Outline of plans to carry out research which formed a substantial part of the PhD thesis of Professor Anthony J Sargeant

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Proceedings of The Royal Society of Medicine 1974 Jun;67(6 Pt 1):498.

Anthony J Sargeant and colleagues preliminary research report on plans to study rehabilitation strategies in injured military personnel.The Assessment of Physiological Changes Occurring During Rehabilitation of Lower Limb Injuries at the Joint Services Medical Rehabilitation Unit by C T M Davies, R H Fox, A J Hackett, F J Imms, Sally James, S P Prestidge and A J Sargeant (MRC Environmental Physiology Unit, London School ofHygiene and Tropical Medicine, and Division ofHuman Physiology, National Institutefor Medical Research, London NW3)1 The research programme aims to record the improvement of general fitness and the return of function in the injured limb. Such data will be of value in assessing the efficacy of present therapies and in the design and evaluation ofnew treatments. Heart rate is monitored during the working day by recording the electrocardiogram using a small portable tape recorder which is strapped to the subject and causes minimum inconvenience. Resting heart rates and cardiac responses to exercise therapy are obtained. Preliminary results show that the therapeutic regimes seldom raise the heart rate above 160 beats/min. Mean night-time heart rates are recorded using an E cell SAMI. Exercise testing is performed in the laboratory using a bicycle ergometer on which the subjects initially work only the non-affected limb. When they are able to use the injured limb the work capacity of the two limbs is compared. The recovery of function in the injured limb is assessed by frequent anthropometry of the legs and measurement of joint mobility, the testing of muscle power and analysis of the gait. Muscle power is measured isometrically using a strain gauge to which either a direct pull or a torque can be applied. On admission there is marked reduction of power in the injured limb. This limitation of voluntary muscle power may be due to a combination of apprehension or pain together with actual loss of contractile force. The gait is analysed using a metal track on which the subject walks whilst wearing shoes fitted with metal contacts. Contact between the foot and the track completes a circuit and the event is recorded. The period of swing of the right and left strides may be compared and the floor contact times of each heel and toe measured. Initially the gait is asymmetrical as regards both swing times and contact times. Movement is further assessed by taking a cinefilm of the subject walking and performing simple acts such as sitting and rising from a chair and climbing stairs. These films are examined for abnormalities of movement and elimination of these abnormalities is studied in serial films.

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