ON LIFE SATISFACTION AND CHRONIC BACK-PAIN IN A SUB-ARCTIC REHABILITATION SAMPLE
Michael Eklund, (Department of Rehabilitation Medicine, Uppsala University, Uppsala, Sweden and The General Hospital of Jacobstad, Finland)
Purpose & method: Levels of satisfaction with life as a whole and with eight specific life domains were explored at the commencement of a multidisciplinary rehabilitation program and two years later in 168 chronic back-pain rehabilitees, who at admission were in the risk zone of becoming or actually were vocationally disabled.
Results: Satisfaction with life as a whole and satisfaction derived from performance- and provider-related domains of life were significantly lower than satisfaction derived from emotional domains. The eight domain-specific items of life satisfaction described a three factor-pattern: An emotional factor, a sociability factor and an instrumental factor. At the 2-year follow-up the emotional and sociability factors had merged, whereas the instrumental factor was split in two, a provider factor and one including only satisfaction with ADL. Successful back-pain rehabilitation that secured vocational activity also led to increased satisfaction with ADL. Turning vocationally active significantly increased vocational satisfaction while becoming vocationally inactive significantly decreased satisfaction with emotional domains of life, financial satisfaction and above all, satisfaction with life as a whole. In contrast to other investigations change in satisfaction with ADL was the cardinal predictor of change in satisfaction with life as a whole.
Conclusions: The results indicate that vocationally successful back-pain rehabilitation leads to increases in ADL and vocational satisfaction. For chronic back-pain rehabilitees satisfaction with ADL and thus sufficient ADL capacity is prerequisite for satisfaction with life as a whole. When ADL capacity sufficient for vocational activity appears unattainable, rehabilitees and staff should aim to secure and restore satisfying emotional life goals.
Manometrie Evaluation of Dysphagia with Stroke
I. Fujishima, R. Ohkuma, I. Shibamoto, C. Kojima, K. Hojyo, S. Tanaka (Seirei Mikatabara General Hospital, Hamamatsu, Japan)
Objective: To study the pharyngeal manometric parameter of dysphagia with stroke.
Subjects: 6 pseudobulbar palsy patients (mean age of 68±11.6), 4 bulbar palsy patients (66±11.1) and 8 asymptomatic aged controls (58±13.7).
Measurements: The manometric exam was performed using a solid state pressure catheter with a sleeve sensor (Konisberg), Micro-Digitrapper (Synetics Medical). The data was analysed by polygram. The position of the sensor was checked on the simultanous videofluoroscopy.
Results: Peak pharyngeal pressure during the pharyngeal contraction was 64.3±17.1 mmHg (pseudobulbar palsy),15.0±7.9 mmHg (bulbar palsy),111.9±19.7 mmHg (control) (p<0.01). Peak pressure of aspirator and non-aspirator was 50.6 ±4.8 mmHg and 78.1±12.0 mmHg, respectively(p<0.05). Conclusion: Manometric evaluation suggested the pharyngeal contraction weakness of dysphagia with stroke.