Incomplete bladder emptying in patients with stroke: is detrusor external sphincter dyssynergia a potential cause?

Abstract:

OBJECTIVES:To delineate the frequency, clinical risk factors, and urodynamic mechanisms of incomplete bladder emptying (IBE) among patients with recent stroke. DESIGN:Retrospective study. SETTING:Inpatient setting in the rehabilitation ward of a university hospital. PARTICIPANTS:All patients with acute stroke admitted for rehabilitation between January and December 2005, excluding those with a history of lower-urinary tract symptoms and urologic diseases. Eighty-two patients (42 women and 40 men; mean age, 65.5 y) were included. INTERVENTIONS:Not applicable. MAIN OUTCOME MEASURES:We measured postvoid residual (PVRs) by catheterization or by using an ultrasonic bladder scanner. Twenty-five patients (30.5%) had IBE with PVRs greater than 100 mL on 2 consecutive days. Patients with IBE were evaluated by a urologist and subsequently underwent urodynamic studies. RESULTS:The presence of IBE was significantly associated with urinary tract infection (P<.001) and aphasia (P=.046). The presence of IBE was not related to sex, stroke location, nature of stroke (hemorrhagic or ischemic), history of diabetes mellitus, or previous stroke. Urodynamic studies done on 22 patients with IBE revealed acontractile detrusor in 8 patients (36%) and detrusor underactivity in 3 (14%). Eleven patients (50%) had detrusor-external sphincter dyssynergia (DESD) combined with normative detrusor function (5 patients) or detrusor hyperactivity (6 patients); all but 1 of these patients had a supratentorial lesion. The presence of DESD was associated with a longer onset-to-evaluation interval (P=.018) [corrected] and spasticity of the stroke-affected lower limb (P=.02). [corrected] Diabetes mellitus was associated with the presence of acontractile detrusor or detrusor underactivity (P=.03). CONCLUSIONS:IBE is common among patients with stroke and is caused by decreased detrusor contractility or DESD. Spasticity of the external urethral sphincter is a possible pathophysiologic mechanism of DESD.

journal_name

Arch Phys Med Rehabil

authors

Meng NH,Lo SF,Chou LW,Yang PY,Chang CH,Chou EC

doi

10.1016/j.apmr.2010.03.017

subject

Has Abstract

pub_date

2010-07-01 00:00:00

pages

1105-9

issue

7

eissn

0003-9993

issn

1532-821X

pii

S0003-9993(10)00160-7

journal_volume

91

pub_type

杂志文章
  • Relationship between arm usage and instrumental activities of daily living after unilateral stroke.

    abstract:OBJECTIVE:To determine whether the preferred pattern of arm use after unilateral hemispheric damage was associated with better everyday functioning. Our previous work showed that right-handed stroke patients with right hemisphere damage (RHD) used their right, ipsilesional arm most frequently, while those with left hem...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:10.1016/j.apmr.2012.05.011

    authors: Haaland KY,Mutha PK,Rinehart JK,Daniels M,Cushnyr B,Adair JC

    更新日期:2012-11-01 00:00:00

  • Postrehabilitation Functional Improvements in Patients With Inflammatory Myopathies: The Results of a Randomized Controlled Trial.

    abstract:OBJECTIVE:To evaluate the medium-term functional effect and the effect on quality of life of a standardized rehabilitation program in patients with inflammatory myopathies (IMs). DESIGN:A multicenter, randomized controlled trial. SETTING:Four university hospitals. PARTICIPANTS:Patients (N=21) with polymyositis. INT...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1016/j.apmr.2016.09.125

    authors: Tiffreau V,Rannou F,Kopciuch F,Hachulla E,Mouthon L,Thoumie P,Sibilia J,Drumez E,Thevenon A

    更新日期:2017-02-01 00:00:00

  • Intractable foot pain following frostbite: case report.

    abstract::This report describes a patient with intractable foot pain following frostbite in 1945. The patient continued to have progressively worsening foot pain, which eventually resulted in his losing his job and becoming wheelchair-bound. A combination of transcutaneous nerve stimulator, patellar, tendon weight-bearing/ankle...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:

    authors: Kumar VN

    更新日期:1982-06-01 00:00:00

  • F-wave conduction velocity in the central segment of the peroneal and tibial nerves.

    abstract::A simple method was devised to measure the F-wave conduction velocity (FWCV) in the central segment (knee to spinal cord) of the peroneal and tibial nerves in contrast to the conventional motor nerve conduction velocity (MNCV) in the distal segment (knee to ankle). In 33 normal subjects, the FWCV in the central segmen...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:

    authors: Kimura J,Bosch P,Lindsay GM

    更新日期:1975-11-01 00:00:00

  • Outcomes after a prone lumbar traction protocol for patients with activity-limiting low back pain: a prospective case series study.

    abstract:OBJECTIVE:To determine outcomes after administration of a prone lumbar traction protocol. DESIGN:Prospective, longitudinal, case series. SETTING:Suburban, chiropractic practice. PARTICIPANTS:A total of 296 subjects with low back pain (LBP) and evidence of a degenerative and/or herniated intervertebral disk at 1 or m...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:10.1016/j.apmr.2007.06.778

    authors: Beattie PF,Nelson RM,Michener LA,Cammarata J,Donley J

    更新日期:2008-02-01 00:00:00

  • Criteria for assessing the tools of disability outcomes research.

    abstract::To recommend instrument assessment criteria, deriving from psychometric textbooks and articles and disability and research experts, for reviewing and assessing surveys and questionnaires for disability outcomes research. Traditional criteria are recommended, including psychometric properties of validity, reliability, ...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章,评审

    doi:10.1053/apmr.2000.20619

    authors: Andresen EM

    更新日期:2000-12-01 00:00:00

  • Developing an item bank to measure economic quality of life for individuals with disabilities.

    abstract:OBJECTIVE:To develop and evaluate the psychometric properties of an item set measuring economic quality of life (QOL) for use by individuals with disabilities. DESIGN:Survey. SETTING:Community settings. PARTICIPANTS:Individuals with disabilities completed individual interviews (n=64), participated in focus groups (n...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:10.1016/j.apmr.2014.02.030

    authors: Tulsky DS,Kisala PA,Lai JS,Carlozzi N,Hammel J,Heinemann AW

    更新日期:2015-04-01 00:00:00

  • Improved arousal and initiation following tricyclic antidepressant use in severe brain injury.

    abstract::Three patients with severe traumatic brain injury demonstrated significant improvement in arousal and initiation after administration of tricyclic antidepressants. The first patient showed improved motor and speech initiation in response to amitriptyline following several months of functional plateau. The second patie...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:10.1016/s0003-9993(96)90225-7

    authors: Reinhard DL,Whyte J,Sandel ME

    更新日期:1996-01-01 00:00:00

  • Cervical radiculopathy.

    abstract::The history, pathoanatomy and pathophysiology, clinical picture, differential diagnosis, diagnostic evaluation, and treatment of cervical radiculopathy are reviewed. The review is based on a 10-year Medline literature search, review of bibliographies in textbooks, and bibliographies in articles obtained through the se...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章,评审

    doi:10.1016/0003-9993(94)90040-x

    authors: Ellenberg MR,Honet JC,Treanor WJ

    更新日期:1994-03-01 00:00:00

  • Medical school effect on student selection of physical medicine and rehabilitation as a specialty.

    abstract::Of the several roads that lead to practice in the specialty of physical medicine and rehabilitation (PM&R), the most common is from a US medical school to a PM&R residency to specialty practice. To reduce the predicted shortage of PM&R physicians, more medical students must be attracted to the specialty. Past studies ...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:

    authors: Bender LF,Dijkers MP

    更新日期:1986-11-01 00:00:00

  • Status of physiatry and physical medicine and rehabilitation departments in adult level I trauma centers.

    abstract:OBJECTIVE:To determine the involvement of physiatrists and physical medicine and rehabilitation (PM&R) departments in the acute care of patients admitted to level I trauma centers. DESIGN:An 18-question survey. SETTING:Adult, level I trauma center. PARTICIPANTS:Physiatrists, administrative directors, and others invo...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:10.1016/s0003-9993(98)90210-6

    authors: Melchiorre PJ

    更新日期:1998-01-01 00:00:00

  • The effect of a high resistance exercise program in slowly progressive neuromuscular disease.

    abstract::A 12-week high resistance home exercise program was completed by 10 subjects with slowly progressive neuromuscular diseases (NMD) and 6 normal control subjects (CTL). After evaluating baseline maximal isometric and isokinetic strength of the elbow flexors and knee extensors, subjects completed the home program using a...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Kilmer DD,McCrory MA,Wright NC,Aitkens SG,Bernauer EM

    更新日期:1994-05-01 00:00:00

  • Decreased isokinetic trunk muscle strength and performance in long-term survivors of childhood malignancies: correlation with hormonal defects.

    abstract:OBJECTIVE:To evaluate trunk muscle strength and performance in long-term survivors of childhood malignancies relative to age and sex-matched controls, and to relate the muscle strength observations to the therapeutic agents used and possible hormonal disturbances. DESIGN:Age and sex-matched cohort study. SETTING:Refe...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:10.1016/s0003-9993(95)81033-1

    authors: Talvensaari KK,Jämsen A,Vanharanta H,Lanning M

    更新日期:1995-11-01 00:00:00

  • Short-stay comprehensive inpatient pulmonary rehabilitation for advanced chronic obstructive pulmonary disease.

    abstract:OBJECTIVE:To evaluate the effectiveness of short-term, comprehensive inpatient pulmonary rehabilitation in severe chronic obstructive pulmonary disease (COPD). DESIGN:Retrospective analysis of several outcome measures. SETTING:Inpatient pulmonary rehabilitation unit. PARTICIPANTS:Thirty-eight consecutive adult patie...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:10.1016/s0003-9993(96)90132-x

    authors: Votto J,Bowen J,Scalise P,Wollschlager C,ZuWallack R

    更新日期:1996-11-01 00:00:00

  • Clinical Features of Disorders of Consciousness in Young Children.

    abstract:OBJECTIVES:To investigate behavioral and demographic features of levels of consciousness in young children with brain injury, including the classifications of consciousness: conscious state (CS), minimally conscious state (MCS), and vegetative state (VS), and to investigate the course of recovery in children with disor...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:10.1016/j.apmr.2018.12.022

    authors: Alvarez G,Suskauer SJ,Slomine B

    更新日期:2019-04-01 00:00:00

  • The use of the Gaussian curve fitting method for scintigraphic measurements of the swallowing process in healthy subjects: implications for evaluation of dysphagia.

    abstract:OBJECTIVE:To present the results of scintigraphic evaluation, using the Gaussian curve fitting method, via 3 parameters of oropharyngeal swallow: (1) pharyngeal transit time, (2) premature pharyngeal entry, and (3) postswallow pharyngeal stasis while ingesting liquid. DESIGN:A descriptive study. SETTING:A rehabilitat...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:10.1016/j.apmr.2006.08.324

    authors: Huang YH,Tseng FF,Tsai SJ,Lin CH,Chou YH,Lew HL

    更新日期:2006-11-01 00:00:00

  • Muscle changes following cycling and/or electrical stimulation in pediatric spinal cord injury.

    abstract:OBJECTIVE:To determine the effect of cycling, electrical stimulation, or both, on thigh muscle volume and stimulated muscle strength in children with spinal cord injury (SCI). DESIGN:Randomized controlled trial. SETTING:Children's hospital specializing in pediatric SCI. PARTICIPANTS:Children (N=30; ages, 5-13y) with...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.apmr.2011.06.031

    authors: Johnston TE,Modlesky CM,Betz RR,Lauer RT

    更新日期:2011-12-01 00:00:00

  • Lupoid sclerosis: evaluation and treatment.

    abstract::The history, physical examination and laboratory data are presented of a patient with multiple sclerosis and systemic lupus erythematosus. The rehabilitation medicine evaluation and course of therapy are reviewed. Other published cases of similar patients are reviewed. ...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:

    authors: Kaplan PE,Betts HB

    更新日期:1977-01-01 00:00:00

  • Ischemic stroke: relation of age, lesion location, and initial neurologic deficit to functional outcome.

    abstract:OBJECTIVE:Establish the relation between age, gender, initial neurologic deficit, stroke location, prior stroke, hemisphere of stroke, and functional outcome in ischemic stroke. DESIGN:Single group, multivariate, repeated measures design with 327 persons having ischemic stroke recruited from 20 participating centers. ...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:10.1016/s0003-9993(98)90271-4

    authors: Macciocchi SN,Diamond PT,Alves WM,Mertz T

    更新日期:1998-10-01 00:00:00

  • Effect of intermittent pneumatic compression on lower limb oxygenation.

    abstract::The effect of intermittent pneumatic compression (IPC) of the lower limbs on transcutaneous oxygen tension (tcPO2) was studied in 14 healthy volunteers and the same number of elderly patients. The oxygen sensor was calibrated at 37C in room air. This temperature was also used for measurements. Compression pressure in ...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:

    authors: Rithalia SV,Edwards J,Sayegh A

    更新日期:1988-09-01 00:00:00

  • Cerebral diaschisis following cerebellar hemorrhage.

    abstract::In 1914, Von Monakow described diaschisis, the recovery of lost cortical function in regions positionally distant from, but linked by neuronal tracts to, the primary site of cortical damage. Cerebellar diaschisis after cortical insult is detailed in the literature; however, cortical diaschisis after cerebellar insult ...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:10.1016/s0003-9993(97)90175-1

    authors: Hausen HS,Lachmann EA,Nagler W

    更新日期:1997-05-01 00:00:00

  • M-response quantification: a technique.

    abstract::Median nerve responses in 13 patients and 9 normal subjects were evaluated using surface bipolar stimulation. The M response from surface electrodes placed upon the thenar eminence was recorded on a fiberoptic chart recorder and simultaneously subjected to true electronic integration. Comparison between the integrated...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:

    authors: Gans BM,Kraft GH

    更新日期:1981-08-01 00:00:00

  • Participation outcomes in a randomized trial of 2 models of upper-limb rehabilitation for children with congenital hemiplegia.

    abstract:OBJECTIVE:To determine if constraint-induced movement therapy (CIMT) is more effective than bimanual training to improve occupational performance and participation in children with congenital hemiplegia. DESIGN:Single-blind randomized comparison trial with evaluations at baseline, 3, and 26 weeks. SETTING:Community f...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1016/j.apmr.2010.11.022

    authors: Sakzewski L,Ziviani J,Abbott DF,Macdonell RA,Jackson GD,Boyd RN

    更新日期:2011-04-01 00:00:00

  • Satisfaction with quality of life poststroke: effect of sex differences in pain response.

    abstract:OBJECTIVE:To study the relationship between sex differences among men and women in the response to pain and the effect on satisfaction with quality of life (QOL) in poststroke patients approximately 90 days after discharge from inpatient medical rehabilitation. DESIGN:Cross-sectional design. SETTING:Community based. ...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:10.1016/j.apmr.2006.12.022

    authors: Bergés IM,Ottenbacher KJ,Kuo YF,Smith PM,Smith D,Ostir GV

    更新日期:2007-04-01 00:00:00

  • Return to productive activity after traumatic brain injury: relationship with measures of disability, handicap, and community integration.

    abstract:OBJECTIVES:To identify which factors are associated with successful return to productive activity (RTPA) 1 year after hospitalization with traumatic brain injury (TBI) and to examine the relations between successful RTPA and other measures of impairment, disability, handicap, and integration into the community. DESIGN...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:10.1053/apmr.2002.27470

    authors: Wagner AK,Hammond FM,Sasser HC,Wiercisiewski D

    更新日期:2002-01-01 00:00:00

  • Cervical spine rotation and lateral flexion combined motion in the examination of the thoracic outlet.

    abstract::The axial rotation and simultaneous lateral flexion of the cervical spine is kinesiologically related to the movements of the upper thoracic spine. Five brachialgia patients were found to have a hypomobile first rib on the painful side in a cineradiographic study. The kinesiologic finding was the following: when the n...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:

    authors: Lindgren KA,Leino E,Hakola M,Hamberg J

    更新日期:1990-04-01 00:00:00

  • Effects of a quantitative progressive rehabilitation program applied unilaterally to the osteoarthritic knee.

    abstract::Decreases in muscular strength, endurance, and angular velocity have previously been demonstrated in the elderly. Osteoarthritis (OA), especially of the knee, may cause further reductions in these parameters and lead to functional limitations. This study measured the effects of a quantitative progressive exercise musc...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 临床试验,杂志文章

    doi:10.1016/0003-9993(93)90087-q

    authors: Fisher NM,Gresham G,Pendergast DR

    更新日期:1993-12-01 00:00:00

  • Why rehabilitation research does not work (as well as we think it should)

    abstract::Establishing treatment effectiveness is a high priority for rehabilitation research. The use of traditional quantitative null hypotheses to achieve this priority is reviewed. Three problems are identified in the analysis and interpretation of investigations based on statistical testing of hypotheses: (1) confusion of ...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:10.1016/s0003-9993(95)80021-2

    authors: Ottenbacher KJ

    更新日期:1995-02-01 00:00:00

  • Course of gross mechanical efficiency in handrim wheelchair propulsion during rehabilitation of people with spinal cord injury: a prospective cohort study.

    abstract:OBJECTIVE:To investigate the course of mechanical efficiency of handrim wheelchair propulsion during rehabilitation of subjects with (in)complete paraplegia and tetraplegia. DESIGN:Subjects were tested at the start of active rehabilitation (t1), 3 months later (t2), and when discharged from inpatient rehabilitation (t...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.apmr.2004.11.025

    authors: de Groot S,Dallmeijer AJ,Kilkens OJ,van Asbeck FW,Nene AV,Angenot EL,Post MW,van der Woude LH

    更新日期:2005-07-01 00:00:00

  • Trajectories of Self-Efficacy and Depressed Mood and Their Relationship in the First 12 Months Following Spinal Cord Injury.

    abstract:OBJECTIVES:To establish self-efficacy and depressive mood trajectories in adults with spinal cord injury (SCI), determine their interrelationship over time, and determine the influence that appraisals and comorbid physical conditions have on the development of self-efficacy. DESIGN:A prospective cohort design. SETTIN...

    journal_title:Archives of physical medicine and rehabilitation

    pub_type: 杂志文章

    doi:10.1016/j.apmr.2018.07.442

    authors: Craig A,Tran Y,Guest R,Middleton J

    更新日期:2019-03-01 00:00:00