Rehabilitation Medicine

Rehabilitation Medicine

  • John Michael Linacre added an answer:
    How do I convert raw FIM scores from a sample of patients from their ordinal scale to an interval scale?

     I am looking to convert raw FIM scores from a sample of patients from their ordinal scale to an interval scale so that I can use summary indices that are currently used in the rehab literature.

    A recent paper ( suggests that when using these indices, the raw data should be first transformed to an equal interval scale via Rasch analysis before applying any of the measures designed to assess rehab efficacy using the FIM, due to the fact that their is no way to quantify that one patient's score (e.g. a 5 on UE dressing) is the same as another patient's score of 5 on the same measure, due to inherent patient differences.

    I was hoping that there was a method someone may know of that could be used to easily accomplish this score transformation for someone with limited knowledge of Rasch analysis and Item Response theory as it pertains to the FIM.

    John Michael Linacre ·

    R.S. writes "you can really only assume that you have an interval scale." In fact, Rasch scales are forced to be interval by their mathematics. (Similarly the distribution of theta parameters for the 2-PL model is forced to be normal.) The extent to which inferences based on Rasch measures are valid for your data depends on the fit of your data to the Rasch model. (Similarly the extent to which inferences based on the 2-PL model are valid for your actual person distribution depends on the fit of your actual person distribution to a normal distribution.)

  • Amit Bansal added an answer:
    What is your experience of blood flow restriction training and lower limb rehabilitation?

    In terms of efficacy, %1RM and volume

    Here's a link to a relevant and interesting blog post. Looking forward!

  • Fidelis Terhemen Iyor added an answer:
    What validated outcome measure or questionnaire could be used to assess the quality of life in the general population?
    I am trying to start a prospective study in a medical exercise facility, which provides pro-active solutions for general health (fitness level, weight management, injury prevention, back pain and sport injury rehab). I am already using basic health screen tools, such as Funcional Movement Sceen (FMS), body composition analysis (Tanita scale) and Astrand Test for VO2 max estimate, but I need a questionnaire to complete this package. Any suggestions?
    Fidelis Terhemen Iyor · Benue State University Teaching Hospital, Makurdi

    WHOQOL- bref is the answer

  • Muzammil A. Nahaboo Solim added an answer:
    Can anyone help with treatment for Dermatomyositis?
    I have a patient who has dermatomyositis for the last four years. She is on steroids since then, but has lot of side effects. She has tried alternative medicine too but there was no change. Whenever her rheumatologist tries to reduce her dose of steriods, her CPK levels increase and she has to increase the dose again. She has developed lot of severe tightness in her calves and has difficulty walking too. Shes thinking of looking into stem cell therapy too. I am giving her physical therapy for her calf and also general flexibility. What else could help?
  • Sandra Holowaty added an answer:
    What is your experience on the effectiveness of Memantine on someone with a MMSE of 10 to 20? Is it effective for BPSD?

    Is Memantine a suitable drug for those with lower MMSE scores?

    Sandra Holowaty · Alberta Health Services

    That is great information! It does help!  will definitely take a look at your paper. Thanks you! 

  • Corey Mcgee added an answer:
    Is there any research that describes the prevention and management of hemiplegic shoulder pain in stroke patient?

    best modality, technique and approach

    Corey Mcgee · University of Minnesota Twin Cities

    Consider the protocol offered by Kondo et al (2001). This focuses on prevention of the the development of hand-shoulder syndrome.

  • Harvey Roy Anderson added an answer:
    Does anyone know of any studies demonstarting a relationship between foot pronation and muscular activity in the extensor chain?

    Does anyone know of any studies demonstarting a relationship between foot pronation and muscular activity in the extensor chain?

    I'm particularly interested in the effect of pronation (or not) on gluteal activation in simple tasks.

    can anyone help please?

    Harvey Roy Anderson · Sheffield Hallam University

    Thank you very much Oliver Ludwig!

    I shall read through these over the weekend.

    Yes, I'm looking at a number of studes about the relationship between the biomechanics of the foot and its influence on the rest of the body

  • Claudio Gil Araujo added an answer:
    Which are the most used and recommeded assessments of mobility in geriatric patients?
    In order to measure dependability in mobility for elderly patients being cared for in community homes or in hospital, which assessments should be used?
    Claudio Gil Araujo · Federal University of Rio de Janeiro

    Hi you may also consider to use the sitting rising test that was developed in our lab.  The is a video explaining it at YouTube.  The srt scores had been shown to be a good psychotropic of all cause mortality for those aged 51 to 80 years old. This study was published in the European journal of preventive  cardiology.  

  • Gary B Wilkerson added an answer:
    Can decreased concentric knee flexor time to peak torque reduce the likelihood of lower extremity injuries?

    Can anybody tell me, if time to peak torque in the hamstrings is reduced in a concentric contraction, could it possibly reduce the likelihood of lower extremity injury? I'm aware that the functional (eccentric) aspect has been recently highlighted using isokinetic dynamometry but am interested in the concentric movement. Appreciate any help on this! Thanks  

    Gary B Wilkerson · University of Tennessee at Chattanooga

    Theoretically, the answer is yes. However, I don't know of any evidence that has directly linked the speed of hamstrings tension development to ACL injury incidence. The concentric hamstrings to concentric quadriceps peak torque ratio is believed to be an important indicator of the ability to co-contract the antagonist muscle groups, which is necessary for dynamic knee joint stability. We have demonstrated that this ratio is improved by plyometric training of female college basketball players. Although the attached 2004 report did not include "time to peak torque" data, we have observed faster peak torque development in the hamstrings as strength improves. Some experts emphasize the importance of eccentric hamstrings strength for protection of the ACL, but jump landing requires the quadriceps to eccentrically dissipate ground reaction force (while the knee is flexing). Logically, any hamstrings tension that is simultaneously generated at the knee must be concentric.

  • Matthew S Tenan added an answer:
    Is it allowed to include a time point with a SD of 0 in my RM-ANOVA?

    I am running a repeated measures ANOVA in which I compare 5 time points - 1 before intervention and 4 after. The score of all time points is normalised to the time point before the intervention so that the values basically indicate a change WRT to before the intervention. Now I am not a 100% sure if I then violate any of the ANOVA assumptions if I include the time point before the intervention in the ANOVA as it effectively has a mean of 1 and SD of 0, but in which case I can use the main factor time to find an effect of the intervention. Personally I think this is wrong, but I'd like to know what others think as I have seen it done in several articles. Thanks, mark.

    Matthew S Tenan · Army Research Laboratory

    Hi Mark,

    You've already received a number of good answers.  Your intuition is correct.  I would choose to either do a repeated-measures ANOVA (a random subject-level effects ANOVA if you want to get fancy and have the expertise) with the 'raw' measure for all time points or do the 'normalised' (I would call them delta-scores or change scores) data without the first time point. 

    I hope everyone's input it helpful!


  • Taco Johan Blokhuis added an answer:
    Can anyone recommend some pressure insoles for gait analysis in adults?
    I need wireless pressure insoles for a study of gait disorders on elders.
    Taco Johan Blokhuis · University Medical Center Utrecht

    Are you still looking for a solution ? We may have a suitable option for you: as a trauma surgeon I am involved in the development of a new amublant device. Please e-mail me for further information,

    kind regards

    Taco Blokhuis

  • Debra Knight added an answer:
    Are mild TBI pediatric patients usually tested with head-shaking at 1-2 weeks as standard practice?
    If one can perform 'Head-Shake Test' (HST) to examine Vestibular deficit after a child has suffered concussion, specially during the acute stage (1 week post injury)? Will there be any risks involved? I suppose child can feel dizzy due to the repetitive head shake but again it is REQUIRED to shake the head to stimulate the vestibular canals. Need suggestions.

    Debra Knight · University of Detroit Mercy

    Studies have shown that the 1st 7-10 days is the period of greatest risk for incurring a second concussion.  In mild TBI there is cellular damage as well as micro-structural damage, and it is imperative that we keep external forces to the brain at a minimum to allow healing.  Studies are showing that the younger children require longer time to recover and we need to be conservative with our return to sports and recreational activity that has the potential to cause re-injury.  Best NOT TO SHAKE THE HEAD!!

  • Robert Firth added an answer:
    Do you know any article where they compare the subacromial syndrome treatment through a trigger points treatment with other conventional treatments?

    Normally the pain only improve with a trigger points treatment.

    Robert Firth · BPP University College

    This may be of use, I'm sure you have come across it but if not, here you go

  • W David Carr added an answer:
    Can anybosy suggest ACL protocol guidelines for rehabilitation for better recovery?

    can any one help me . with recent articles on acl rehabilitation for clinical  practitioner rule

    W David Carr · Missouri State University

    Have you tried this site?

  • Vasanth Kumar added an answer:
    Which is the Effectiveness of MET In Preventing LBA ?

    Any One working On MET In specific for LBA

    Vasanth Kumar · Sri Ramachandra University

    with the involvement of hamstrings tightness, MET works brilliant to ease the muscle. however with added soft tissue releases on the antagonists will have a good beneficial effect. 

  • Jesse Jutkowitz added an answer:
    For chronic plantar fasciitis: let`s describe the risk factors (causes) and link to interventions?

    The major problem on this issue is that "plantar fasciitis" has multifactorial causes and risk factors. The interventions are (or must be) related to those. Suggestion to answers:

    Cause or risk factor: NEURAL (article by Alshami et al. A review of plantar heel pain of neural origin: Differential diagnosis and management. Manual Therapy 13 (2008) 103–111)

    Cause or risk factor: Delayed pronation... and go on

    Jesse Jutkowitz · Institute for Advanced BioStructural Correction

    PF as Brian notes above is usually more about entire body mechanics rather than the local pathology.  Using the Advanced BioStructural Correction™ protocol people worldwide report clearing of long standing PF within a two week period.

    Pertinent site

  • Taher Jarafa added an answer:
    Does anyone have an experience using isokinetic exercise for low back pain?

    I have not got various researches that have been written in English, so could anyone give me a hand?

    Taher Jarafa · Oxford Brookes University

    abstract refers to an optimistic research,it was really helpful


  • Mohsen Javidi added an answer:
    What is the most important muscle to resistance exercise in rats?

    In the context of ladder training.

    Mohsen Javidi · Shahid Beheshti University

    thank you very much.I think i got the answer.

  • Sirbu Elena added an answer:
    Can anyone help me with a questionnaire for the investigation of low back problems in adolescents?
    I need this questionnaire for investigate the low back pain in adolescents. Please send me suggestions for a reliable questionnaire.
    Sirbu Elena · West University of Timisoara

    Thank you!

  • Thirumugam M added an answer:
    Which standard tool can I use to assess the quality of life of children with disability due to leprosy (peripheral neuropathy)?
    Leprosy is a chronic infectious disease which affects skin and nerve. It is the nerve damage that sets this disease apart from other conditions. When nerve damage is not detected early enough it may lead to permanent damage, as a result deformities (claw hand, ape thumb, foot-drop etc) and sensory loss. When not cared properly these primary impairments can lead to secondary impairments like contracture, wounds etc.. There is no tool I could find the problem faced by children with disability. Can you help me in getting the right to tool to assess the activity and participation level of a children with disability due to leprosy...
    Thirumugam M · German Leprosy & Tb Relief Association

    You may modify the FIM (Functional Independence Measure) scale/FISH (Functional Independence Score in Hemophilia) for activity assessment.

  • Paul B Gerrard added an answer:
    Does anyone know where to find conversion formulas to convert SF12v1 answers to SF12v2?

    In the SF12v1, four items are 2-level.

    In de SF12v2, those items are 5-level.

    I would like to know how I can convert the answers on the SF12v1 to the SF12v2.

    Paul B Gerrard · New England Rehabilitation Hospital of Portland

    To be frank, I don't think there is a good way to do what you want to do. Here are a couple of options to convert SFv2 to SFv1 (the opposite conversion).

    1. If you can find a study that does some type of item response theory or Rasch analysis on both v1 and v2, you can use the thresholds for the 5 level items and the 2 level items to condense the 5 level items to 2 levels.

    2. If you cannot find this, then you can simply condense 5 levels to 2 levels using pre-specified rules. You can either make these rules up a-priori or you can do some preliminary analysis on the data to see if there are some natural splits in the data (some IRT). This may not a great way to do things, but sometimes you have to do things that aren't great and accept it as a limitation of your study.

  • Dilek Şura Özden added an answer:
    Can anyone suggest any papers on the use of dynamic ultrasound to determine the effect of kinesiology tape on soft tissue?
    We recently acquired a dyanamic ultrasound machine and are performing some preliminary assessments of soft tissue changes using yoga tune up balls and kinesiology tape. I'm looking for literature to help inform study design.
    Dilek Şura Özden · Hacettepe University

    Dear  Francisco García-Muro San José, paper you shared said that ultrasonic imaging can help muscle to improve its theraphy, am I wrong? I am quite interested in this technique to use as a theraphy, if it is possible, I need to get more information then, many thanks for now

  • Mark Scheper added an answer:
    Does anyone know of an established Hand-Myomometry Micro-Fet Placement for testing the posterior head of gluteus medius in a side lying position?

    I am looking for an established micro-fet apparatus placement on the lower extremity during a hip abduction test in side-lie position. I've seen several different methods (a certain number of centimeters vs. a percentage of the leg length). 

    Does anyone have a method that they use that is easy and consistent? 

    Great Thanks! 

    Heidi Moyer, SPT

    Mark Scheper · Academic Medical Center (AMC)


    I wouldnt know if there is a real specific best way of assessing that specific muscle function. You could try at looking at the website of CITEC. That a simular device which has a open sourche manual with testing positions.

    If not than i would suggest that you use the percentage method above the exact inches protocol. This accounts for anatomic variation. I use this a lot in my research.

    Good luck

  • Karl Bechter added an answer:
    How would you distinguish Central Sensitization of pain (CS) from Complex Regional Pain Syndrome (CRPS) for injury-induced pain?

    Both appear to involve allodynia, hyperalgesia. Do they both also involve reduced threshold for pain, peripheral and central hyperexcitability, recruitment of other sensory motor pathways, convergence and increased brain receptive field size for pain? What clinical features would you use to distinguish them diagnostically?

    I am writing up a case report of manual therapy for what appears to be centrally sensitized pain and wonder if I can cite relevant literature from both topics? I am seeking to develop a hypothesis of the mechanism, since I do not find research on similar treatments.

    I realize CS also includes whole body pain, such as from fibromyalgia, osteoarthritis, and pain not associated with peripheral injury such as migraine. I am specifically referring to injury-induced pain.

    Thank you for clarification and any suggestions!

    Karl Bechter · Universität Ulm

    Differentiating central from peripheral pain seems to me often impossible because both is most frequently present, although it has been proven, that exclusive central pain can be elicited. The anatomical distribution of symptoms in fibromyalgia syndromes and in neuroinflammation may be explained on the one hand by the nerves and neuronal connectivity, but an intriguing idea according to my opinion is an own hypothesis from unexpected observations in severe depression and chronic pain syndrome treated with CSF filtration: pain and depression disappeared within days, before being chronic for long time (catamnesis of 15 years now in one case). This suggested that CSF itself is signaling. The CSF outflow pathways demonstrated a distribution all over brain and spinal nerves and therefore the appearance can involve the whole body (with only minor asymmetries) depending from CSF flow mechanisms (compare my recent short paper and the previous hypothesis), both needing much more scientific work.

  • Je-Hyun Yoo added an answer:
    Are you with or against arthroscopic management for the meniscal pathology, for example like degeneration in people over 50 years old? and why?

    Lots of authors see that in old age the main cause of pain is osteoarthritis not degenerated meniscus, so what would you do with that meniscus?

    Je-Hyun Yoo · Hallym University Sacred Heart Hospital, Anyang, South Korea

    Arthroscopic management is generally useful and effective in the well-selected patients over 50 years. The main problems in these patients are degenerative meniscal tear or chondral damage (chondromalacia.). We can treat degenerative meniscal tear and grade II-III chondromalacia effectively.

    However,only arthroscopic treatment is inadequate for chronic meniscal root tear with degeneration and III-IV chondromalacia. Especially, meniscal root tear is at high risk of retear due to low healing potential after arthroscopic fixation regardless of the method.  Accordingly, we perform HTO after arthroscopic debridment  in active patients with chronic meniscal root tear accompanied by grade III-IV chondromalacia, and think that this method is very effective. 

  • Marco Rampazzo added an answer:
    Any research to Osgood Schlatter syndrome rehabilitation?

    I'm working on my thesis to define a protocol for the rehabilitation of Osgood Schlatter syndrome. Are there people who study this syndrome? Is there someone who has the references? Thanks

    Marco Rampazzo · University of Padova

    If you want my mail is

    if you could collaborate with me I would be very grateful

  • Loh Ping Yeap added an answer:
    Can anyone give me advice on conservative treatment of lesions in TFCC due to overburden and delayed recovery?

    The TFCC with its discus, ulna-carpal joint and ligaments is crucial for stability and mobility of the wrist. Due to its anatomic complexity it is submitted to delayed generation when it is injured.

    Expected lesions in the TFCC in young pregnant woman are due to overburden of extension-pronation stance of wrist after a long bicycle-trip.


    Loh Ping Yeap · Kyushu University

    Last time when I worked in Hand therapy team, we fabricate TFCC splint to support the wrist joint, splint provide a more rigid support and limit the wrist pronation/supination. Subsequently change to the TFCC soft strap (as mentioned by others) during day time.

    Other than exercises mentioned by other authors, the exercise programme include the use of Exercise ball for wrist stability training. You may check the research paper by Marc Garcia-Elias regarding the exercise ball.

    good luck.

  • Vasilios Garatziotis added an answer:
    Can paraplegia be categorised under neuromuscular diseases?
    W hat is the exact definition of neuromuscular disease? Genetic conditions as muscular dystrophy and myopathies, cerebral palsy are considered as neuromuscular disease but is acquired spinal cord injury come under the definition of neuromuscular diseases.
    Vasilios Garatziotis · Technological Educational Institute of Athens


  • Jan-Paul van Wingerden added an answer:
    Why does the primary somatosensory cortex change in (some) chronic pain patients?
    There is a vast amount of literature on how the somatosensory cortex changes in chronic pain. What is less clear is WHY this happens. What is the purpose. What is the brain attempting to perceive? Pain is a means, not a goal, so creating pain sensations cannot be the purpose. Then what is? Do we consider this a physiological or pathological response?
    Jan-Paul van Wingerden · Spine & Joint Centre

    Dear Rosi,

    I agree with your perspective! This approach to how the mind works might provide therapeutic entrances, or explain why some interactions work.

    We collect psychosocial data to a small extend. We could though implement specific questions in this area for future patients. (500-700 per year)........

  • Alexandra Portlock added an answer:
    Are there any recommendations concerning physical activity after hip replacement?
    A patient I follow has a double hip replacement and experiences pain. He refuses to walk for that reason. Isn't walking recommended? Any articles on this subject?
    Alexandra Portlock · Université de Montpellier 1
    Thank you very much!

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