Emotional adjustment in compensated head injury patients.

Patterns of emotional adjustment based on the Minnesota Multiphasic Personality Inventory (MMPI) were examined in a group of 124 patients who had suffered head injuries, reported postconcussional symptoms, and were receiving compensation. Cluster analytical procedures were used to identify subgroups. The sample was divided into two equivalent groups for purposes of crossvalidation. The results of the analyses in the two samples yielded similar patterns. Within each subgroup, the groups differed on the level and pattern of emotional disturbance. Approximately 65% of the sample had normal profiles or only mild elevations on the "neurotic" scales. The largest subgroup had mild elevations. After the exclusion of invalid profiles, a small proportion had severe disturbances. The injury-related neurological characteristics of these groups are similar. These findings are discussed in terms of the previous literature on the effects of compensation on posttraumatic personality adjustment.

Human trunk strength profile in flexion and extension.

STUDY DESIGN: Isometric and isokinetic trunk flexion-extension strengths were studied among 73 subjects (41 males and 32 females) and 10 patients (9 males and 1 female). The isometric strengths were measured in four postures of trunk flexion. The isokinetic trunk strengths were measured through the range of these postures. OBJECTIVES: The study had two objectives: to develop a database for isometric flexion-extension strength at different levels of trunk flexion and isokinetic strength at corresponding angles and to determine the decrement in strength characteristics among patients of idiopathic low back pain. SUMMARY OF BACKGROUND DATA: Though flexion-extension strength among normal subjects and patients has been studied, its variation due to standardized postural change has not been reported extensively. The influence of postural deviation on flexion-extension ratios are also largely unknown. METHODS: To achieve the objectives of the study, a device flexion-extension-lateral flexion tester (FELT) was designed and fabricated. The male and female subjects performed isometric flexion and extension at 0 degree, 20 degrees, 40 degrees and 60 degrees of trunk flexion; and isokinetic flexion starting at neutral posture, and isokinetic extension starting at 60 degrees of trunk flexion. The patients performed isometric flexion and extension in neutral posture only; and isokinetic flexion-extension similar to normal sample. RESULTS: The average strength in each activity was between 70 and 80% of the corresponding peak strength. The isokinetic activity strengths ranged between 60 and 70% of the corresponding isometric activities in each group. The strength of females ranged between 60 and 70% of males. The ANOVA revealed that posture had a significant effect on strength. The multiple regression explained 73% of variance in isometric and 34% in isokinetic modes. CONCLUSIONS: A patient's strength profile should be determined in a posture that simulates activities of daily living to determine impairment and plan rehabilitation.

Human trunk strength profile in lateral flexion and axial rotation.

STUDY DESIGN: To determine the functional capability in asymmetric trunk motion, isometric and isokinetic lateral flexion and axial rotation strengths of a normal and patient samples were measured. Seventy-three normal asymptomatic subjects (41 males and 32 females) and ten patients (9 males and 1 female) were tested. OBJECTIVES: The dual objectives of the study were to develop a database for isometric and isokinetic lateral flexion and axial rotation strength capabilities of a normal sample and to determine the functional impairment of a sample of patients. SUMMARY OF BACKGROUND DATA: More than 60% of low back injuries are associated with trunk twisting. Asymmetric motions are important risk factors. However, strength capability data for axial rotation are sparse and those for lateral flexion nonexistent. METHODS: To achieve the objectives of the study, two devices were designed and fabricated. Isometric lateral flexion was tested bilaterally in neutral posture and at 10 degrees, 20 degrees, and 30 degrees of lateral bending. Isometric axial rotation was tested bilaterally in neutral posture and at 5 degrees, 10 degrees, 15 degrees, and 20 degrees of axial rotation. Isokinetic lateral flexion and axial rotation strengths were tested bilaterally starting from the neutral posture. RESULTS: The strength invariably declined progressively for all groups with increasing postural asymmetry. The strength in isokinetic activities ranged between 60% to 70% of the strength measured in isometric activities. All groups were significantly stronger in lateral flexion compared with axial rotation. The female sample ranged between 60% to 70% values of males for all activities studied. The patient group was weakest, ranging between 45% to 55% for isometric and 52% to 58% for isokinetic activities of their control group.