Research on physical activity and health among people with disabilities: a consensus statement.

Research is required to advance the understanding of issues related to the effect of physical activity on health and disease prevention among people with disabilities. This report is the result of a consensus process using selected experts in health and exercise. The purpose of the consensus conference was to identify research priorities for physical activity and health among people with disabilities. Priorities were established by 30 participants, who were selected by the principal investigators to achieve balance in the areas of engineering, epidemiology, medicine, nutrition, exercise physiology, and psychology. Experts summarized relevant data from their research and from comprehensive review of the scientific literature on the topic areas chosen for the conference. Public commentary was provided by participants in the 1996 Paralympic Congress. Panel members discussed openly all material presented to them in executive session. Commentary from open discussion periods were recorded and transcribed. Selected panelists prepared first drafts of the consensus statements for each research priority question. All of these drafts were distributed to the panelists and pertinent experts. The documents were edited by the drafting committee to obtain consensus. This research priority setting process revealed that greater emphasis must be placed on determining the risks and benefits of exercise among people with disabilities. Exercise must be studied from the perspective of disease prevention while mitigating risk for injury. Five areas were identified as focal points for future work: epidemiological studies; effects of nutrition on health and ability to exercise; cardiovascular and pulmonary health; children with disabilities; and accessibility and safety of exercise programs. As people with disabilities live longer, the need for addressing long-term health issues and risk for secondary disability must receive greater attention. As a consequence of the consensus process, specific recommendations for future research regarding the impact of exercise on the health and quality of life of persons with disabilities were defined.

Preliminary test method for the determination of surface firmness.

The Americans with Disabilities Act Accessibility Guidelines (ADAAG) specify that ground and floor surfaces should be firm, stable, and slip-resistant. These specifications are subjective; objective methods for assessing surface firmness and stability are lacking. Objective measures are needed to assess the accessibility of walking and wheeling surfaces and to improve accessibility for people with mobility limitations. This research study focused only on the development of an objective wheelchair work measurement method to assess surface firmness. Firmness was quantified in terms of the work per meter required to propel a wheelchair across the surface. Work was determined by using a SMARTwheel to measure the forces applied to the pushrim. This measurement method was evaluated on carpet, hard trail surfaces, and various playground surfacing materials. Measurements were also taken on an adjustable ramp set at different grades, cross slopes, and grade/cross slope combinations. Reliable results were obtained on all test surfaces except two (sand and pea gravel) which could not be negotiated by the test wheelchair rider according to the test protocol. The test method was capable of measuring a wide range of surface types, produced repeatable results on nearly all test surfaces, and was sensitive enough to measure 1% changes in grade and differences in surfacing materials. Comparisons between the measurements made on level surfaces and on various ramp angles demonstrated the feasibility of using the work per meter value for a specific ramp grade as pass/fail performance criteria for short distances of accessible surfaces. For outdoor recreational environments, this work measurement method would provide an objective measure of firmness which could be used to classify surfaces into categories (e.g., hard, firm, soft).

[The use of bone morphogenetic proteins in delayed fracture healing, pseudoarthrosis and in ulna osteotomy carried out because of elbow joint diseases]. / Die Anwendung knochenmorphogenetischen Proteins bei verzögerter Frakturheilung, Pseudarthrose und bei wegen Ellbogengelenkerkrankungen durchgeführter Ulnaosteotomie.

This study deals with the application of bone morphogenetic protein (BMP) as an osteoinductive factor in the treatment of fractures and elbow disease in the dog. Partially purified canine bone morphogenetic protein (cBMP) was used in the repair of a delayed union fracture and a pseudoarthrosis. The cBMP was applied in Biocoral and Tricalciumphosphate carriers using a subcortical grafting method. Two dogs suffering from incongruence and subluxation of the elbow joint were treated with a partially purified bone morphogenetic protein of moose bone origin placed in the gap produced by ulnar osteotomy.

Presentation on assistive technologies for the seating and mobility needs of persons with osteogenesis imperfecta.

Persons with Osteogenesis Imperfecta (OI) are often protected and sheltered because of the fragile nature of their bones. Regardless of the degree of OI. over protecting a person with OI can be just as devastating as fractured bones. It is important that persons with OI are given the opportunity to participate in a wide variety of activities to develop the experiential, physical, and sociological dimensions of their lives. Assistive technology can help to make this participation a reality. Assistive technology should help protect the person from fractures, provide support to assist with postural alignment, and stability so that function and comfort can be enhanced. Technologies such as contoured foam mattresses, seating supports, temperature regulation technologies, orthotic supports, walking and wheelchair mobility devices can enhance the quality of live of people with OI.

Fixation of cancellous bone and physeal fractures in dogs and cats. A comparison of the use of self-reinforced biodegradable devices to the use of metallic devices and external fixations.

The use of self-reinforced biodegradable devices made of polyglycolide in the cancellous bone and physeal fractures of dogs and cats was compared to the use of metallic devices and external fixations on similar fractures. The series consisted of 64 dogs and 22 cats divided into 6 comparable groups. The patients in the 2 groups fixed with biodegradable devices started to use their operated limbs earlier than in the other groups. The same 2 groups also healed clinically (showed no lameness) earlier than the other groups. Radiographically there was no statistical difference between the 6 groups. On the basis of this study it may be concluded that the fixation with self-reinforced biodegradable devices is as suitable for the fixation of cancellous bone and physeal fractures of dogs and cats as the fixation with metallic devices or external fixation. This biodegradable technique has additional benefits allowing the patients to feel less pain in their operated limbs and making secondary operations to remove the devices unnecessary.