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June 2003

Prosthetic Help For Those In Need

Dana Reeve

Reeve’s Wife Receives Humanitarian Award

Dana Reeve, wife of quadriplegic actor Christopher Reeve, has received the 2003 Global Conference Institute’s Healthcare Humanitarian Award.

The Pittsburgh-based institute honored Reeve with the award during its fifth annual conference in Chicago in early May. After Reeve’s husband sustained a physically disabling spinal cord injury in a horse-riding accident in May 1995, she became actively involved in the fight for increases in medical research funding and a leading advocate for the rights of the disabled. She is also the moving force in the Christopher Reeve Paralysis Foundation.

“My hope is in accepting this prestigious award, I will be able to use the opportunity to offer a deeper look into the challenges facing people with disabilities in this country and all over the world,” said Reeve.

Past recipients of the award are liver transplant pioneer Thomas E. Starzl, MD, PhD (1999); cardiovascular surgeon and scientist Michael E. DeBakey, MD (2000); Nancy Brinker, founder of the Susan G. Komen Breast Cancer Foundation (2001); and Sharon Stone, chairman of the Campaign for AIDS Research, American Foundation for AIDS Research (2002).

Study: Postconcussion Headache Should Be Closely Watched

A recent study by the University of Pittsburgh Medical Center (UPMC) Sports Medicine Concussion Program suggests that a postconcussion headache even a week after the injury is likely to be associated with incomplete recovery.

The study, published in the March-April 2003 issue of The American Journal of Sports Medicine, indicates the need to keep athletes from returning to contact play until headache and all other postconcussion symptoms resolve.

Looking at 109 high school athletes, the study showed that the concussed athletes with any degree of headache at 1 week postinjury also had significantly more postconcussion symptoms and performed more poorly on neurocognitive tests measuring reaction time and memory than concussed athletes who reported no headache at 1 week postinjury. Athletes with headaches 1 week postinjury were also four times more likely to have experienced memory loss and other symptoms on the playing field immediately following the injury, and were five times more likely to experience on-the-field symptoms that lasted longer than 5 minutes.

The athletes were divided into two groups on the basis of self-reported headache at 1 week postinjury evaluation; 73 of the athletes reported no headache while 36 athletes reported various degrees of headache. At that time, a neurocognitive function test was administered to all study participants to compare headache presence to objective neurocognitive function data. Athletes with postconcussion headaches had significantly slower reaction times and reduced memory performance as measured by the neurocognitive test scores.

The test used in the evaluation was Immediate Post-concussion Assessment and Cognitive Testing (ImPACT), a 20-minute computer assessment tool developed by the researchers. It includes tests of mental function such as attention, memory, reaction time, and information processing speed. Approximately 250 high schools across the country currently use the system to evaluate the effects of concussion.

Hospital Launches SCI Research Initiative

Helen Hayes Hospital, West Haverstraw, NY, has entered into a partnership with the US Department of Veteran Affairs to study the secondary medical consequences of spinal cord injury (SCI).

The initiative, which will take place at the physical rehabilitation hospital in West Haverstraw, is being overseen by Inocencia Carrano, MD, the hospital’s director of spinal cord injury rehabilitation, in collaboration with William A. Bauman, MD, and Ann M. Spungen, EdD, of the Veterans Affairs Medical Center, Bronx, NY.

Resistance Exercise May Aid Osteoarthritis Pain

A study published in a recent issue of the Archives of Physical Medicine and Rehabilitation shows that resistance exercise relieves the pain of osteoarthritis of the knee.

In a randomized, controlled clinical trial involving more than 100 volunteers, researchers from the University of Louisville and the Medical College of Toledo concluded that a home-based strengthening program with elastic resistance bands improves functional ability and reduces knee joint pain of patients with osteoarthritis, a wearing out of the joint and loss of articular cartilage surrounding the ends of the long bones in the body. It is estimated that 80% of older adults have at least one joint affected by osteoarthritis, and by the year 2020, as many as 40 million Americans will likely suffer from its effects.

The study, The Effect of Dynamic Versus Isometric Resistance Training on Pain and Functioning Among Adults With Osteoarthritis of the Knee, compared three groups of patients with knee osteoarthritis over a 16-week period. One group performed isometric exercises against elastic resistance, while a second group performed dynamic exercises against elastic resistance. A third group was a control group that did not exercise. The study measured the time required to go up and down a flight of 27 stairs, and time to get down and up off the floor. Knee pain was assessed immediately after each task was completed. Results of the study concluded that in the isometric group, the time it took to perform all four functional tasks decreased by 16% to 23%. The dynamic group reduced its time by 13% to 17%. The study also showed that both groups decreased knee pain while performing the tasks, and that knee pain was reduced by 28% to 58%.

Certain Exercises May Hasten Course of Arthritis in Knees

New research warns that certain exercises for arthritic knees do not help, and may even speed up the disease’s course.

According to a study published in the Annals of Internal Medicine, researchers from Northwestern University found that although people with arthritis of the knee are often advised to exercise the quadricep muscle, strengthening the quadriceps appears to pose a risk to those whose knees are misaligned or whose knees are unusually loose.

Researchers followed the conditions of 230 arthritis patients over an 18-month period, finding an association between quadricep strength and a worsening of the disease. One explanation is that lax and misaligned knees do not properly distribute the load in exercise, placing too much pressure on vulnerable parts.

According to the researchers, the results raise questions about the use of quadriceps strengthening. They also cautioned that they were not advising arthritis patients to avoid physical activity. Instead, they suggested that patients with misaligned or lax knees be taught exercises tailored to specific muscles so that the benefits would outweigh the harm.

AOTA Helps Seniors “Age in Place”

As part of its celebration of Occupational Therapy Awareness Month in April, the American Occupational Therapy Association announced its effort to focus on enabling more seniors to remain independent, or “age in place.”

To help facilitate the effort, AOTA partnered with Rebuilding Together, a national volunteer organization that rehabilitates houses for low-income home owners. The two organizations released a list of home modification strategies in advance of April 26, National Rebuilding Day, when volunteers worked to repair about 8,000 homes nationwide.

AOTA suggested that adult children work with their senior parents to use the list in order to find safety solutions.

Senior Women on Antidepressants May Be Prone to Fractures

According to a new study, elderly women taking antidepressants might be more susceptible to bone fractures.

The study, led by researchers at the University of Minnesota and the University of California, San Francisco, and published in the April 28 issue of the Archives of Internal Medicine, found that women taking mood medication and other drugs that affect the nervous system were 70% more likely than those not taking the drugs to suffer a broken hip.

Evidence has suggested that people with depression tend to have weaker bones than others, and narcotic drugs and sedatives may make people unsteady on their feet and more prone to falls. One study from the late 1990s showed that women taking older, tricyclic mood drugs were more likely to break bones than those on newer medications called selective serotonin-reuptake inhibitors such as Prozac and Zoloft.

The University of Minnesota study included more than 8,200 women aged 65 and older and not living in nursing homes. Of those, 8% were taking tranquilizers, 6% were on antidepressants, 5% were taking narcotics, and 2% were using drugs to control seizures. Over the course of the study, 1,256 women, or 15% of the total, suffered at least one broken bone away from the spine. Of those, 288 had a first broken hip. Even after researchers took into account factors known to affect fracture risk, such as smoking status, physical activity, and the use of estrogen, they still saw a link between some of the drugs and broken bones.

Tranquilizers did not seem to be associated with fractures, but mood drugs, narcotics, and possibly seizure medications were, according to the researchers. The study found no difference in fracture risk for women taking either older or newer antidepressants.

More than 320,000 Americans are hospitalized each year with broken hips. Nine in 10 of these fractures occur in people over the age of 65.

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