Diana Rintala

Baylor College of Medicine | BCM · Department of Physical Medicine & Rehabilitation

Purpose/aim: The purpose of this study was to measure the predictive validity, internal consistency and clinical utility of the Matching Assistive Technology to Child & Augmentative Communication Evaluation Simplified (MATCH-ACES) assessment. Methods: Twenty-three assistive technology team evaluators assessed 35 children using the MATCH-ACES ass...

Background Levodopa treatment has been shown to improve gait spatio-temporal characteristics in both forward and backward walking. However, effect of levodopa on gait variability during backward walking compared with forward walking has not been reported.Aims of studyTo study the effects of levodopa on gait variability of forward and backward walki...

Background Chronic low back pain (CLBP) is common and results in significant costs to individuals, families and society. Although some research supports the efficacy of hypnosis for CLBP, we know little about the minimum dose needed to produce meaningful benefits, the roles of home practice and hypnotizability on outcome, or the maintenance of trea...

Objective: To identify determinants for the use of a walking device in persons with Parkinson's disease (PD). Design: Cross-sectional study of participants with PD. Setting: Laboratory. Participants: Persons with PD (N=85; 60 men) were studied. Their mean age was 69.4±8.9 years. The average time since diagnosis was 7.9±5.3 years. Interventi...

To investigate the relationships between falls, fear of falling and activity limitations in individuals with Parkinson's disease (PD). Cross-sectional study of individuals with mild to moderate PD (N=83). Associations among demographic data, fall frequency, disease severity, motor impairment, ability to perform Activities of Daily Living (ADL), Act...

Purpose: Compare predictive validity (relative to psychological well-being) of long and short versions of 2 measures of social support for persons with spinal cord injury (SCI). Research method: Sixty-nine men with SCI completed (a) a long and short version of the Interpersonal Support Evaluation List (ISEL), (b) a structured interview regarding...

Purpose: To study the relationship of fear of falling (FoF) with gait characteristics and balance in individuals with Parkinson's disease (PD). Method: Seventy-nine non-demented individuals (62 males) with PD were studied. Their mean age was 69.22 ± 8.93 years. The average time since diagnosis was 8.27 ± 5.31 years. FoF was assessed by the Activ...

Purpose: To study the reliability of a Non-Instrumented Walk Test in individuals with Parkinson's disease (PD). Method: Thirty individuals (21 Males) with PD were studied. Their mean age was 68.90 ± 9.28 years. The average time since diagnosis was 8.75 ± 5.68 years. The reliability of the manual Non-Instrumented Walk Test was studied while "OFF"...

To characterize non-motor symptoms in individuals with Parkinson's disease (PD) who experience falls compared to those who do not fall. Fifty-four individuals with PD were studied. Thirty-six were fallers and 18 were non-fallers. Fatigue was assessed by the Iowa Fatigue Scale. Excessive daytime sleepiness was assessed by the Epworth Sleepiness Scal...

To study the effects of levodopa and walking speed on gait variability in individuals with Parkinson's disease (PD). Thirty-three individuals with PD were studied. Their mean age was 70.61±9.23 year. The average time since diagnosis was 9.65±5.80 year. Gait variability was studied while 'OFF' and 'ON' dopaminergic medication when the subjects walke...

Chronic pain is a significant problem for many individuals following spinal cord injury (SCI). Unfortunately, SCI-related neuropathic pain has proven to be largely refractory to analgesic medications and other available treatments. Cranial electrotherapy stimulation (CES) has been effective in managing some types of pain. It involves the applicatio...

Backward walking is difficult for persons with Parkinson's disease (PD). It is unknown how levodopa influences backward gait patterns, especially when compared to forward gait patterns. Investigate the effects of levodopa on forward and backward gait patterns in individuals with PD. A repeated measures design was used. The sample consisted of 21 in...

To investigate the effect of red and green light beams on gait and freezing of gait (FOG) in persons with Parkinson's disease (PD). Seven persons with PD who experienced FOG participated in the study. Gait and turning performances were studied while walking with canes with red, green, and no light beams while "off" and "on" anti-Parkinsonian medica...

This pilot study was designed to compare a change in micrographia between using grid lines and parallel horizontal lines as visual cues in individuals with Parkinson's disease. Single group pre- and post-test. Research lab. Eleven males with Parkinson's disease. Practice writing words with parallel and grid lines. The sequence of practising was ran...

To test the efficacy and safety of a cannabinoid, dronabinol, compared with an active control, diphenhydramine, in relieving neuropathic pain in persons with spinal cord injury. A randomized, controlled, double-blind, crossover pilot study. Seven adults with spinal cord injury and neuropathic pain below the level of injury participated. Two partici...

Objectives. To assess the feasibility of treating musculoskeletal pain in the lower back and/or lower extremities in persons with Parkinson's disease (PD) with cranial electrotherapy stimulation (CES). Design. Randomized, controlled, double-blind trial. Setting. Veterans Affairs Medical Center, Community. Participants. Nineteen persons with PD and...

To evaluate a self-administration of auditory cueing on gait difficulties in people with Parkinson's disease over a one-week period. Single group pre and post test. Research lab, community. Twenty-one individuals with Parkinson's disease. Self-application of an auditory pacer set at a rate 25% faster than preferred cadence. Self-selected gait speed...

To compare walking characteristics of individuals with Parkinson's disease (PD) using a new walking aid, the WalkAbout, with usual walking. Fifteen subjects with PD were recruited. Subjects walked in their usual fashion and then walked again in the WalkAbout. Gait parameters, 5-min walk, and oxygen consumption were recorded. Stride lengths were sho...

To test the hypothesis that enhanced education and structured follow-up after pressure ulcer surgery will result in fewer recurrences. Randomized controlled trial. Veterans Affairs medical center. Forty-nine veteran men with spinal cord injury or dysfunction were approached on admission for pressure ulcer surgery. Five never had surgery, 2 refused...

Previous research has supported the concept of classifying pain intensity into distinct categories (of mild, moderate, and severe) based on the effects of pain on functioning. Such categories, however, have not been studied in samples of veterans. The current study sought to validate the concept of pain intensity classification in a sample of veter...

Spinal cord injury often results in chronic pain syndromes that conventional pain management is unable to resolve. Healing Touch (HT) is a biofield therapy that involves using the hands to promote healing and mediate the perception of pain by affecting the energy field of the person. The practice of HT is based on the premise that the energy field...

Service dogs help persons with mobility impairments by retrieving items and performing other tasks. Hearing dogs alert persons with hearing impairments to environmental sounds. We conducted a pre-post, wait list-controlled pilot study to assess the impact of the dogs on the lives of recipients. Participants were recruited through two assistance dog...

The purpose of this study was to evaluate trends among postgraduate year (PGY) IV physiatry residents, at the time of graduation from residency, in terms of their perceived experiences in the core clinical areas, confidence with procedural subspecialization, choice in career specialization, and desire to pursue clinical fellowship. Surveys were dis...

To test the hypotheses that both amitriptyline and gabapentin are more effective in relieving neuropathic pain than an active placebo, diphenhydramine. Randomized, controlled, double blind, triple crossover 8-week trial. Veterans Affairs medical center. Community dwelling adults with spinal cord injury (N=38) were recruited by telephone, letters, a...

To assess gender differences in academic progress and attitudes toward promotion in academic physical medicine and rehabilitation (PM&R). A survey was sent to members of the Association of Academic Physiatrists (AAP). Questions addressed demographics, job description, hours worked, childcare responsibilities, publications, career aspirations, mento...

To report the physical medicine and rehabilitation (PMR) conditions seen in the Astrodome Clinic after Hurricane Katrina. Retrospective chart analysis from the county hospital-sponsored disaster-relief clinic in large urban city, including a study of 239 patients with 292 PMR conditions. The total number of patients seen in the Astrodome Medical Cl...

To examine the reliability, validity, sensitivity, and practicality of various outcome measures for pain after spinal cord injury (SCI), and to provide recommendations for specific measures for use in clinical trials. Relevant articles were obtained through a search of MEDLINE, EMBASE, CINAHL, and PubMed databases from inception through 2006. The a...

This pilot study assessed the role of Healing Touch (HT), an energy-based therapy, in modulating chronic neuropathic pain and the associated psychological distress from post spinal cord injury. Twelve veterans were assigned to either HT or guided progressive relaxation for six weekly home visits. The instruments selected showed sensitivity, althoug...

Treatments for chronic pain in persons with spinal cord injury (SCI) have been less than effective. Cranial electrotherapy stimulation (CES), a noninvasive technique that delivers a microcurrent to the brain via ear clip electrodes, has been shown to effectively treat several neurological and psychiatric disorders. The present study examined the ef...

To explore racial/ethnic differences in FIM data from admission to discharge in underinsured patients undergoing inpatient stroke rehabilitation. This is a retrospective analysis of the Uniform Data System for Medical Rehabilitation (UDSMR) database of an inpatient rehabilitation unit of a county hospital in a large urban city. Data included 171 ad...

To determine the effect of low ejection fraction (<or=35%) on the rehabilitation progress and outcome of stroke patients and compare these variables with patients with high ejection fraction (>35%). A retrospective chart review of the 332 stroke patients admitted to the inpatient rehabilitation unit of an acute tertiary general hospital during a 36...

To assess prevalence and characteristics of individual chronic (>6 mo) pain components in the veteran spinal cord injury (SCI) population, we conducted a telephone survey with 348 (66%) of 530 veterans with SCI who received care from one regional Department of Veterans Affairs SCI center during a 3 yr period. The short-form McGill Pain Questionnair...

A study was undertaken to assess the association of preoperative and postoperative hemoglobin levels with rehabilitation outcomes, age, and selected co-morbidities Charts of 49 patients admitted to rehabilitation after total knee arthroplasty due to degenerative joint disease were reviewed. Outcome measures included rehabilitation admission and dis...

We undertook a telephone survey to examine perceived stress among 165 veterans with spinal cord injury (SCI) who received care from a Department of Veterans Affairs Medical Center. Measures included Perceived Stress Scale, Hassles Scale, Center for Epidemiologic Studies Depression Scale, Short-Form State-Trait Anxiety Inventory, Satisfaction with L...

A study was undertaken to determine the technical acceptability of information available via a customized telerehabilitation system regarding patients with lower-limb ulcers or recent lower-limb amputations receiving care at a Veterans Affairs Medical Center. Among the 54 participants, 57 wounds (39 ulcers, 19 amputation incisions) were evaluated b...

To determine the diagnostic, functional, and demographic characteristics and to review the progress of nonagenarians admitted to a general rehabilitation unit. In addition, to compare their outcomes with a selected group of younger patients. A 4-yr retrospective chart review of the 40 admitted nonagenarians. Functional status was assessed by means...

This longitudinal study was designed to test the hypothesis that persons who consistently report pain at three (women) or four (men) measurement points across 10 years (1988 to 1998) are different both physically and psychologically from those who inconsistently or never report pain. Participants were 96 persons with spinal cord injury (SCI) living...

Veterans with spinal cord injury (SCI) who received care at the Houston Department of Veterans Affairs Medical Center were interviewed about their use of formal and informal assistance to meet their daily physical needs. Informal caregivers were found to play an important role in the daily care of veterans with SCI, with 37% receiving some informal...

To determine differences between dalteparin and enoxaparin in patients with spinal cord injury. This prospective, randomized, open-label study was performed as a multiple hospital trial in a large urban setting. A total of 100 patients with acute (<3 mo) spinal cord injury were recruited. A total of 95 patients met all inclusion criteria. Fifty rec...

Objective: To investigate the effects of comorbidities (heart disease, diabetes, anemia, hypertension) on functional outcomes and rehabilitation length of stay after total knee or hip replacement or lower-extremity amputation. Design: Retrospective chart review study. Setting: A Veterans Affairs medical center in Texas. Participants: The medical re...

Pressure ulcers are a major complication of spinal cord injury (SCI) and have a significant effect on general health and quality of life. The objectives of this retrospective chart review were to determine prevalence, duration, and severity of pressure ulcers in veterans with SCI and to identify predictors of (1) outcome in terms of healing without...

To determine serum levels of vitamins A, C, and E among individuals with spinal cord injury (SCI) living in the community, to compare these levels with general population norms, and to assess their association with demographic and injury-related data (age at onset, time since onset, level and completeness of injury), function, nutritional behaviors...

Moussavi RM, Garza HM, Eisele SG, Rodriguez G, Rintala DH. Serum levels of vitamins A, C, and E in persons with chronic spinal cord injury living in the community. Arch Phys Med Rehabil 2003;84:1061-7.

To evaluate the inpatient rehabilitation progress and functional outcome of stroke patients aged 80 yr and over and make comparisons with a younger (<80 yr) stroke population receiving similar comprehensive rehabilitation therapies. A case series of 223 stroke patients consecutively admitted to the inpatient rehabilitation unit of a tertiary acute...

Ergeletzis D, Kevorkian CG, Rintala D: Rehabilitation of the older stroke patient: Functional outcome and comparison with younger patients. Am J Phys Med Rehabil 2002;81:881–889. Objective: To evaluate the inpatient rehabilitation progress and functional outcome of stroke patients aged 80 yr and over and make comparisons with a younger (<80 yr) str...

This paper describes an educational model for increasing and retaining the knowledge of pressure ulcer prevention and management in veterans with spinal cord injury (SCI) or multiple sclerosis (MS) who have had surgical repair of a pressure ulcer. It also describes the correlates of pressure ulcer knowledge at admission and discharge. Before pressu...

Objective: To develop and test the psychometric properties of a Spanish version of the Community Integration Questionnaire (CIQ)1993). Study Design: Descriptive data, comparison of Spanish and English versions, and test-retest comparisons of the Spanish version. Setting: Community in southeastern Texas. Participants: Individuals with spinal cord...

Objective: To develop and test the Psychometric properties of a Spanish version of the Community Integration Questionnaire (CIQ; Willer et al., 1993). Study Design: Descriptive data, comparison of Spanish and English versions, and test-retest comparisons of the Spanish version. Setting: Community in southeastern Texas. Participants: Individuals wit...

A cross-sectional study of 189 community-dwelling persons with spinal cord injury (SCI) (a) assessed levels of dietary and serum lipids, (b) determined the proportion of persons whose levels were out of the recommended/desired range, and (c) identified predictors of dietary and serum lipids. Lipid levels were out of range for a substantial proporti...

Changes in healthcare management and reimbursement have contributed to alterations in the traditional culture of academic medical centers and the roles and responsibilities of their physician faculty, including clinician-educators. Questions concerning the appropriate evaluation methodology and criteria for promotion of such clinical faculty have b...

The final report of the National Study on Women with Disabilities provides an overview of the research conducted from 1992 to 1996 at the Center for Research on Women with Disabilities. The report addresses the methodologies used in the recruitment of women and reviews the various analyses conducted on the data. In addition, the report provides a d...

To determine if shoulder pain and range-of-motion (ROM) problems can be predicted by demographic, injury-related, body weight, and radiographic data over 3 years and to determine the relationships among these shoulder problems and functional limitations, disability, and perceived health. A longitudinal, 2-panel study in which data were collected at...

To identify predictors of pressure ulcers in men with spinal cord injury over a 3-year period. Longitudinal, two-panel, cohort. Community. One hundred eighteen men with spinal cord injury. Interviews, questionnaires, and physical examinations were completed in two phases, 3 years apart. Information obtained included demographic and spinal cord inju...

This study compared the parenting styles of 62 individuals with spinal cord injury (SCI) and 62 individuals without disabilities and the behavior of their children aged 6 through 13 years. The relationship between parenting style and children's behavior was assessed. Pairs were matched by gender of parent and age and gender of child. The Parenting...

To plan targeted, relevant continuing medical educational activities, a study was undertaken to assess demographic data, practice patterns, and current continuing medical educational needs of former graduates of the physical medicine and rehabilitation program. A survey was sent to the 168 physicians who had completed a physical medicine and rehabi...

To plan targeted, relevant continuing medical educational activities, a study was undertaken to assess demographic data, practice patterns, and current continuing medical educational needs of former graduates of the physical medicine and rehabilitation program. A survey was sent to the 168 physicians who had completed a physical medicine and rehabi...

While the scope of the clinician-patient relationship in rehabilitation includes the opportunity to provide information on sexuality, all too often this does not occur. This article identifies barriers to providing information on sexuality and makes suggestions for overcoming them. At a preconference workshop, "Sexuality After Spinal Cord Injury: U...

The relationship of race/ethnicity to community integration and other variables was assessed in a sample of 164 adults who had lived with spinal cord injury for 2 to 47 years. Compared with blacks and Hispanics, whites were older, better educated, better off financially, less likely to have a violent etiology, less severely impaired, more physicall...

To assess the prevalence, severity, and correlates of chronic pain in a community-based sample of men with spinal cord injury (SCI). Survey. Community. Seventy-seven men with SCI randomly selected from a sampling frame solicited from the community. Participants completed standardized questionnaires assessing many areas of life, were interviewed in...

Emotional, physical, and sexual abuse of women with physical disabilities is a problem largely unrecognized by rehabilitation service providers. This article documents the prevalence of abuse of women with physical disabilities compared to women without physical disabilities. Case-comparison study using written survey. Data were analyzed using chi...

The purpose of this study was to identify factors that resulted in severe pressure ulcers in a community-based sample of 23 persons with spinal cord injury (SCI). A correlational design was used. Twenty men and three women, 57% with tetraplegia and 43% with paraplegia, participated. Adult participants with an ulcer of 12 weeks' duration or less wer...

To study adaptive processes following spinal cord injury, unstructured audiotaped interviews were conducted on an almost daily basis with a 30-year-old divorced male during the first 3 months of his initial comprehensive inpatient rehabilitation. Analysis of the transcribed tapes identified a number of important themes, including the theme of socia...

As a component of Baylor College of Medicine study of the life status of people with spinal cord injury (SCI), this study determined the educational topics of interest to a cohort of 590 adults with SCI living in the community. Thirty-five items in nine topic areas were included in the inventory. Three topic areas--medical, sexuality, and wellness-...

Three a priori hypotheses were tested: (1) There are significant differences in sociosexual behaviors of women with physical disabilities compared with women without disabilities; (2) the sexual functioning of women with disabilities is significantly related to age at onset of disability; (3) psychological factors explain more of the variance in th...

This study examined barriers to reproductive health maintenance among women with physical disabilities. A qualitative interview methodology was used. All interviews were recorded on audio cassette, transcribed, and analyzed using constant comparison and analytic induction. Thirty-one women with disabilities that resulted in functional impairments w...

The prevalence of self-reported alcohol and marijuana use, along with alcohol abuse as measured by the Short Michigan Alcoholism Screening Test, was assessed for a community-based sample (n = 123) of persons with spinal cord injury (SCI). Correlates of alcohol and marijuana use and alcohol abuse also were examined, including demographic variables,...

Most previous research on rehabilitation of patients after spinal cord injuries has dealt with the attainment of outcomes valued by staff members or with the prediction of successful outcomes based on sociodemographic characteristics of patients. This study examined the rehabilitation process from the insider's perspective of an individual patient...

Long-term outcome assessment of people with spinal cord injury (SCI) beyond acute rehabilitation is becoming an increasingly important issue as life expectancies for people with SCI approach those of the general population. This article provides information about research on the long-term physical and psychological well-being and the community inte...

Functional assessment for persons with disabilities has been an important component of the traditional inpatient rehabilitation process. Recently there has been increasing interest in functional assessment for persons residing in the community as a means to understanding the role of rehabilitation in community integration and the effects of aging o...

A sample of 100 men and 40 women was drawn randomly from a community-based sampling frame of 640 persons with spinal cord injury (SCI) to examine the vocational status of persons with SCI living in the community. Individual differences in vocational status and productivity were explored in terms of demographic variables, such as sex and age, and va...

This article considers sexuality among women with physical disabilities from a wellness perspective by presenting the results of the first phase of a 3-year, NIH-funded study. This phase was a qualitative study using semi-structured interviews with 31 women with a variety of physical disabilities, representing diverse racial and ethnic minorities a...

A representative sample of 40 women selected from a community-based sampling frame of 661 men and women with spinal cord injury was studied for sexual activities, concerns and interests. Participants responded to a questionnaire and rating scales and were physically examined to establish their neurologic status. With respect to 11 other areas of li...

140 adults (aged 19–77 yrs) were randomly selected from a sampling frame of 661 persons with spinal cord injury. They completed a questionnaire assessing amount of social support, degree of reciprocity with supporters, and satisfaction with relationships with supporters; the Center for Epidemiologic Studies Depression Scale; a self-report version o...

A naturalistic, ethnographic, phenomenological study of adaptation to wheelchair use was conducted with one key informant, a 30-year-old white man with acquired paraplegia who was undergoing acute rehabilitation. Primary staff members served as additional informants. It was found that adaptation to wheelchair use had both pragmatic and emotional co...

The prevalence and correlates of pressure ulcers in terms of their number, severity, and anatomical location were studied in a community-based sample of 100 men and 40 women with spinal cord injury. Thirty-three percent (n = 46) presented with one or more ulcers of at least one stage I severity when visually examined. Twenty-one individuals had mor...

Depressive symptomatology was studied in a community-based sample of 100 men and 40 women with spinal cord injury. The mean for the Center for Epidemiologic Studies Depression Scale was higher than that reported previously for the general population, and the mean for women was higher than that for men. Findings from the Mobility dimension of the Cr...

Previous discussions of personal assistance have focused on census data and descriptions of service programs. The current study examines patterns of usage of personal assistance among a community-based sample of 284 persons with spinal cord injury and how these patterns relate to other aspects of their lives. Expected significant relationships were...

White MJ, Rintala DH, Hart KA, Young ME, Fuhrer MJ: Sexual activities, concerns and interests of men with spinal cord injury. Am J Phys Med Rehabil 1992;71:225-231. A representative sample of 79 men with spinal cord injury, drawn from a sampling frame of 661 women and men who reside