success from clinical evaluation (CE) of pathology and impairments, especially in the presence of chronic pain. Additional information from a functional capacity evaluation (FCE) may improve the accuracy of their physical capacity assessments. It is not known whether FCE information will change these assessments. No such study has been published using Veterans or non-Veterans. To determine the influence of FCE data on the physician&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s assessment of the US Department of Labor&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Dictionary of Occupational Titles (DOT) work capacity levels of Veterans with chronic moderate-intensity pain. Retrospective analysis. Tertiary care medical center. Veterans aged 18-60 years with moderate chronic musculoskeletal pain who were seeking employment. Two kinesiotherapists performed FCEs on all participants, namely, the lumbar protocol of the EvalTech Functional Testing System (BTE, Inc, Hanover, MD). One physiatrist performed CEs in all participants. Two other physiatrists assessed DOT physical capacity levels using CE data alone and later using combined CE and FCE data. DOT physical capacity level (sedentary = 1, light = 2, medium = 3, heavy = 4, very heavy = 5). Of 55 charts reviewed, 27 met inclusion/exclusion criteria. The mean age was 38 years, and there were 25 male and 2 female participants. The predominant pain location was the lower back. DOT scores for 2 physicians were averaged. The mean ± SD DOT scores for CE only and CE+FCE conditions were 2.04 ± 0.33 and 2.40 ± 0.90, respectively. In all, 65% of DOT scores changed (17% decreased and 48% increased at least 1 level) after FCE data were considered. A 1-sample t test revealed that the mean CE+FCE DOT score was significantly greater than the mean CE-only score (by 20%, P = .02). Interrater agreement (weighted κ) for CE+FCE-based DOT scores was much higher than for CE alone (0.715 versus 0.182). The addition of FCE data to CE changed the majority of physician-assigned DOT levels. FCE significantly increased the mean DOT physical work capacity level provided by the physician to Veterans with chronic moderate-intensity pain, especially if the initial assessment was designated as &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;light.&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; FCE may facilitate a more objective and accurate determination of Veterans&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; work capacity. To be determined.
Adapted Physical Activity Quarterly, 1988
The purpose of this study was to compare quadriplegic and able-bodied men on selected cardiovascu... more The purpose of this study was to compare quadriplegic and able-bodied men on selected cardiovascular and metabolic responses to arm-crank ergometry at the same rate of oxygen consumption (V̇O2). Subjects included 11 untrained, spinal cord-injured, C5–C7 complete quadriplegic men and 11 untrained, able-bodied men of similar age (27 years), height (177 cm), and mass (65 kg). Measurement techniques included open-circuit spirometry, impedance cardiography, and electrocardiography. Compared with the able-bodied group, at the V̇O2 of 0.5 L/min, the quadriplegics displayed a significantly higher mean heart rate and arteriovenous O2 difference, lower stroke volume and cardiac output, and similar myocardial contractility. These results suggest that quadriplegic men achieve an exercise-induced V̇O2 of 0.5 L/min through different central cardiovascular adjustments than do able-bodied men. Quadriplegics deliver less O2 from the heart toward the tissues but extract more O2 from the blood. Tachyc...
Adapted Physical Activity Quarterly, 1988
This project assessed training behaviors and attributes of elite wheelchair racers. Training info... more This project assessed training behaviors and attributes of elite wheelchair racers. Training information was received from 36 participants in the 1985 National 10K Wheelchair Roadracing Championship. Data were obtained about age, weight, nature and level of disability, racing experience, sources of training information, level of cigarette and alcohol use, and dietary habits. Weekly training behaviors across yearly quarters were assessed with regard to the number of weekly pushing workouts, length of pushing workouts, number of miles pushed per week, percentage of training time allocated to interval training and/or speedwork, number of weekly weight-training sessions, and number of other augmentative physical activities pursued twice or more per week. Perceived exertion during interval and noninterval, steady-state training tasks was also measured. Results revealed that training behaviors of elite wheelchair racers are very heterogeneous. Participation in and age of introduction to e...
Arch Phys Med Rehabil, 2008
absent sensory nerve action potentials in lower limbs compared with upper limbs, with proximal sl... more absent sensory nerve action potentials in lower limbs compared with upper limbs, with proximal slowing, have been shown. These patterns may aid in early diagnosis. The pathophysiology will be discussed. Conclusions: POEMS syndrome is a differential diagnosis to be considered in mixed peripheral neuropathy, especially when it is coupled with plasma cell disorder. Recognizing this disease is essential to providing patients with appropriate rehabilitation management, as well as for prompt referral of these patients to specialists.
The Journal of Strength and Conditioning Research, Apr 30, 2000
Amer J Phys Med Rehabil, 2005
Clinical …, 2003
The purpose of this study was to assess the reliability and validity of a mobility obstacle cours... more The purpose of this study was to assess the reliability and validity of a mobility obstacle course for women with mobility impairments. Participants included 72 adult women with permanent physical disabilities including arthritis, orthopedic conditions, paraplegia, and others. The 60-m course consisted of carpeted runways and turns, ramps, a doorway, a transfer, and object manipulation. Pa1ticipants completed two trials, walking or wheeling through the course as quickly as possible, safely and without running. Total course time and peak hemt rate data were con•elated with SF-36 health survey subscales. Overall, peak heart rate was significantly (p < .05) con-elated with physical functioning (r =-.328), limitations due to physical functioning (r = .261), and pain (r = .296). Total course time was significantly conelated with physical functioning. These findings indicate very high reliability and preliminary evidence of validity.
Journal of Rehabilitation Research and Development, 1991
Cost. Access. Quality. These are three objectives that must drive a responsible discussion regard... more Cost. Access. Quality. These are three objectives that must drive a responsible discussion regarding reform of the delivery of health care in this country, and specifically, decreasing (or at least controlling) cost while increasing access and quality. A fool's errand? Maybe. A zero-sum game, with any reduction in cost leading to a concomitant decrease in access and quality? Not necessarily. Why is reform needed? Quite simply, because the health care system of the United States is falling short in the areas of cost,' access 2 and, by certain measures, even quality.' This year the Law Review of Mississippi College School of Law dedicated its annual symposium to bringing together scholars to discuss these and other difficult issues surrounding health care reform. As the articles and essays in this symposium issue demonstrate, it succeeded. The symposium was held on Friday, February 26, 2010, just one day after President Obama's "failed" 4 summit on February 25, and less than a month prior to the President signing the historic Patient Protection and Affordable Care Act (PPACA) on March 23. There is timely, and then there is timely!
Peptides have great potential as therapeutic agents, however, their clinic applications are sever... more Peptides have great potential as therapeutic agents, however, their clinic applications are severely hampered by their instability and short circulation half-life. Zero-order release carriers could not only extend the circulation lifetime of peptides, but also maintain the plasma drug level constant, and thus maximize their therapeutic efficacy and minimize their toxic effect. Here using PEGylated salmon calcitonin (PEG-sCT)/tannic acid (TA) film as an example, we demonstrated that hydrogen-bonded layer-by-layer films of a PEGylated peptide and a polyphenol could be a platform for zero-order peptide release. The films were fabricated under mild conditions. The second component, TA, is a natural product and presents potential therapeutic activities itself. Unlike common carriers, the new carrier releases the peptide via gradual disintegration of the film because of its dynamic nature. The release of PEG-sCT follows a perfect zero-order kinetics without initial burst release. In addition the release rate could be tuned via external stimuli, such as pH and temperature. When implanted in rats, the films could remain the plasma level of PEG-sCT constant over an extended period. Accordingly, the serum calcium level was reduced and maintained constant over the same period, suggesting an improved therapeutic efficacy of the released drug. The tremendous advances in biotechnology are introducing more and more peptide therapeutics for the treatment of various diseases, particularly metabolic diseases and cancers 1-3. Unfortunately, their intrinsic weaknesses, e.g. poor chemical and physical stability and therefore a short circulating plasma half-life, severely limited their clinical applications 4. One method to extend circulation lifetimes is via PEGylation 5. It was well documented that PEG conjugation could protect the fragile drug from enzymatic digestion, slow its filtration by the kidneys, and thus increase its retention in the circulation 6. Another important approach is the using of drug carrier. Encapsulation of peptide therapeutic in a carrier could not only protect the drug against degradation but also allow its sustained release, leading to prolonged systemic exposure to the drug. Up to now, many carriers were designed for peptide release, including biodegradable microparticles (particularly poly(D,L-lactide-co-glycolide) (PLGA) microparticles) 7, 8 , micelles 9 , and hydrogels 10. PEG conjugations can be regarded as a type of drug carriers too, in which the drug is chemically bound, instead of physically encapsulated 11. Although significant progress has been achieved in the development of drug carriers for peptide release, some challenges still remain. Particularly the carriers usually release the drug in a "fast-then-slow" manner. The rapid release at the initial stage will result in a high plasma drug level, which will pose a serious toxicity threat for the patients 8. For example, biodegradable microspheres, which were extensively investigated for peptide release, usually suffer from a significant initial burst release 8, 12. Initial burst was also observed in peptide releasing hydrogels both in vitro and in vivo, and is considered a limiting factor for their applications 10. At the late stage of release, however, as the release rate slows down gradually, the plasma drug level will finally drop to a level not high enough to achieve therapeutic effects 13. As a result, only a small portion of the precious drug will exert its therapeutic effects.
Medicine & Science in Sports & Exercise, 1995
Journal of Biomechanics, 1992
Our knowledge about the wear mechanisms occurring in synovial joints is still very poor. The effe... more Our knowledge about the wear mechanisms occurring in synovial joints is still very poor. The effects of various operating parameters such as surface speeds, chemical and physical disruptions to the articular surface on consequent wear have not yet been studied in detail. On the other hand the information about the wear processes taking place in synovial joints is critical to the proper functioning of joints and the development of joint diseases. There are obvious technical problems in conducting wear studies of synovial joints in in-vivo conditions. A joint simulator that would very closely reproduce a working cycle of a synovial joint to enable study of the wear of synovial joints under laboratory conditions was designed and built. The simulator has been specifically designed to reproduce very closely the working cycle of a natural joint. The information resulting from the tests conducted will hopefully yield information on the mechanisms of wear occurring in synovial joints, the effects of various operating conditions on wear and joint performance and the development of degenerative joint diseases. Sheep joints were used for initial testing in the simulator. The operating principles of the simulator and initial test results are described in this paper.
Archives of Physical Medicine and Rehabilitation, 2002
Objective: To evaluate the construct validity of a new 13-item physical activity survey designed ... more Objective: To evaluate the construct validity of a new 13-item physical activity survey designed to assess physical activity in individuals with physical disabilities. Design: Mail survey requesting information on physical activity, basic demographic characteristics, self-rated health, and self-rated physical activity. Setting: In February 2000, surveys were sent to 1176 individuals who had used rehabilitative services at a major midwestern university between 1950 and 1999. Participants: Two hundred twenty-seven men and 145 women with disabilities responded to the mail survey (80%, spinal cord or other locomotor injuries; 13%, visual and auditory injuries; 7%, other; 92%, white; mean age Ϯ standard deviation, 49.8 Ϯ 12.9y; mean length of disability, 36.9 Ϯ 14.9y). Interventions: Not applicable. Main Outcome Measures: Physical activity was assessed with the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD). The PASIPD requests the number of days a week and hours daily (categories) of participation in recreational, household, and occupational activities over the past 7 days. Total scores were calculated as the average hours daily times a metabolic equivalent value and summed over items. Results: Pearson correlations between each survey item and the total PASIPD score were all statistically significant (P Ͻ .05) and Ն .20 (range, .20-.67). Factor analysis with principal component extraction and varimax orthogonal rotations revealed 5 latent factors (eigenvalues Ն 1, factor loadings Ն .40): home repair and lawn and garden, housework, vigorous sport and recreation, light sport and recreation, and occupation and transportation. These 5 factors accounted for 63% of the total variance. Cronbach ␣ coefficients ranged from .37 to .65, indicating low-to-moderate internal consistency within factors. Those who reported being "active/highly active" had higher total and subcategory scores compared with those "not active at all." Those in "excellent" health had higher total, vigorous sport and recreation, and occupation and transportation subcat-egory scores compared with those who rated their health "fair/ poor" (all P Ͻ .05). Conclusion: These results provide preliminary support for the construct validity of the PASIPD. Additional validation studies using an external criterion and in more generalizable samples are warranted.
Journal of Rehabilitation Research and Development, 1991
Medicine and Science in Sports and Exercise, 1980
The Journal of the American Paraplegia Society, 1990
The purposes of this study were three-fold: (a) to determine acute physiologic responses of spina... more The purposes of this study were three-fold: (a) to determine acute physiologic responses of spinal cord injured (SCI) subjects to peak levels of leg cycle ergometry utilizing functional neuromuscular stimulation (FNS) of paralyzed leg muscles, (b) to determine the relative contributions of passive and active components of FNS cycling to the peak physiologic responses, and (c) to compare these physiologic responses between persons who have quadriplegia and those who have paraplegia. Thirty SCI subjects (17 quadriplegics and 13 paraplegics) performed a discontinuous graded FNS exercise test from rest to fatigue on an ERGYS 1 ergometer. Steady-state physiologic responses were determined by open-circuit spirometry, impedance cardiography with ECG, and auscultation. In the combined statistics of both groups, it was noted that peak FNS cycling significantly increased (from rest levels) mean oxygen uptake by 255%, arteriovenous O2 difference VO2 and VE, Q and a-vO2 and VCO by 69%, and stro...
Journal of rehabilitation research and development
We studied 31 subjects with severe leg ischemia and 29 age-matched nonischemic control subjects t... more We studied 31 subjects with severe leg ischemia and 29 age-matched nonischemic control subjects to compare preamputation assessments of leg ischemia using laser Doppler imaging (LDI), transcutaneous partial pressure of oxygen (TcPO(2)), and transcutaneous partial pressure of carbon dioxide (TcPCO(2)). TcPO(2) and TcPCO(2) were evaluated with Novametrix Medical Systems, Inc, monitors (Wallingford, Connecticut) and perfusion (flux) of skin topically heated to 44 degrees C, and adjacent nonheated areas were evaluated with a Moor Laser Doppler Imager (Moor Instruments, Ltd; Devon, England). LDI flux of heated areas, its ratio to nonheated areas, and TcPO(2) (not TcPCO(2)) were lower in ischemic subjects than in control subjects. LDI flux ratio performed better than TcPO(2) in identifying ischemia, with fewer false positive and false negative results. Moreover, LDI flux of heated skin detected a proximal to a distal gradient of perfusion in ischemic subjects, while TcPO(2) did not. LDI w...
The Journal of Spinal Cord Medicine
Cardiopulmonary Physical Therapy Journal
ABSTRACT
The Journal of orthopaedic and sports physical therapy, 2017
Synopsis Claudication from peripheral artery disease (PAD) may mimic or coexist with musculoskele... more Synopsis Claudication from peripheral artery disease (PAD) may mimic or coexist with musculoskeletal conditions and represents an important diagnostic consideration in patients over 50 years of age. Physical therapists are optimally positioned to recognize this condition by incorporating a vascular history and physical examination in appropriately selected patients. Recognition of PAD is important both from the standpoint of addressing the ischemic risk to the limb and because PAD is associated with high cerebrovascular and cardiovascular risk. Therefore, multidisciplinary management of patients with PAD is essential. Extensive evidence supports treatment of PAD-related claudication with supervised exercise, and physical therapists are well positioned to play an important role in this treatment. J Orthop Sports Phys Ther 2017;47(12):957-964. Epub 9 Oct 2017. doi:10.2519/jospt.2017.7442.
PM&R, 2016
Physicians have difficulty predicting patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;am... more Physicians have difficulty predicting patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; occupational limitations, abilities, and success from clinical evaluation (CE) of pathology and impairments, especially in the presence of chronic pain. Additional information from a functional capacity evaluation (FCE) may improve the accuracy of their physical capacity assessments. It is not known whether FCE information will change these assessments. No such study has been published using Veterans or non-Veterans. To determine the influence of FCE data on the physician&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s assessment of the US Department of Labor&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Dictionary of Occupational Titles (DOT) work capacity levels of Veterans with chronic moderate-intensity pain. Retrospective analysis. Tertiary care medical center. Veterans aged 18-60 years with moderate chronic musculoskeletal pain who were seeking employment. Two kinesiotherapists performed FCEs on all participants, namely, the lumbar protocol of the EvalTech Functional Testing System (BTE, Inc, Hanover, MD). One physiatrist performed CEs in all participants. Two other physiatrists assessed DOT physical capacity levels using CE data alone and later using combined CE and FCE data. DOT physical capacity level (sedentary = 1, light = 2, medium = 3, heavy = 4, very heavy = 5). Of 55 charts reviewed, 27 met inclusion/exclusion criteria. The mean age was 38 years, and there were 25 male and 2 female participants. The predominant pain location was the lower back. DOT scores for 2 physicians were averaged. The mean ± SD DOT scores for CE only and CE+FCE conditions were 2.04 ± 0.33 and 2.40 ± 0.90, respectively. In all, 65% of DOT scores changed (17% decreased and 48% increased at least 1 level) after FCE data were considered. A 1-sample t test revealed that the mean CE+FCE DOT score was significantly greater than the mean CE-only score (by 20%, P = .02). Interrater agreement (weighted κ) for CE+FCE-based DOT scores was much higher than for CE alone (0.715 versus 0.182). The addition of FCE data to CE changed the majority of physician-assigned DOT levels. FCE significantly increased the mean DOT physical work capacity level provided by the physician to Veterans with chronic moderate-intensity pain, especially if the initial assessment was designated as &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;light.&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; FCE may facilitate a more objective and accurate determination of Veterans&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; work capacity. To be determined.
Adapted Physical Activity Quarterly, 1988
The purpose of this study was to compare quadriplegic and able-bodied men on selected cardiovascu... more The purpose of this study was to compare quadriplegic and able-bodied men on selected cardiovascular and metabolic responses to arm-crank ergometry at the same rate of oxygen consumption (V̇O2). Subjects included 11 untrained, spinal cord-injured, C5–C7 complete quadriplegic men and 11 untrained, able-bodied men of similar age (27 years), height (177 cm), and mass (65 kg). Measurement techniques included open-circuit spirometry, impedance cardiography, and electrocardiography. Compared with the able-bodied group, at the V̇O2 of 0.5 L/min, the quadriplegics displayed a significantly higher mean heart rate and arteriovenous O2 difference, lower stroke volume and cardiac output, and similar myocardial contractility. These results suggest that quadriplegic men achieve an exercise-induced V̇O2 of 0.5 L/min through different central cardiovascular adjustments than do able-bodied men. Quadriplegics deliver less O2 from the heart toward the tissues but extract more O2 from the blood. Tachyc...
Adapted Physical Activity Quarterly, 1988
This project assessed training behaviors and attributes of elite wheelchair racers. Training info... more This project assessed training behaviors and attributes of elite wheelchair racers. Training information was received from 36 participants in the 1985 National 10K Wheelchair Roadracing Championship. Data were obtained about age, weight, nature and level of disability, racing experience, sources of training information, level of cigarette and alcohol use, and dietary habits. Weekly training behaviors across yearly quarters were assessed with regard to the number of weekly pushing workouts, length of pushing workouts, number of miles pushed per week, percentage of training time allocated to interval training and/or speedwork, number of weekly weight-training sessions, and number of other augmentative physical activities pursued twice or more per week. Perceived exertion during interval and noninterval, steady-state training tasks was also measured. Results revealed that training behaviors of elite wheelchair racers are very heterogeneous. Participation in and age of introduction to e...
Arch Phys Med Rehabil, 2008
absent sensory nerve action potentials in lower limbs compared with upper limbs, with proximal sl... more absent sensory nerve action potentials in lower limbs compared with upper limbs, with proximal slowing, have been shown. These patterns may aid in early diagnosis. The pathophysiology will be discussed. Conclusions: POEMS syndrome is a differential diagnosis to be considered in mixed peripheral neuropathy, especially when it is coupled with plasma cell disorder. Recognizing this disease is essential to providing patients with appropriate rehabilitation management, as well as for prompt referral of these patients to specialists.
The Journal of Strength and Conditioning Research, Apr 30, 2000
Amer J Phys Med Rehabil, 2005