==================================HSR18================================== 18. I would like information on treatment planning/programming for physically disabled long term care patients. Physically disabled defined as those with neurogenic disorders, stroke victims, and spinal cord injured, head trauma victims. We want to design an ideal treatment program and physical environment to identify and meet medical, reha- bilitative, and psycho-social needs (also recreation needs) of facility residents 18-55 yrs. of age. Recent innovative equipment/assistive devices information would be helpful and guidelines for estimating costs of care/budgeting for a comprehensive program. 1 UI - 87116702 AU - Webb OJ ; Wells JE ; Hornblow AR TI - Institutions versus community placements: the effects of different residential environments on the behaviour of intellectually handicapped adults. AB - A major issue in the care of the intellectually handicapped is whether they should continue to be cared for in large institutions, or live in community homes. The community homes are presumed to provide more normal environments than institutions, and to therefore encourage residents to behave more normally than they would in institutions. This study used a measure of normalisation to compare three hospital and four community residences for the intellectually handicapped. It also measured changes in the behaviour of residents who moved from one environment to another. Results showed overlap in the level of normalisation of hospital and community units. Whether in the hospital or the community, the more normal environments had residents with higher levels of adaptive behaviour and mental functioning. The everyday behaviour of residents who moved to more normalised units generally remained unchanged but some adaptive skills and interactive behaviours declined. The existence of continued training programmes appeared more critical than the normalisation of the home in developing and maintaining residents' behaviour. MH - Adult ; *Behavior ; Comparative Study ; Deinstitutionalization ; *Halfway Houses ; Human ; Mental Retardation/*PSYCHOLOGY ; Middle Age ; New Zealand ; *Residential Facilities ; Support, Non-U.S. Gov't SO - NZ Med J 1986 Dec 10;99(815):951-4 2 UI - 87097442 AU - Krauss MW ; Seltzer MM TI - Comparison of elderly and adult mentally retarded persons in community and institutional settings. AB - Four hypotheses were tested to determine whether there are significant differences between elderly and adult mentally retarded persons living in institutional and community-based settings with respect to cognitive, medical, and functional impairments and service needs and utilization. The findings did not support the hypotheses that such differences exist, except with respect to service needs and utilization. The implications of these results for policy and program development were discussed. MH - Adult ; Age Factors ; Aged ; Aging/PSYCHOLOGY ; Comparative Study ; Female ; Health Services for the Aged ; Health Services Needs and Demand ; Human ; Institutionalization ; Male ; Massachusetts ; Mental Retardation/PSYCHOLOGY/*REHABILITATION ; Middle Age ; *Residential Facilities ; Support, U.S. Gov't, P.H.S. SO - Am J Ment Defic 1986 Nov;91(3):237-43 3 UI - 87056254 AU - Lesser R ; Bryan K ; Anderson J ; Hilton R TI - Involving relatives in aphasia therapy: an application of language enrichment therapy. AB - A programme of therapy for aphasia devised in Finland, Language Enrichment Therapy, was tested in an English version, particularly in respect of its co-operative use by speech therapists and the patients' relatives at home. Although a number of changes were recommended, the method was approved of by therapists and relatives. The majority of patients showed improvement, as assessed by the Western Aphasia Battery, over a period of less than three months with a regimen of one hour a week with the therapist supplemented by an average of five hours of help by a relative at home. These results should encourage the development of programmes such as Language Enrichment Therapy as an economic way of enabling speech therapists to use volunteer helpers. MH - Adult ; Aged ; Aphasia/*THERAPY ; *Family ; Female ; Human ; Language ; Male ; Middle Age ; Neuropsychological Tests ; Speech Therapy/*METHODS SO - Int J Rehabil Res 1986;9(3):259-67 4 UI - 87046263 AU - Neistadt ME TI - Occupational therapy treatment goals for adults with developmental disabilities. AB - This study examined whether occupational therapists were using treatment time to prepare adults with developmental disabilities for independent living opportunities. Eighty-eight occupational therapy evaluations for 54 adults with developmental disabilities in 18 different community agencies in the Boston area were reviewed to ascertain the focus of treatment goals that reflect treatment approaches. Results indicate that remedial goals significantly outnumbered adaptive ones. Within the adaptive goals, self-care and community living skills were equally represented, but some important community skill areas like advocacy, money management, personal care attendant management, sexuality, and transportation received little or no attention. Implications of these findings for therapists, clients, and third-party payers are discussed. MH - Activities of Daily Living ; Adolescence ; Adult ; Comparative Study ; Evaluation Studies ; Female ; *Handicapped ; Human ; Male ; Middle Age ; Occupational Therapy/*METHODS ; Patient Care Planning ; Self Care SO - Am J Occup Ther 1986 Oct;40(10):672-8 5 UI - 87015901 AU - Morris AF TI - A case study of a female ultramarathon wheelchair road user. AB - This unique report contains selected physical and structural characteristics of a female ultramarathon wheelchair road racer. When tested, this 25-year-old athlete weighed 65.6 kilograms, with a height of 171.4 centimetres. The resting heart rate was 57 beats per minute, which rose to a maximum of 161 during a progressive, arm-cranking, maximal work task. Maximum oxygen uptake was 21.0 ml X kg-1 X min-1. These values are significant, considering that this individual had traumatic paraplegia at the T-3/T-4 spinal level. She also had slight weakness of the upper extremities. It is suggested that with a graduated and intelligently structured training programme, greatly enhanced endurance capacity can be achieved. With the type of training outlined in this paper, an athlete who performs in a wheelchair can be conditioned to race successfully over distances of 26 to 50 miles. MH - Adult ; Case Report ; Female ; Heart Rate ; Human ; Paraplegia/ *PHYSIOPATHOLOGY ; Physical Endurance ; Physical Fitness ; Respiratory Function Tests ; *Sports ; *Wheelchairs SO - Paraplegia 1986 Aug;24(4):260-4 6 UI - 86255473 AU - Tyler RS ; Preece JP ; Lansing CR ; Otto SR ; Gantz BJ TI - Previous experience as a confounding factor in comparing cochlear-implant processing schemes. AB - It is of great importance to compare the relative merits of different cochlear-implant speech-processing strategies. Some groups have compared different strategies within single subjects, but usually the subject has prior experience with one strategy, and no allowance is made for this prior experience. We show in the present study that this is inappropriate. We tested one subject using the Melbourne (Cochlear Corp.) multichannel implant with the device set to process sounds in two different ways. In the first processing scheme, the device functioned normally, extracting information about voicing frequency, amplitude and second-formant frequency. This information activated the 21-channel device, determining pulse rate, pulse amplitude and electrode position (respectively). In the second processing scheme, a single electrode (with the largest dynamic range) was activated. This electrode coded overall amplitude and voicing frequency. The subject was tested on an audiovisual test of a 14-choice consonant recognition in the form /iCi/ over a period of over 4 months. During this time the subject used the 21-channel processor outside of the laboratory. Upon initial connection, there was little difference between the results obtained with the two schemes when tested in sound alone or in sound plus vision. However, after about 4 months, scores obtained with the 21-channel processor in sound plus vision were superior to the scores obtained with the one channel. This advantage came from a superiority in the features of voicing and nasality, but not place. Scores for sound-alone conditions between the two processing schemes remained similar for the 4-month period.(ABSTRACT TRUNCATED AT 250 WORDS) MH - Auditory Threshold ; Case Report ; Cochlear Implant/*STANDARDS ; Comparative Study ; Deafness/*THERAPY ; Female ; Human ; Meniere's Disease/COMPLICATIONS ; Middle Age ; Phonetics ; Prosthesis Design ; Set (Psychology) ; Speech Reception Threshold Test SO - J Speech Hear Res 1986 Jun;29(2):282-7 7 UI - 86314185 AU - Twist DJ ; Ma DM TI - Physical therapy management of the patient with post-polio syndrome. A case report. AB - This case report documents the treatment of a patient who experienced progressive muscle weakness and a decrease in function over time that did not appear to be related to any secondary neuromuscular disease. We discuss the relationship between age and maximal muscle function in addition to some general guidelines for rehabilitation. This type of patient can represent a challenge for the physical therapist. This case report, however, illustrates the degree of muscular and functional recovery that can result with a physical therapy program aimed at reducing levels and intensity of exercise, daily activity, and stress. Such a combination of short-term goals appears to be essential to the successful management of a patient with post-polio syndrome. MH - Adult ; Case Report ; Exertion ; Female ; Gait ; Human ; Locomotion ; Muscles/PHYSIOPATHOLOGY ; Neuromuscular Diseases/PHYSIOPATHOLOGY/*THERAPY ; Patient Education ; *Physical Therapy ; Poliomyelitis/*COMPLICATIONS ; Support, Non-U.S. Gov't ; Time Factors SO - Phys Ther 1986 Sep;66(9):1403-6 8 UI - 86305366 AU - Sandman PO ; Norberg A ; Adolfsson R ; Axelsson K ; Hedly V TI - Morning care of patients with Alzheimer-type dementia. A theoretical model based on direct observations. AB - Five hospitalized patients in different stages of Alzheimer-type dementia were monitored by unstructured, direct observations during morning care. Orem's model of nursing as a compensation for the patient's lack of self-care capabilities was used as a frame of reference for an analysis of the behaviours of patients and nurses during morning care. A 12-step classification system was developed to be used as a guide to understand and determine abilities essential for performance of morning care for demented patients. The quantitative assessment showed that none of the patients was able to manage morning care independently, but there was a wide variation in their highest level of performance. MH - Activities of Daily Living ; Aged ; Alzheimer's Disease/*NURSING/ PSYCHOLOGY ; Female ; Human ; Male ; Middle Age ; *Models, Theoretical ; Nursing Assessment ; Nursing Care ; *Self Care ; Support, Non-U.S. Gov't SO - J Adv Nurs 1986 Jul;11(4):369-78 9 UI - 86294966 AU - Gehlsen G ; Beekman K ; Assmann N ; Winant D ; Seidle M ; Carter A TI - Gait characteristics in multiple sclerosis: progressive changes and effects of exercise on parameters. AB - This study determines the characteristics of the multiple sclerosis gait, identifies the progressive gait changes associated with this degenerative disease, and determines the effects of an aquatic exercise program on gait parameters. Eleven patients with multiple sclerosis volunteered to participate and were filmed three times during a 10 week period with a Locam camera at 100 frames/s. During the testing period, subjects participated in an aquatic exercise program. In addition, they were rated according to the Kurtzke Scale for Evaluating Disability in Multiple Sclerosis. Results indicated that these patients with MS have shorter stride lengths, slower free speed walking rates, and higher cadence than do persons without MS. Knee and ankle joint rotation were characterized by lower than normal excursion with less vertical lift of the center of gravity and greater trunk lean than normal. Significant correlations between the Kurtzke Scale and gait parameters were indicated for step length and hip and ankle joint excursion. The aquatic exercise program appeared to have had no effect on the studied gait parameters. MH - Adult ; Ankle Joint/PHYSIOPATHOLOGY ; Exercise Therapy/*METHODS ; Female ; *Gait ; Gravitation ; Hip Joint/PHYSIOPATHOLOGY ; Human ; Knee Joint/ PHYSIOPATHOLOGY ; Male ; Middle Age ; Multiple Sclerosis/PHYSIOPATHOLOGY/ *REHABILITATION SO - Arch Phys Med Rehabil 1986 Aug;67(8):536-9 10 UI - 86283160 AU - Calculator SN ; Delaney D TI - Comparison of nonspeaking and speaking mentally retarded adults' clarification strategies. AB - Interactions between speaking and nonspeaking persons using communication boards have frequently been found to be plagued by conversational breakdowns. Previous investigators, drawing upon anecdotal evidence, have painted a scenario in which the nonspeaker confuses the listener by transmitting an ambiguous message, the listener then requests clarification, the nonspeaker fails to clarify, and the discourse is abruptly terminated. The present study examined 5 speaking and 5 nonspeaking moderately-severely mentally retarded subjects' responses to their listeners' requests for clarification. An informal conversational format was used to evoke 40 possible repairs from each subject. Few differences were noted with respect to the ways in which speaking and nonspeaking subjects revised or failed to revise their messages. Both groups were highly responsive to their listeners' requests for clarification; subjects rarely ignored or changed the topic of discourse following these listener requests. However, unlike previous reports of nonretarded normally developing language-disordered children operating at comparable mental and linguistic levels, these speaking and nonspeaking subjects generally repeated their ambiguous messages rather than revising them. The results indicated the need to develop techniques for teaching speaking and nonspeaking retarded adults alternate methods of repairing conversational breakdowns. MH - Adult ; *Communication Aids for Handicapped ; Comparative Study ; Female ; Human ; Male ; Mental Retardation/COMPLICATIONS/*PSYCHOLOGY ; Middle Age ; *Self-Help Devices ; Speech Disorders/ETIOLOGY/*REHABILITATION ; *Speech Intelligibility SO - J Speech Hear Disord 1986 Aug;51(3):252-9 11 UI - 86275226 AU - Cirillo S ; Sorrentino AM TI - Handicap and rehabilitation: two types of information upsetting family organization. AB - This article aims to show that the birth of a physically handicapped child should be regarded as powerful information, compelling the family to reorganize. The three subsystems most frequently challenged by the onset of a handicap are examined: the extended family, the couple, and the siblings. Further potent information involving the whole family arises in the rehabilitation program by placing demands on parents that may radically upset the existing equilibrium, and inevitably entailing a highly significant relationship with the child's therapists. Rehabilitation staff should be adequately trained to monitor the various phases during which family members adjust to both these types of information (handicap and rehabilitation) in order to ward off the development of dysfunctional games. A family therapy approach is appropriate in the all too many cases in which a rigid dysfunctional game has already set in such that the handicapped member is playing the role of identified patient. MH - Adolescence ; Case Report ; Child ; Child, Preschool ; *Family ; Family Therapy ; Female ; Handicapped/*PSYCHOLOGY ; Human ; Male ; Middle Age ; Models, Psychological ; Professional-Family Relations ; Rehabilitation/ *PSYCHOLOGY ; Sibling Relations SO - Fam Process 1986 Jun;25(2):283-92 12 UI - 86260155 AU - Wagner MB ; Vignos PJ Jr ; Fonow DC TI - Serial isokinetic evaluations used for a patient with scapuloperoneal muscular dystrophy. A case report. AB - This article reports the reversal of an atypical rapid decline in muscle strength experienced by a patient with scapuloperoneal muscular dystrophy by modulating his excessive daily physical activity. This process was aided by our monitoring the strength of the quadriceps femoris and hamstring muscles using an isokinetic dynamometer. Serial torque values for muscle strength were compared as the total daily physical activity was decreased systematically. The torque values for thigh muscle strength increased as the subject's total work load was decreased. A complete management program for neuromuscular patients should include specified amounts of daily physical activity, rest, and therapeutic exercise. MH - Adult ; Case Report ; Exertion ; Human ; Male ; Monitoring, Physiologic/ *INSTRUMENTATION ; Muscles/*PHYSIOPATHOLOGY ; Muscular Dystrophy/ PHYSIOPATHOLOGY/*REHABILITATION ; *Physical Therapy ; Support, Non-U.S. Gov't SO - Phys Ther 1986 Jul;66(7):1110-3 13 UI - 86241375 AU - Naeser MA ; Haas G ; Mazurski P ; Laughlin S TI - Sentence level auditory comprehension treatment program for aphasic adults. AB - The purpose of this study was to investigate whether a newly developed sentence level auditory comprehension (SLAC) treatment program could be used to improve language comprehension test scores in adults with chronic aphasia. Results indicate that the SLAC treatment program can be used with chronic patients; performance on a standardized test (the Token Test) was improved after treatment; and improved performance could not be predicted from either anatomic CT scan lesion sites or pretreatment test scores. One advantage to the SLAC treatment program is that the patient can practice listening independently with a tape recorder device (Language Master) and earphones either in the hospital or at home. MH - Aphasia/DIAGNOSIS/RADIOGRAPHY/*THERAPY ; Aphasia, Acquired/THERAPY ; Aphasia, Broca/RADIOGRAPHY/THERAPY ; Aphasia, Wernicke/RADIOGRAPHY/ THERAPY ; Brain/RADIOGRAPHY ; Comparative Study ; Female ; Human ; Language Therapy/*METHODS ; Male ; Middle Age ; Neuropsychological Tests ; Support, U.S. Gov't, Non-P.H.S. ; Support, U.S. Gov't, P.H.S. ; Tape Recording ; Tomography, X-Ray Computed SO - Arch Phys Med Rehabil 1986 Jun;67(6):393-9 14 UI - 86239395 AU - Silverman WP ; Silver EJ ; Sersen EA ; Lubin RA ; Schwartz AA TI - Factors related to adaptive behavior changes among profoundly mentally retarded, physically disabled persons. AB - Changes in adaptive competence over a 1-year period of profoundly mentally retarded, physically disabled persons living in a moderately sized residential facility or in small community programs were examined. No evidence was found to indicate that habilitative growth was greater for residents in the small community programs. Indeed, residents of the moderately sized facility showed evidence of skill acquisition whereas community residents declined slightly in adaptive skill. Within community programs, presence of a relevant goal was positively related to change in independent living skills, and clients with musculoskeletal impairments tended to regress in motor and eating skills. These data suggest that client characteristics and habilitative program content are significant predictors of client growth, and size of the residence is probably not as important for delivery of effective services. MH - *Activities of Daily Living ; Adult ; Environment ; Feeding Behavior ; Female ; Goals ; Handicapped ; Hospitals, Special ; Human ; Intermediate Care Facilities ; Male ; Mental Retardation/*REHABILITATION ; Motor Skills ; *Residential Facilities ; Support, Non-U.S. Gov't SO - Am J Ment Defic 1986 May;90(6):651-8 15 UI - 86233724 AU - Bohannon RW ; Jones PL TI - Results of manual resistance exercise on a manifesting carrier of Duchenne muscular dystrophy. A case report. AB - This case report is about a manifesting carrier of Duchenne muscular dystrophy who participated in a program of maximal concentric-eccentric manual resistance exercise three days each week for 12 weeks. As a consequence, she achieved mean strength increases exceeding 28% bilaterally. She also ceased falling, which she had been experiencing several times a month before beginning the exercise program. MH - Case Report ; *Exercise Therapy ; Female ; Heterozygote ; Human ; Middle Age ; Muscle Contraction ; Muscular Dystrophy/*FAMILIAL & GENETIC/ PHYSIOPATHOLOGY/REHABILITATION ; Time Factors SO - Phys Ther 1986 Jun;66(6):973-5 16 UI - 86231931 AU - Kouyoumdjian JH ; Chalian VA ; Hutton C TI - An intraoral positive-pressure device for treatment of trismus. AB - Trismus is a challenging clinical problem that may result from several different causes. The dentist may choose from a wide spectrum of treatment modalities, depending on the severity of the individual case and the health and cooperation of the patient. An individual course of treatment must be planned for each patient. It is important to monitor the treatment closely for effectiveness of the therapy and to ensure the patient's compliance. Treatment should be modified as necessary, according to the patient's progress. We have described an intraoral dynamic device that may be used as part of a treatment program and that enhances patient compliance as compared to traditional extraoral devices. MH - Case Report ; Equipment Design ; Human ; Male ; Middle Age ; Physical Therapy/*INSTRUMENTATION ; Pressure ; Trismus/*THERAPY SO - Oral Surg Oral Med Oral Pathol 1986 May;61(5):456-8 17 UI - 86223592 AU - Williams GE ; Cuvo AJ TI - Training apartment upkeep skills to rehabilitation clients: a comparison of task analytic strategies. AB - The research was designed to validate procedures to teach apartment upkeep skills to severely handicapped clients with various categorical disabilities. Methodological features of this research included performance comparisons between general and specific task analyses, effect of an impasse correction baseline procedure, social validation of training goals, natural environment assessments and contingencies, as well as long-term follow-up. Subjects were taught to perform upkeep responses on their air conditioner-heating unit, electric range, refrigerator, and electrical appliances within the context of a multiple-probe across subjects experimental design. The results showed acquisition, long-term maintenance, and generalization of the upkeep skills to a nontraining apartment. General task analyses were recommended for assessment and specific task analyses for training. The impasse correction procedure generally did not produce acquisition. MH - *Activities of Daily Living ; Adult ; Education of Mentally Retarded ; Female ; Follow-Up Studies ; Generalization (Psychology) ; Human ; Imitative Behavior ; Male ; Mental Retardation/*REHABILITATION ; *Social Adjustment ; Support, U.S. Gov't, Non-P.H.S. SO - J Appl Behav Anal 1986 Spring;19(1):39-51 18 UI - 86232092 AU - Banfai P ; Karczag A ; Kubik S ; L:uers P ; S:urth W TI - Extracochlear sixteen-channel electrode system. AB - This article summarizes 10 years of work by the Cologne-D:uren Research Group. The purpose of our research was to develop a noninvasive operation technique and to avoid opening the inner ear cavities (extracochlear technique). On the basis of empiric experience, a 16-channel electrode system was developed. The electrodes were fixed on a "hedgehog: contact plate with an arrangement corresponding to the projection of the cochlea. A microprocessor, which enables individual programmability in the different groups of deaf persons (prelingual, postlingual deafness), was integrated into the speech processor. Experience to date was summarized in statistical data. Not only the results of the psychoacoustic tests, but also the applicability of the cochlear implant as seen by the patients were considered. We next plan to miniaturize the system. MH - Acoustic Nerve/PHYSIOPATHOLOGY ; Adolescence ; Adult ; Audiometry, Evoked Response ; Auditory Threshold ; Child ; Child, Preschool ; Cochlea/ ANATOMY & HISTOLOGY ; *Cochlear Implant ; Deafness/DIAGNOSIS/ *REHABILITATION ; Electrodes, Implanted ; Evoked Potentials, Auditory ; Hearing Aids ; Human ; Middle Age ; Prosthesis Design ; Psychoacoustics ; Speech Discrimination Tests ; Support, Non-U.S. Gov't SO - Otolaryngol Clin North Am 1986 May;19(2):371-408 19 UI - 86232090 AU - Clark GM TI - The University of Melbourne/Cochlear Corporation (Nucleus) program. AB - The Nucleus multichannel cochlear prosthesis has been implanted in over 100 patients. Speech discrimination improved greatly in most patients. Overall, the results with this type of implant are very satisfactory. MH - Adolescence ; Adult ; Aged ; Animal ; Australia ; Biocompatible Materials ; Cats ; Clinical Trials ; Cochlea/INJURIES ; *Cochlear Implant/ADVERSE EFFECTS ; Deafness/DIAGNOSIS/*REHABILITATION ; Equipment Safety ; Human ; Labyrinth Diseases/ETIOLOGY ; Middle Age ; Otitis Media/ETIOLOGY ; Postoperative Care ; Postoperative Complications/ETIOLOGY ; Prosthesis Design ; Risk ; Speech Discrimination Tests ; Speech Perception ; Staphylococcal Infections/ETIOLOGY SO - Otolaryngol Clin North Am 1986 May;19(2):329-54 20 UI - 86232087 AU - Schindler RA ; Kessler DK ; Rebscher SJ ; Yanda J TI - The University of California, San Francisco/Storz cochlear implant program. AB - Using a four-channel implant system with a vocoder-based processor developed at UCSF over an extensive period of research, clinical trials of the UCSF/Storz device were initiated in February 1985 under the sponsorship of Storz Instrument Company. To date, 13 patients have been implanted with the UCSF/Storz device, 10 of whom have been fitted with their external processor and transmitter and have received at least their initial postoperative evaluations. Of these 10 patients, nine are able to use all four channels of their implant system. The device fitting/adjusting process for these patients has been remarkably easy, requiring only approximately 30 to 60 minutes. Patient results have been extremely good, with eight of the 10 patients obtaining some open-set auditory only speech understanding. Without extensive rehabilitation and training, most patients have demonstrated an improvement in speech reception over time. Lip-reading and tracking results indicate that all patients have attained an enhancement of lip-reading ability with the use of the device, suggesting that improved general communication skills have been provided for each UCSF/Storz patient. MH - Adult ; Aged ; Biocompatible Materials ; California ; Clinical Trials ; Cochlea/INJURIES ; *Cochlear Implant ; Comparative Study ; Deafness/ *REHABILITATION ; Electrodes, Implanted ; Female ; Human ; Lipreading ; Male ; Middle Age ; Postoperative Care ; Postoperative Complications/ ETIOLOGY ; Prosthesis Design ; Silicone Elastomers ; Speech Discrimination Tests ; Speech Perception SO - Otolaryngol Clin North Am 1986 May;19(2):287-305 21 UI - 86232086 AU - House WF ; Berliner KI TI - Safety and efficacy of the House/3M cochlear implant in profoundly deaf adults. AB - The House/3M cochlear implant system is no longer considered investigational. Many years of clinical experience led to development of a clinically feasible program for selecting patients, fitting the device, training patients in its use, and evaluating results. Both laboratory and clinical data support the conclusion that this device is safe and provides significant benefits for profoundly deaf adults. The House/3M cochlear implant has had a significant impact in the treatment of the profoundly deaf, even while in the investigational stage. First and foremost, patients who were previously turned away as "untreatable: were provided with a new option. Furthermore, the professionals--otologists and audiologists--had a new set of tools, including assessment and rehabilitation materials, to use in dealing with the profoundly deaf patient. These patients can now be provided more effective care whether they obtain an implant or a hearing aid. Finally, the introduction of this device stimulated the development of better devices, better assessment tools, and other alternatives. The future calls for device improvements, objective methods for selection of candidates, and expansion of the application of electrical stimulation of hearing to children, to patients with more residual hearing, and to those who require a central electroauditory prosthesis for stimulation in the brain stem. Cochlear implants are rapidly becoming a part of clinical otology and audiology. It is important that accurate information be disseminated among these professionals, that professional training programs teach their students about this area, and that other professionals, such as educators of the deaf, speech/language pathologists, and psychologists who deal with the hearing impaired, become knowledgeable in dealing effectively with the implanted child or adult. MH - Adult ; Auditory Perception ; *Cochlear Implant/ADVERSE EFFECTS ; Deafness/*REHABILITATION ; Equipment Safety ; Follow-Up Studies ; Human ; Postoperative Complications/ETIOLOGY ; Prosthesis Design ; Questionnaires ; Speech Perception ; Tinnitus/ETIOLOGY ; Vestibular Apparatus/ PHYSIOPATHOLOGY SO - Otolaryngol Clin North Am 1986 May;19(2):275-86 22 UI - 86232138 AU - Taylor AW ; McDonell E ; Brassard L TI - The effects of an arm ergometer training programme on wheelchair subjects. AB - The purpose of the present investigation was to study the effects of an arm ergometer training programme on several physiological variables of recreational wheelchair subjects. Ten paraplegics (5 experimental, 5 control) were tested prior to and immediately after a 2 month exercise regimen at 80% of peak heart rate (30 min per day, 5 days per week, for 8 consecutive weeks at 50 rev/min). The results demonstrated significant increases (P less than 0.05) in VO2max (1 min-1 & ml kg-1 min-1) and workload but only mild improvements in maximal heart rate and post exercise blood lactates. Body fat, vital capacity and forced expiratory volume did not change with training. Triceps lateralis fibre distribution and fast twitch (FT) fibre area were unaffected by the endurance training programme. However, slow twitch (ST) fibre area increased (P less than 0.05) with training. The results indicate that physiological variables of paraplegic subjects following an arm ergometer endurance training programme react similarly to changes previously observed in non-handicapped subjects. The values when compared with normals are low as a result of the relative inactivity of the subjects due to the lack of available exercise programmes for wheelchair people. MH - Adolescence ; Adult ; Arm ; Biopsy ; Human ; Male ; Middle Age ; Muscle Contraction ; Muscles/PATHOLOGY ; Paraplegia/*REHABILITATION ; Physical Education and Training/*METHODS ; Spinal Cord Injuries/*REHABILITATION ; Support, Non-U.S. Gov't ; *Wheelchairs SO - Paraplegia 1986 Apr;24(2):105-14 23 UI - 86206233 AU - Glasser L TI - Effects of isokinetic training on the rate of movement during ambulation in hemiparetic patients. AB - The purpose of this study was to determine the effects of isokinetic training on the rate of movement during ambulation in hemiparetic patients. Ten male and 10 female subjects, aged 40 to 75 years, participated in the study. The 20 hemiparetic subjects were assigned randomly to either a control group or an experimental group. All of the subjects participated in a conventional therapeutic exercise program and gait training. The experimental group also received isokinetic training on the Kinetron exercise machine as part of their program. Functional ambulation profile tests were administered to each subject before and after the five-week experimental period. All of the subjects showed improvement in the rate of ambulation and in overall ambulation performance. The differences in ambulation times and functional ambulation profile scores between the two groups were shown to be insignificant. MH - Adult ; Aged ; Analysis of Variance ; Evaluation Studies ; Exercise Therapy/*METHODS ; Female ; *Gait ; Hemiplegia/*REHABILITATION ; Human ; Male ; Middle Age ; Physical Therapy ; Random Allocation SO - Phys Ther 1986 May;66(5):673-6 24 UI - 86201633 AU - Samar VJ ; Metz DE ; Sacco PR TI - Changes in aerodynamic characteristics of stutterers' fluent speech associated with therapy. AB - Stuttering frequency and four aerodynamic measures of articulatory events within perceptually fluent voiced and voiceless intervocalic intervals were obtained from 15 stutterers prior to and at the termination of a concentrated program of stuttering therapy. Three of the four aerodynamic variables showed group changes over the course of therapy concomitant with improvements in fluency. Additional correlational analyses suggested that one of the aerodynamic variables was specifically related to stuttering frequency. It is argued that both fluency enhancing and ancillary components of therapy operate to influence the intervocalic interval. MH - Adult ; Female ; Human ; Male ; Respiration ; Speech Articulation Tests ; *Speech Therapy ; Stuttering/*PHYSIOPATHOLOGY/THERAPY ; Support, Non-U.S. Gov't SO - J Speech Hear Res 1986 Mar;29(1):106-13 25 UI - 86192291 AU - Fraser RT ; Clemmons DC ; Dodrill CB ; Trejo WR ; Freelove C TI - The difficult-to-employ in epilepsy rehabilitation: predictions of response to an intensive intervention. AB - In this prospective study, 46 adult seizure outpatients with suspected brain impairment were referred for vocational services at the University of Washington Regional Epilepsy Center and counseled for job placement. Among the demographic, intellectual, neuropsychological, and psychosocial variables considered, the Wechsler Adult Intelligence Scale (WAIS) Digit Symbol subtest and the name-writing procedure from the neuropsychological battery by Dodrill (1978) were the best discriminators of later employability. Using discriminant function analysis, these two tests correctly classified 75.0% of the group which ultimately became employed (n = 22) and 73.9% of the group which did not attain employment (n = 26). Implications of these findings are discussed in relation to rehabilitation planning. MH - Adolescence ; Adult ; Employment ; Epilepsy/*PSYCHOLOGY/REHABILITATION ; Female ; Human ; Male ; Psychological Tests ; *Rehabilitation, Vocational ; Support, U.S. Gov't, Non-P.H.S. ; Support, U.S. Gov't, P.H.S. SO - Epilepsia 1986 May-Jun;27(3):220-4 26 UI - 86186086 AU - Thyberg M ; Johansen PB TI - Prosthetic rehabilitation in unilateral high above-elbow amputation and brachial plexus lesion: case report. AB - Rehabilitation in persons with high above-elbow amputation presents a considerable prosthetic problem, especially in those who also have brachial plexus lesion. A case is reported of a patient having left above-elbow amputation and left brachial plexus lesion who was successfully fitted with a hybrid prosthesis with a myoelectric hand. MH - Accidents, Traffic ; Activities of Daily Living ; Adult ; Amputation, Traumatic/*REHABILITATION ; *Artificial Limbs ; Brachial Plexus/INJURIES ; Case Report ; Elbow/*INJURIES ; Electromyography ; Follow-Up Studies ; Human ; Male ; Patient Care Team SO - Arch Phys Med Rehabil 1986 Apr;67(4):260-2 27 UI - 86158201 AU - Cardenas DD ; Larson J ; Egan KJ TI - Hysterical paralysis in the upper extremity of chronic pain patients. AB - The patient with chronic pain who develops the conversion symptom of hysterical paralysis in the upper extremity can be treated successfully by rehabilitation medicine services, using a shaping behavioral program. Four case reports illustrate the management of this condition and the basic ingredients for such a program are outlined. The approach is based upon learning principles and experience with conversion reactions affecting gait. Treatment outcome often is related directly to the care and skill with which psychological assessment is performed and to the coordinated effort of the various team members. MH - Adult ; Case Report ; Chronic Disease ; Conversion Disorder/*PSYCHOLOGY/ REHABILITATION ; Female ; Human ; Male ; *Occupational Therapy ; Pain/ *PSYCHOLOGY ; Paralysis/*PSYCHOLOGY/REHABILITATION ; *Physical Therapy ; Support, U.S. Gov't, Non-P.H.S. SO - Arch Phys Med Rehabil 1986 Mar;67(3):190-3 28 UI - 86102573 AU - Yarkony GM ; Jones R ; Hedman G ; O'Donnell A TI - Jones-Hedman walker modification for C7 quadriplegic patient: case study in team cooperation. AB - A 20-year-old man with C7 quadriplegia was admitted to a tertiary care rehabilitation facility 1.5 months after discharge from an acute care community hospital. The patient's goals were to improve his skills in activities of daily living to a level of maximum independence, and to walk. Although his high level of spinal cord injury made ambulation unlikely, an occupational therapist and a rehabilitation engineer, working together, devised a method to help the patient meet his ambulation goal. They modified an ordinary walker by fabricating polyvinyl chloride-acrylic alloy guards lined with foam to reduce palmar pressure. The patient was then able to use wrist and finger extension during walker advancement and was able to ambulate 300m with Craig-Scott orthosis. The case illustrates the importance of a skilled interdisciplinary team in a specialized center for management of spinal cord injured patients. MH - Adult ; Case Report ; Cooperative Behavior ; Equipment Design ; Human ; Male ; *Orthopedic Equipment ; Orthotic Devices ; *Patient Care Team ; Quadriplegia/*REHABILITATION ; *Walkers SO - Arch Phys Med Rehabil 1986 Jan;67(1):54-5