Clinical Evaluation and Research Unit

Toronto, Canada

Clinical Evaluation and Research Unit

Toronto, Canada

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Pauley T.,Clinical Evaluation and Research Unit | Ismail F.,West Park Healthcare Center | Ismail F.,University of Toronto | Boulias C.,West Park Healthcare Center | And 5 more authors.
Topics in Stroke Rehabilitation | Year: 2013

Background: Although inpatient stroke rehabilitation provides clinicians with the opportunity to prepare patients for continuation of prestroke activities, little is known about the patients' ability to safely resume driving at the point of discharge to the community. Objective: To compare foot pedal response times of 20 stroke patients with right hemiplegia (RH) or left hemiplegia (LH) and 10 controls. Methods: A cross-sectional design was used. Response times were measured using 3 foot pedal operation techniques: (1) right-sided accelerator with right leg operating accelerator and brake, (2) right-sided accelerator with left leg operating accelerator and brake, and (3) left-sided accelerator with left leg operating accelerator and brake. Outcomes included reaction time (RT), movement time (MT), and total response time (TRT). Results: Controls demonstrated faster RT than patients with RH (263 vs 348 ms; P < .001) or LH (316 ms; P < .05) for all conditions, as well as faster MT than patients with RH (P < .05 for all) but not LH when using the right leg (258 vs 251 ms; P = .82). Controls demonstrated faster TRT than patients with RH (P < .001 for all) but not LH when using the right leg (515 vs 553 ms; P = .44). Conclusions: When using the nonparetic leg, patients with LH had braking response times comparable to controls, but patients with RH demonstrated significant impairment of both the paretic and nonparetic legs. © 2013 Thomas Land Publishers, Inc.


Pauley T.,Clinical Evaluation and Research Unit | Devlin M.,West Park Healthcare Center | Devlin M.,University of Toronto
Journal of Rehabilitation Medicine | Year: 2011

Objective: To evaluate the influence of a secondary task on foot pedal reaction time, movement time and total response time in patients with transtibial amputation. Design: Controlled trial without randomization. Subjects: Ten patients with transtibial amputation and 13 age-matched controls. Methods: Foot pedal reaction time and movement time were measured for both legs under simple and dual-task conditions. Results: While mean simple reaction time was similar for both groups (258 (standard deviation (SD) 53) vs 239 (SD 34) ms), a group by reaction time condition interaction (p < 0.05) identified a disproportionately greater mean dual-task effect among patients with transtibial amputation (432 (SD 109) vs 317 (SD 63) ms), apparently affecting the prosthetic and intact legs equally (426 (SD 110) vs 438 (SD 107) ms). Among patients with transtibial amputation faster movement time was achieved with the intact leg (185 (SD 61) vs 232 (SD 58) ms, p < 0.0001). Compared with controls, patients with transtibial amputation demonstrated impaired mean movement time (142 (SD 37) vs 208 (SD 64) ms, p < 0.001) and total response time (420 (SD 80) vs 552 (SD 151) ms, p < 0.001) regardless of reaction time condition. Conclusion: This study appears to have identified a functional manifestation of central reorganization following transtibial amputation, affecting the prosthetic and intact lower limbs equally. © 2011 The Authors.


PubMed | Clinical Evaluation and Research Unit
Type: Comparative Study | Journal: Topics in stroke rehabilitation | Year: 2013

Although inpatient stroke rehabilitation provides clinicians with the opportunity to prepare patients for continuation of prestroke activities, little is known about the patients ability to safely resume driving at the point of discharge to the community.To compare foot pedal response times of 20 stroke patients with right hemiplegia (RH) or left hemiplegia (LH) and 10 controls.A cross-sectional design was used. Response times were measured using 3 foot pedal operation techniques: (1) right-sided accelerator with right leg operating accelerator and brake, (2) right-sided accelerator with left leg operating accelerator and brake, and (3) left-sided accelerator with left leg operating accelerator and brake. Outcomes included reaction time (RT), movement time (MT), and total response time (TRT).Controls demonstrated faster RT than patients with RH (263 vs 348 ms; P < .001) or LH (316 ms; P < .05) for all conditions, as well as faster MT than patients with RH (P < .05 for all) but not LH when using the right leg (258 vs 251 ms; P = .82). Controls demonstrated faster TRT than patients with RH (P < .001 for all) but not LH when using the right leg (515 vs 553 ms; P = .44).When using the nonparetic leg, patients with LH had braking response times comparable to controls, but patients with RH demonstrated significant impairment of both the paretic and nonparetic legs.


PubMed | Clinical Evaluation and Research Unit
Type: Comparative Study | Journal: Journal of rehabilitation medicine | Year: 2011

To evaluate the influence of a secondary task on foot pedal reaction time, movement time and total response time in patients with transtibial amputation.Controlled trial without randomization.Ten patients with transtibial amputation and 13 age-matched controls.Foot pedal reaction time and movement time were measured for both legs under simple and dual-task conditions.To evaluate the influence of a secondary task on foot pedal reaction time, movement time and total response time in patients with transtibial amputation.Controlled trial without randomization.Ten patients with transtibial amputation and 13 age-matched controls.Foot pedal reaction time and movement time were measured for both legs under simple and dual-task conditions.While mean simple reaction time was similar for both groups (258 (standard deviation (SD) 53) vs 239 (SD 34) ms), a group by reaction time condition interaction (p < 0.05)identified a disproportionately greater mean dual-task effect among patients with transtibial amputation (432 (SD 109)vs 317 (SD 63) ms), apparently affecting the prosthetic and intact legs equally (426 (SD 110) vs 438 (SD 107) ms). Among patients with transtibial amputation faster movement time was achieved with the intact leg (185 (SD 61) vs 232 (SD 58)ms, p < 0.0001). Compared with controls, patients with transtibialamputation demonstrated impaired mean movement time (142 (SD 37) vs 208 (SD 64) ms, p < 0.001) and total response time (420 (SD 80) vs 552 (SD 151) ms, p < 0.001) regard less of reaction time condition.This study appears to have identified a functional manifestation of central reorganization following patients with transtibial amputation, affecting the prosthetic and intact lower limbs equally.

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