Users' responses to contoured wheelchair handrims.

The responses of 28 spinal cord injured wheelchair users who tested a contoured handrim design were analyzed. Paraplegics, who had stronger grip strength, preferred the contoured design compared with their own handrims in 10 of 12 circumstances of use, as well as according to overall assessment. Most indicated they would pay the estimated additional cost to produce the test shape, which is designed for increasing the contact between hand and rim. Quadriplegics, with weaker and more viable grips, gave mixed responses. This opinion study illustrates some of the problems encountered in evaluation of a new equipment for disabled persons.

Effect of exercise on serum creatine kinase in carriers of Duchenne muscular dystrophy.

In order to evaluate the effect of exercise on serum creatine kinase levels, blood samples were obtained from 17 normal females and 12 Duchenne muscular dystrophy carriers before and 9 hours after moderately strenuous exercise. The results revealed that after exercise serum creatine kinase levels may be better indicators of carrier status than resting levels. The mean serum creatine kinase levels before and after exercise, as well as the mean increases, were found to be significantly greater in Duchenne muscular dystrophy carriers than in normal control subjects.

Rehabilitation recommendations for institutionalized motor-disabled patients.

Consultation reports on 142 profoundly retarded and severely motor-disabled patients in a state residential care facility who were seen by physiatrists from an academic department of physical medicine and rehabilitation (PM&R) were reviewed. In all, 168 reasons for consultation were listed: 117 for specific identification or management of disabilities related to gross-motor or fine-motor function, 37 for surgical problems, and 10 for medical problems. The consultants made 314 recommendations altogether: 100 suggested the evaluation or treatment of gross-motor disabilities by a physical therapist, 43 suggested occupational therapy evaluation or treatment, and an additional 73 suggested adaptive equipment involving an orthotist. The recommendations also involved the following problems: medical-33; surgical-37; behavioral-27; further rehabilitation-1. The skills of a consultant knowledgeable in the management of multiply handicapped people include the coordination of medical, surgical, physical and behavioral care. Such knowledge is also a useful adjunct to overall patient care in complex cases with motor involvement. The preliminary association during which these consultations were done served as the basis of a growing affiliation between the state institution and the department of PM&R.