Physical Therapy - Dictionary

Patents 143 • Therapeutic method with capsaicin and capsaicin analogues Inventor(s): Campbell; James N. (707 Hillstead Dr., Lutherville, MD 21093), Meyer; Richard A. (10084 Shaker Dr., Columbia, MD 21046), Pappagallo; Marco (2809 Boston St. Aplt. 151, Baltimore, MD 21224) Assignee(s): none reported Patent Number: 5,962,532 Date filed: March 12, 1998 Abstract: Methods and compositions for treating pain at a specific site with an effective concentration of capsaicin or analogues thereof are described. The methods involve providing anesthesia to the site where the capsaicin or analogues thereof is to be administered, and then administering an effective concentration of capsaicin to the joint. The anesthesia can be provided directly to the site, or at remote site that causes anesthesia at the site where the capsaicin is to be administered. For example, epidural regional anesthesia can be provided to patients to which the capsaicin is to be administered at a site located from the waist down. By pretreating the site with the anesthetic, a significantly higher concentration of capsaicin can be used. Effective concentrations of capsaicin or analogues thereof range from between 0.01 and 10% by weight, preferably between 1 and 7.5% by weight, and more preferably, about 5% by weight. This provides for greater and more prolonged pain relief, for periods of time ranging from one week to several weeks. In some cases the pain relief may be more sustained because the disease that underlies the pain may improve due to a variety of factors including enhancement of physical therapy due to less pain in the soft tissues which may foster enhanced mobilization of soft tissues, tendons, and joints. Excerpt(s): This application is directed to compositions and methods for relieving pain at a specific site, for example, associated with inflammation of joints, tendons, nerves, muscle, and other soft tissues, nerve injury and neuropathies, and pain from tumors in soft tissues or bone. Capsaicin, a pungent substance derived from the plants of the solanaceae family (hot chili peppers) has long been used as an experimental tool because of its selective action on the small diameter afferent nerve fibers (C fibers and A-delta fibers) that are believed to signal pain. From studies in animals, capsaicin appears to trigger C fiber membrane depolarization by opening cation channels permeable to calcium and sodium. Recently one of the receptors for capsaicin effects has been cloned. Although detailed mechanisms are not yet known, capsaicin mediated effects include: (i) activation of nociceptors in peripheral tissues; (ii) eventual desensitization of peripheral nociceptors to one or more stimulus modalities; (iii) cellular degeneration of sensitive A-delta and C fiber afferents; (iv) activation of neuronal proteases; (v) blockage of axonal transport; and (vi) the decrease of the absolute number of nociceptive fibers without affecting the number of non-nociceptive fibers. Web site: http://www.delphion.com/details?pn=US05962532__

144 Physical Therapy • Thermal treatment apparatus radiating low and high temperature Inventor(s): Yoon; Hee-Sun (#A-101 Miju Apartment, 302-54 Dongbuichon-Dong, Yongsan-Gu, Seoul, KR 140-031), Yoon; Jung-Sun (#310-303 Shinbanpo 8cha Hanshin Apartment, Chamwon-Dong, Seocho-Gu, Seoul, KR 137-797) Assignee(s): none reported Patent Number: 6,640,051 Date filed: January 11, 2002 Abstract: Disclosed is a thermal treatment apparatus radiating low and high temperature, which includes a low-temperature radiating section and a high- temperature radiating section, and can rotatably scan affected parts. Both the low and the high temperature radiating sections are rotatable. The thermal treatment apparatus according to the present invention further includes a controller, with which a user can adjust the period of time for radiating low and high temperature as well as for rotation of the low-temperature radiating section and the high-temperature radiating section. The low-temperature radiating section is connected to a cryo-pump, while the high- temperature radiating section comprises an infrared ray lamp or a far infrared ray lamp. The present invention is applicable to medical treatment, physical therapy, sterilization of cosmetics or pharmaceuticals, or to tests of critical temperature for survival of cells. Excerpt(s): The present invention relates to a thermal treatment apparatus radiating low and high temperature. More particularly this invention relates to a thermal treatment apparatus radiating low and high temperature, which can repeatedly turn the period of time for radiating low temperature and high temperature by integrating a high- temperature radiating section with a low-temperature radiating section, and can rotatable treat the affected parts. The conventional physical treatment apparatuses mostly radiate high temperature using infrared ray, etc., although there also exist some apparatuses radiating low temperature serving for particular purposes. Those apparatuses normally comprise a heat radiating section for radiating high or low temperature to affected parts, a stand for supporting the heat radiating section, and a control section for controlling the temperature or a period of time for thermal irradiation. However, the conventional apparatuses radiating either high or low temperature only pose the problem of requiring two separate apparatuses for radiating both low and high temperature. Web site: http://www.delphion.com/details?pn=US06640051__ • Traction apparatus for physical therapy of herniated nucleosus pulposus or sprain and strain Inventor(s): Park; Chang Joon (244-326, Sangdo-4-dong, Dongiak-ku, Seoul, KR) Assignee(s): none reported Patent Number: 5,823,982 Date filed: January 17, 1997 Abstract: Traction apparatus for medically and physically treating herniated nucleosus pulposus or sprain and strain is disclosed. The traction apparatus comprises an upper support frame, a lower support frame, and a plurality of tubes. The traction apparatus further includes an exercising device. The upper support frame encircles the upper part of the therapy region and has two free ends positioned in space relation. The lower

Patents 145 support frame encircles the lower part of the therapy region and hits two free ends positioned in space relation. The tubes are expandable to provide traction on the therapy region and are filled up with fluid which is generated by a fluid generating device. Preferably, the fluid generating device is a programmed controller including additionally pressure regulating function, timing function, intermittent ON and OFF function, etc. Excerpt(s): The present invention relates to a medical aid appliance, and more particularly to a traction apparatus for physical therapy of herniated nucleosus pulposus or sprain and strain. The herniated nucleosus pulposus (hereinafter referred to as \"HNP\"), which is limited to the explanations thereof with omitting the explanations of the sprain and strain, is one of vertebral diseases. The HNP is caused by the herniation of the nucleosus pulposus of disk which is interposed between one vertebra and one adjacent vertebra. Excessive loads and external impacts trigger a person to the HNP. The HNP takes place at cervical region, thoracic region, or lumbar region of a vertebral column. The HNP sufferers undergo lumbago most of all because the nerves root and is pressed also undergo radiating pain as the lower half of sufferers' body. If the sufferers take a turn for the worse, they cannot perform their normal activities and, moreover cannot lead a normal daily life. Accordingly, as number of attempts have been made to treat the NHP. Various therapy techniques, for example, operating therapy technique, physical therapy technique including bed rest therapy, therapy by hot heat, optical therapy, electrotherapy, traction therapy, and mediation technique, may have been used for the treatment of the HNP. Web site: http://www.delphion.com/details?pn=US05823982__ • Traction device for physical therapy Inventor(s): D'Amico; Anthony T. (362 Eckford, Troy, MI 48084) Assignee(s): none reported Patent Number: 5,957,876 Date filed: August 7, 1997 Abstract: A cervical traction device which can be used on a support surface such as a bed which applies a tractive force to the back of the patient's skull approximate to the occipital bone through the use of contoured blocks which can preferably be positioned behind the patient's head and mounted on a head rest assembly. The tractive force can be administered in a continuous cyclical or intermittent manner controlled by the patient during a cervical traction session. The device has an integrated damping system which permits return of tractive force to the patient during each cycle in a gradual fashion. This gradual return enables this unit to closely simulate cyclic, and cyclic intermittent traction performed in the more expensive in-office equipment used by physical therapists. The head rest assembly slides on the bed or similar surface and can be vertically and laterally adjusted to vary the flexion-extension angle. The cervical traction device can be operated by the patient with or without the help of a second party. The mechanism is configured with gas springs to control the rate of descent of the weight and apply a constant tractive force to the patient in a manner which maximizes safety. Excerpt(s): The present invention is related to physical therapy devices. More particularly, the present invention is related to devices for administering cervical traction to the neck region of a patient. Even more particularly, the present invention is

146 Physical Therapy related to cervical traction devices for home-use which provide the option of administering cervical traction in a cyclical, intermittent or non-cyclical manner. The need for simple, low cost cervical traction devices which can be used at home to administer cervical traction to provide relief to patients with various musculo-skeletal disorders of the neck and back is well recognized. Heretofore there have been developed a great number of head halters or other devices which apply cervical traction through the head of the patient. Many of these devices engage the jaw of the patient while surrounding the head. These type of halters not only inhibit the ability of the patient to talk, they also cause aggravation of the temporomandibular (TMJ) points. As a device for administering cervical traction, these devices are less than desirable. Jaw-type head halters of this type pull from an axis offset from the spine and thereby apply an undesirable twisting moment (cervical extension) to the patient's head and neck contrary to most types of desired cervical traction. In most types of cervical traction situations, it is desirable to engage the head of the patient at the occipital area of the head rather than the chin so that the pulling axis is in straight alignment with the spine and so that the pulling force is concentrated along the posterior of the head where it is most beneficial. Other types of devices for engaging the head to correct neck problems are cervical braces. Such braces, which are referred to as \"halo type\", actually contact the patient's head with pointed screws which are forced inward through the skin to make contact with the bone of the skull. Aside from the obvious pain which a patient must endure when this type of brace is employed, the potential for infection to the person's head at the points where the skin is broken is ever present. Web site: http://www.delphion.com/details?pn=US05957876__ • Versatile physical therapy apparatus Inventor(s): Steinbach; Emil C. (Charlotte, NC), Steinbach; John M. (Charlotte, NC) Assignee(s): Bedside Rehabilitation Technology, Inc. (Charlotte, NC) Patent Number: 6,228,004 Date filed: June 26, 1998 Abstract: A versatile physical therapy apparatus is disclosed. Beneficially, the apparatus, when mounted, is adapted to be supported by an end of a bed, and includes an angularly positionable guide wheel for variation in exercise and in the muscles exercised. Excerpt(s): This invention relates to an exercise apparatus adapted to be mounted to a bed. Many types of exercise apparatus exist as illustrated by U.S. Pat. No. 3,118,441 to George. However, there are few exercise apparatus designed for use by a bed-ridden patient, whether in a hospital, nursing home, or at home. Moreover, as exemplified by U.S. Pat. No. 2,601,686 to Roessler and U.S. Pat. No. 5,005,829 to Caruso, versatility and portability are features lacking in a physical therapy apparatus for a bed-ridden patient. In accordance with the present invention, there is provided a versatile physical therapy apparatus preferably to be used with the aid of a physical therapist. The apparatus beneficially includes a mounting member adapted to be supported by an end of a bed, a resistance element attached to the mounting member, and a guide wheel rotatably mounted in a pulley block and normally spaced apart from the resistance element. Normally, the resistance element is in a contracted or relaxed position, but in use, is extended or elongated and may as a result, closely approach the guide wheel. Web site: http://www.delphion.com/details?pn=US06228004__

Patents 147 • Weighted exercise and therapeutic suit Inventor(s): Raines; Mark T. (304 Fawn Field Dr., Cedar Park, TX 78613) Assignee(s): none reported Patent Number: 5,937,441 Date filed: August 5, 1996 Abstract: Weighted suit to be used in athletic training, physical therapy, muscle toning and weight reduction. The suit has a bottom and top that can be adjusted to accommodate the physical characteristics of the wearer, as well as the activity to be performed by the wearer while the suit is worn. The suit also has weighted gloves which may be attached to the sleeve portion of the top of the suit. The suit is constructed from spandex material that accommodates stretch in one direction and resists it in another direction approximately perpendicular to the first. Weight compartments are located about the suit into which weight units may be installed. Variable weight packets may be used to selectively apply different resistance experienced during the user's activity. The weights are located away from the user's joints, and protective components may be integrally included into the suit to cover vulnerable knee and elbow joints. The suit is reinforced with support strapping that is continuously sewn to the suit for supporting the weight packets against gravity and inertial forces during use. A support belt for the user's back may be optionally included as an integral component. The suit clings snugly to the user's physique and therefore may be worn beneath other clothing, such as a business suit. Excerpt(s): This invention pertains to athletic and therapeutic wearing apparel, and more particularly to weighted suits for applying variable resistance during user activity. Persons training for athletics and undergoing physical therapy often include work-outs with weights to increase and speed their progress. To meet this need, wearing apparel has been developed that incorporates weights into various designs. By inclusion of the weights in the garment itself, the wearer enjoys further benefits from the added resistance. An example is U.S. Pat. No. 5,144,694 entitled Exercise Apparel and Weight Packets issued to Conrad Daoud et al. Therein, a garment is disclosed that includes a vest, pants, spine strap, belt, wrist bands, ankle bands and weight packets. The weight packet includes plural rows and plural columns of weight members that are installed in pockets; the pockets position the weights about the wearer's body. The placement of the weight is solely maintained by the snugness of the garment's fit to the wearer's body. Web site: http://www.delphion.com/details?pn=US05937441__ • Weighted footwear garment for exercise, training and/or therapy Inventor(s): Glass; Alvin (151 Tamalpais Ave., Mill Valley, CA 94941) Assignee(s): none reported Patent Number: 5,893,223 Date filed: November 25, 1997 Abstract: A readily removable two piece stretch fabric garment (3) with four pockets (4,5,6,7) for containing weights (4a, 5a, 6a 7a) is attached to the users athletic or conventional shoe (2) for the purpose of exercise, training and/or physical therapy. The weights are contoured to match the shape of that portion of the shoe which they overly and they are secured in their respective pockets by releasable Velcro (R) closures. A

148 Physical Therapy durable rubber or vinyl sole (8) connected to the toe portion of the footwear garment grips the toe segment of the shoe and forms a partial under surface for the garment to the shoe. Excerpt(s): This invention relates to a removable garment that contains weights which fit around an athletic or conventional shoe and allows for total unrestricted mobility for use in exercise, training and/or therapy. There are a number of weight devices for exercising that can be connected to a leg or attached to a shoe or foot and used principally for the purpose of improving strength in this are ankle cuff weights which are used by some runners and power walkers and do allow for unrestricted mobility of the limb. However, they usually cannot be sufficiently secured to the ankle to avoid some movement while running, jumping or walking. The movement of the cuff weights while engaged in such activities often results in skin irritations as well as other potential injuries. U.S. Pat. No. 5,514,056 to Ronca addresses this issue by firmly securing a weight apparatus to the lower leg proximal to the ankle. The fact that both of these weight devices are located at the ankle or proximal to it precludes their capability of strengthening the lower leg muscles whose tendons insert on the foot and/or toes. In addition both of these devices are likely to be perceived as unnatural encumbrances around the lower limbs of their users. In regard to prior art there are four weight devices that can be attached to a shoe and one weighted shoe that allows for unrestricted mobility of the foot and limb while performing aerobic exercises including activities such as running and/or walking. They are U.S. Pat. No. 3,114,982 to McGowan, G.B. patent 2139103 to Rogers, U.S. Pat. No. 4,458,432 to Stempski, U.S. Pat. No. 757,983 to Vaile and FR patent 2,535,211 to Deschamps. Web site: http://www.delphion.com/details?pn=US05893223__ Patent Applications on Physical Therapy As of December 2000, U.S. patent applications are open to public viewing.9 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to physical therapy: • Adaptable range-of-motion exercise apparatus Inventor(s): Harmon, Larry Shane; (Sausalito, CA) Correspondence: Grant R Clayton; Clayton Howarth & Cannon, PC; P O Box 1909; Sandy; UT; 84091-1909; US Patent Application Number: 20020169058 Date filed: June 13, 2002 Abstract: A resistance exercise apparatus is provided which includes structures for receiving a body extremity of a user, the means for receiving a body extremity subject to a force provided by the body extremity, structures for maintaining the means for receiving a body extremity in a predefined plane during movement; and resistance providing devices to impose resistance against the movement of the body extremity. Versions of the apparatus may positioned on a floor, on a wall, or be free standing. Various embodiments of the invention are particularly suited to provide range-of- 9 This has been a common practice outside the United States prior to December 2000.

Patents 149 motion exercises for legs, arms, and hands of the user for both recreational strengthening and physical therapy applications. Excerpt(s): 1. The Field of the Invention. This invention relates generally to exercise apparatus and more specifically to a novel apparatus for exercising the human body which provides beneficial range-of-motion exercises. 3. The Background Art. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html • Article and method for self-administered physical therapy to alleviate back pain Inventor(s): Pecora, Ralph R.; (Baltimore, MD) Correspondence: Royal W. Craig; A Professional Corporation; Suite 153; 10 North Calvert Street; Baltimore; MD; 21202; US Patent Application Number: 20020193714 Date filed: June 13, 2002 Abstract: A therapeutic device for alleviating mid-to-upper back pain. The device comprises a hard cylindrical body wrapped in a cushioning sleeve. The sleeve is sufficiently firm to resist deforming, thereby maintaining its round shape and enabling it to roll easily along the ground. At the same time, the sleeve comfortably supports the user and transfers the force of the hard inner element to the user's back muscles and joints without causing pain or injury. The device can be used by individuals suffering from mid-to-upper back pain associated with muscle spasms, soreness, or injury. The device enables the individual to self-administer therapy to the back muscles and joints to relieve back pain and reduce the likelihood of future incidences of pain. Excerpt(s): The present application derives priority from U.S. Provisional Patent Application 60/297,803, filed: Jun. 13, 2001. The present invention relates to physical therapy devices, and, more particularly, to a therapeutic device for alleviating mid-to- upper back pain resulting from muscle spasms or tired, stiff muscles. Worldwide back pain is estimated to afflict 60-80% of the human population at some point in their lives, and it afflicts 2-5% of the population at any given time. Anatomically, the back is divisible into three regions defined by the vertebrae of the spinal column. Beginning at the neck, the first 7 descending vertebrae are the cervical vertebrae. Next, the thoracic region consists of 12 vertebrae, and finally the lumbar region comprises five vertebrae of the lower back. The trapezius and the latissimus dorsi represent two large muscle groups in the back most commonly associated with muscular back pain. The present invention is directed to alleviating the discomfort and debilitating effects of mid-to- upper back pain, generally corresponding to regions of the thoracic and cervical vertebrae. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html • Assistive clothing Inventor(s): Simmons, John C.; (Germantown, TN) Correspondence: John C. Simmons; 7993 Caversham Wood LN; Germantown; TN; 38138; US Patent Application Number: 20030120183 Date filed: July 22, 2002

150 Physical Therapy Abstract: An apparatus and process for empowering those in wheelchairs and others with loss of limb control to walk, climb stairs, sit in ordinary chairs, use normal bathroom facilities and stand at normal height with their peers. It also provides a means to speed rehabilitation of the injured and a means to deliver more comfortable and effective prostheses while providing superior physical therapy without draining professional resources which includes new simulation and training means. Most of the apparatus is worn under normal clothing allowing them to enjoy a normal appearance. Additional advancements include improved actuator design, user interface, visual means and advanced responsive virtual reality. Excerpt(s): The present application is a Continuation-in-Part of U.S. utility patent application Ser. No. 09/960,293 titled \"Wheel-less Walking Support and Rehabilitation Device\" which application was filed Sep. 20, 2001 and which claims the benefit of provisional application 60/234,191 which was filed on Sep. 20, 2000. 1. The current design of a wheelchair, except for the addition of power, is not much improved in functionally over the original invented by Eric Von Bulenheimer in 1672. 2. Perhaps the greatest advancement since then has been a chair on wheels that can climb stairs but must be navigated backwards, doesn't work on many staircases including but not limited to spiral staircases and short depth staircases, depends on the traction of its wheels even on slippery stairs for stability, requires some strength to manage the handrail and is still a heavy (202 pounds) wheelchair that must be accommodated (lugged) everywhere the user goes including airplanes, cars, escalators, bathrooms, etc. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html • Electrical drive assembly for an exercise machine Inventor(s): Ho, Shou-Shan; (Taichung Hsien, TW) Correspondence: Jones, Tullar & Cooper, P.C.; Suite 1002; 2001 Jefferson Davis Highway; Arlington; VA; 22202; US Patent Application Number: 20030153436 Date filed: February 11, 2002 Abstract: An drive assembly for an exercise bike consists of an electrical motor (10), a driven wheel (20), a unidirectional clutch (30), a flywheel (40), a shaft (47) and a crank wheel (50). The shaft (47) penetrates the driven wheel (20), the unidirectional clutch (30) and the flywheel (40). The driven wheel (20) is driven by the electrical motor (10) and then passes on the rotating momentum via the clutch (30), the flywheel (40), the belt wheel and the crank wheel (50) in sequence when the electrical motor (10) is switched on. The exercise bike can rotate in an automatic way to make the ordinary exercise bike into a physical therapy training bike. Excerpt(s): The present invention relates to an electrical drive assembly, and more particularly to a drive assembly used in an exercise machine, which allows the exercise machine to be used in an active or passive way. Indoor sports and exercise have become much more popular in modern urban societies because people do not have enough time or space for outdoor sports. Thus the use of aerobic exercise machines such as exercise bikes, steppers, treadmills and fitness flyers has mushroomed, but the use of the individual exercise machines is limited. Take the exercise bike as an example, the exercise bike is a zero-impact exercise device and can be used by all people of different ages to exercise. However, the exercise bike is only used in a passive mode. That is to say, the exercise bike only works when a user rotates the exercise bike pedals. Therefore,

Patents 151 an injured people who is unable to operate the exercise bike but needs physical therapy to recover from an injury cannot use the exercise bike for physical therapy. Toward the objective of using an exercise bike to improve the range of motion in and strength of a patient's legs, the present invention provides a modified electrical drive assembly for an exercise bike that allows the exercise bike to be operated in either an automatic or passive mode. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html • Exercise apparatus and method Inventor(s): Weitzman, Bernard; (New York, NY) Correspondence: Darby & Darby P.C.; Post Office Box 5257; New York; NY; 10150-5257; US Patent Application Number: 20030096685 Date filed: November 15, 2002 Abstract: This invention relates to health and fitness, and more particularly to exercise methods and devices. More particularly, the invention is directed to stretching exercises and physical therapy, for example an apparatus and exercises for lower back pain. The exercise apparatus comprises at least three cells abutting each other on a common base or frame. Each cell can be independently inflated and deflated to provide an adjustable support cushion having a range of shapes and firmness. An articulated frame is optionally provided for additional independent movement of the cells. Users lie down on the cushion and produce precise stretches and exercises by controlling the rate and degree of inflation or deflation of each cell or group of cells, and optionally, articulated movement of the frame. Stretching can occur passively, as when the body conforms to the shape of the cushion, or actively by exercising in concert with the conformation of the cushion. Excerpt(s): This application claims priority from Provisional Application No. 60/335,854 filed on Nov. 16, 2001. This invention relates to health and fitness, and more particularly to exercise methods and devices. More particularly, the invention is directed to stretching exercises and physical therapy, for example an apparatus and exercises for lower back pain. Lower back pain is widespread in our civilization. It has been estimated, for example by the US government, that its cost to the economy is second only to upper respiratory infection. Many forms of treatment are employed. These include verbal, psychotherapeutic or educational interventions, massage, exercise, physical therapy, and surgery. The usefulness of all of these approaches is real, but limited. Some people are helped by each of them; many are not. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html • Game and exercise device and method Inventor(s): Carlson, Carl A.; (Bensalem, PA) Correspondence: Dann Dorfman Herrell & Skillman; Suite 720; 1601 Market Street; Philadelphia; PA; 19103-2307; US Patent Application Number: 20030073541 Date filed: September 30, 2002

152 Physical Therapy Abstract: The invention is directed to apparatus and a method of playing a skill game, conducting exercise, or learning movements such as dance steps. Ordinarily, it would be used for contact by the feet, but it could be used for contact by the hands, particularly in connection with physical therapy activity or the like. The contact surfaces are arranged in a coordinated pattern that may consist of a matrix of adjacent colored illuminatable tiles or simply stepping stones positioned in a random array perhaps quite different from a regular matrix. The contact surfaces are illuminated normally one at a time so as to cue sequential steps in a random pattern and at varying speeds in a game. Changes may also be made in a regular repeatable pattern with predetermined timing rhythms of a dance or may be made variable so that they may be slowed or quickened in therapy as the patient progresses. Illumination may be internal as with the tiles, which may be translucent and illuminated from beneath, or may be provided by a movable beam provided with suitable directing means to reposition the beam from one contact surface to another. Switch means are needed for individual fixed lights and may be operated by a switch panel, for example, push buttons which may be provided, one for each contact surface, and arranged in a pattern corresponding to the contact pattern of the surfaces, e.g., a matrix. Other situations for controlling lights may have a means for controlling the lights in a predetermined sequence along a guided path for the controller which preferably can be moved back and forth and over longer or shorter distances as desired. Where beam lighting is employed, a single source of light conceivably could be used, but ordinarily coordinated lights directed to a single contact surface and moved together from one selected contact surface to another are required. These may be coordinated and moved by suitable mechanical drive means controlled by some manually adjusted actuator or by a computer. When tiles are employed they may be built into a frame which permits solid support as well as wiring for illumination and even folding of the frame to provide more convenient portability. Excerpt(s): Applicant claim the benefit of priority of U.S. Provisional Application Ser. No. 60/329,471, filed on Oct. 11, 2001. The present invention has to do with a system useful for games as well as for exercise routines. In its simplest form it provides an array of surfaces, either regularly or randomly distributed sufficiently proximate to one another that an individual may reach all, or many, of the surfaces with his hands or feet. The object of the game or exercise is to move from one to another of the surfaces as they are illuminated, in succession with his feet, or hands, or both. The movements in a game might be random testing of the skill and agility of the player. In exercise or dance, the movements might be repetitive, but subject to change in a predetermined pattern, for example. In the prior art, systems for teaching dancing have been devised using either fixed or movable marks or footprints arranged, or capable of arrangement into in the pattern of the dance steps to be followed by the feet of a student learning the dance. Games, such as hop scotch, have been devised using a pattern to designate hand or foot positions to be successively assumed. Alternatively, a contortionist game, using a game board with numbered positions for hands or feet, has been played by randomly selecting numbered successive sites for positioning a hand or foot by a spinning pointer or by dice toss. However, when using such prior art, there is normally no pace set for the user, but movement is in response to random directions, obtained sporadically, often by the player himself. In the case of dance patterns, music may direct movement at some stage, but the user must know the pattern to follow. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Patents 153 • Gravity-independent constant force resistive exercise unit Inventor(s): Colosky, Paul E. JR.; (Houston, TX), Ruttley, Tara M.; (Houston, TX) Correspondence: James K. Poole, ESQ.; P.O. Box 925; Loveland; CO; 80539; US Patent Application Number: 20020025891 Date filed: August 16, 2001 Abstract: This invention describes a novel gravity-independent exercise unit designed for use in microgravity, or on the ground, as a means by which to counter muscle atrophy and bone degradation due to disuse or underuse. Modular resistive packs comprising constant torque springs provide constant force opposing the withdrawal of an exercise cable from the device. In addition to uses within the space program, the compact resistive packs of the CFREU allow the unit to be small enough for easy use as a home gym for personal use, or as a supplement for rehabilitation programs. Resistive packs may be changed conveniently out of the CFREU according to the desired exercise regimen. Thus, the resistive packs replace the need for expensive, heavy, and bulky traditional weight plates. The CFREU may be employed by hospitals, rehabilitation and physical therapy clinics, and other related professional businesses. Excerpt(s): This application claims priority from Applicants' provisional application, U.S. Ser. No. 60/225,871, filed Aug. 17, 2000. This invention describes a novel gravity- independent exercise unit designed for use in microgravity, or on the ground, as a means by which to counter muscle atrophy and bone degradation due to disuse or underuse. Exposing humans to weightlessness during space flight induces significant structural and functional changes in the musculoskeletal system. These changes are manifested as muscle atrophy and bone degradation accompanied by neuromuscular changes including muscle fatigue and weakness, abnormal reflex behavior, and diminished neuromuscular efficiency, as noted by Nicogossian in \"Countermeasures to space deconditioning,\" Space Physiology and Medicine, Third Ed., eds. Nicogossian et al., Williams & Wilkins, Baltimore (1994), pp. 447-469. Support-unloading and structural changes of the muscle and bone seem to be the main causes of these functional abnormalities. See Booth & Criswell, \"Molecular events underlying skeletal muscle atrophy and the development of effective countermeasures,\" Int. J. Sports Med. 18[4], s265-s269 (1997); Convertino, \"Exercise as a countermeasure for physiological adaptation to prolonged spaceflight,\" Med. Sci. Sports Exerc. 28[8], 999-1014 (1996); and Leblanc et al., \"Muscle atrophy during long duraction bed rest,\" Int. J. Sports Med. 18, s283-s285 (1997). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html • Inflatable cushioning device with manifold system Inventor(s): Wilkinson, John W.; (Bennington, VT) Correspondence: Arlen L. Olsen; Schmeiser, Olsen & Watts; 3 Lear Jet Lane; Suite 201; Latham; NY; 12110; US Patent Application Number: 20010023511 Date filed: May 29, 2001 Abstract: A cushioning device for a body support such as a mattress, seat, sofa, or the like where support is obtained from a fluid. The cushioning device is self-inflating, self- adjusting, and provides a low interface pressure under the entire contact surface of a

154 Physical Therapy patient. Shear force scraping damage is prevented by a sleeve apparatus. A support system apparatus provides separately adjustable pressure support zones. For physical therapy, an alternating pressure system provides alternating lifting and lowering pressure zones under a patient. Excerpt(s): The present invention relates generally to an inflatable cushioning device for body supports such as a mattress, sofa, or chair cushion. In particular, the present invention relates to a body support for preventing the formation of pressure induced soft tissue damage. Heretofore, inflatable cushioning devices for use with body supports, such as a mattress, sofa, seat, or the like, typically included a plurality of air cells or bladders that are inflated to support a person. The air cells provide support to the person, and can be inflated to a desired pressure level to provide the person with a predetermined level of comfort and support. In the medical field, cushioning devices including a plurality of air cells are often used to provide different levels of support under various portions of a patient's body. For example, a mattress may include separate air cells located in the upper, middle, and lower portions of the mattress. These air cells can be inflated to different pressures to support the upper, middle, and lower portions of the patient's body with different pressures. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html • Kick bag for physical therapy Inventor(s): Bouvier, Ronald O.; (Phillipston, MA) Correspondence: Blodgett Blodgett; 43 Highland Street; Worcester; MA; 016092797 Patent Application Number: 20020010057 Date filed: January 17, 2001 Abstract: A striking bag assembly which includes a primary bag suspended from a fixed support and an anchor bag suspended from the primary bag. The anchor bag is smaller and heavier and, therefore, considerably denser than the primary bag. More specifically, the anchor bag is pivotally connected to the primary bag and the primary bag is pivotally connected to the fixed support. Excerpt(s): This application claims the benefit under 35 U.S.C.sctn.119(e) of prior U.S. Provisional Application No. 60/217,267 filed Jul. 11, 2000; all of which is hereby incorporated by reference. The present invention is directed to a striking bag or kick bag for physical training. The physical training can be for activities such as boxing, martial arts, aerobics, or as part of an overall physical fitness program. The bag is not limited to kicking and may be punched as in the case of training by a boxer. Kick bags are relatively heavy as compared to \"punching bags\" which are most often associated with boxing. For this reason, kick bags are frequently referred to as \"heavy bags\", and range from 25 pounds to 100 pounds. Most kick bags are suspended from a fixed support and swing when kicked. The weight of the bag provides resistance to kicking and, therefore, promotes timing and strengthening of the muscles involved in delivering a kick. Kick bags are a popular and widely used training tool for a wide range of physical activities. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Patents 155 • Machine for upper limb physical therapy Inventor(s): Colello, Matthew S.; (Tranquility, NJ), Hardy, Christopher; (Montclair, NJ), Mahoney, Richard M.; (Westmont, NJ), Siffeti, Aman; (Livingston, NJ), Wunderly, Craig; (Hackettstown, NJ), Zuckerman, Daniel; (Bloomfield, NJ) Correspondence: Richard M. Mahoney; Rehabilitation Technologies Division; Applied Resources CORP.; 1275 Bloomfield AVE.; Fairfield; NJ; 07004; US Patent Application Number: 20030028130 Date filed: August 5, 2002 Abstract: This invention relates to an electromechanical arm and accessories which are mountable on a battery powered wheelchair and used to grasp objects in the personal environment of the operator. The device is designed for simplicity of operation and comprises lower arm, mid arm, and forearm components which are rotationally and pivotally interconnected and selectively rotated through the utilization of a controller which is preferably disposed upon the battery powered wheelchair. The accessories include end-effectors (also called grippers), with features that are task specific or for general manipulation, other tools and means of holding tools, baskets, pouches, holders and other means of storing objects and tools, a variety of input devices that are tailored to the needs of the operator, a sleeve for protection, aesthetics, and increased functionality (with pockets and other means of holding objects), and mounting hardware for the electromechanical arm and associated components. Excerpt(s): The present application is related to and claims priority from U.S. Provisional Patent Application 60/310,107 filed Aug. 4, 2001. People who have experienced a severe stroke often have significant impairment of muscle function of the arms, legs, and hands, resulting in severe disability. Other types of diseases, traumatic accidents, and neurological disorders result in similar deficiencies in strength, coordination, and range of motion. In order to recover or retain functional ability after a stroke or injury, people normally enter into a rehabilitation program at a rehabilitation facility, under the treatment of a physical and/or occupational therapist. Although the invention described here applies to all rehabilitation programs of this type for upper limb therapy, it is described in terms of its applicability to stroke patients because stroke is the number one disability for which rehabilitation services are provided in the United States. For upper limb rehabilitation, the nature of the disability requires that the Therapist carry out a program whereby he or she will move the patient's arms through a range of motion that is comfortable to the patient as appropriate given the level of recovery of their strength and coordination. Typical therapy programs administered by a Therapist can also involve functional tasks and movements using one or both arms. As the patient's functional ability increases, the Therapist modifies the regiment to provide less assistance, to extend the range of motion, and to increase the types and difficulty of functional tasks. Such a rehabilitation program requires that the Therapist assess the physical ability of the person on an ongoing basis. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

156 Physical Therapy • Medical apparatus for the treatment and prevention of heel decubitus Inventor(s): Gluskin, Lawrence E.; (Buffalo Grove, IL), Grabell, Marc; (Buffalo Grove, IL), Simms, Barbara; (Lombard, IL) Correspondence: Leydig Voit & Mayer, Ltd; 6815 Weaver Road; Rockford; IL; 61114- 8018; US Patent Application Number: 20010016960 Date filed: May 10, 2001 Abstract: A heel supporting medical apparatus for the treatment and prevention of decubitus or pressure ulcers. The present invention provides a medical and physical therapy apparatus adapted to elevate heels of individuals subjected to substantial bed rest. By elevating the heels, the skin of the heel will not be in constant contact with the bed mattress, and thus pressure ulcers or bedsores will be substantially avoided. Moreover, the present invention provides an apparatus by which the legs of the individual can be substantially immobilized while at the same time elevating the heel. The apparatus also provides adjustably cushioned support from several angles to increase the comfort of the individual. Excerpt(s): The present invention generally relates to medical and physical therapy apparatus, and more particularly relates to the apparatus for the treatment and prevention of decubitus, or pressure ulcers, specifically on the heel of the foot. When individuals are injured, ill, or otherwise infirm, they are often subjected to relatively long periods of rest wherein the body maintains the substantially same position for relatively long periods of time. For example, if the individual is injured and confined to bed rest, the body will rest on the bed or mattress in the relatively same position and be supported by discreet portions of the body, including the heel of each foot. As a result of this sedentary position, the heels will continually rub against the bed or mattress and result in a pressure ulcer, sometimes referred to as a bedsore, or decubitus. If left untreated, such decubitus can present a serious health concern and subject the individual to substantial pain and discomfort. As a result of the foregoing, a number of mechanisms and methods have been developed to limit the formation of such decubitus. If the patient is mobile or sufficiently healthy to allow it, he or she will be required to move about to a sufficient degree to avoid such formation. Alternatively, pillows or other impromptu elevation devices can be used to elevate the heel away from the mattress. In addition, still further devices, such as foam cushions, can be wrapped around the leg or placed below the leg to elevate the heel. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html • Method and apparatus for treating poor laryngeal-elevation disorder with sequential- high voltage electrical stimulation Inventor(s): Geater, Alan; (Hatyai, TH), Leelamanit, Vitoon; (Hatyai, TH), Limsakul, Chusak; (Hatyai, TH) Correspondence: Reed Smith Hazel & Thomas Llp; Suite 1400; 3110 Fairview Park Drive; Falls Church; VA; 22042; US Patent Application Number: 20020133194 Date filed: January 29, 2001

Patents 157 Abstract: The sequential stimulator for the treatment of dysphagic patients incorporates a unit which is capable of detecting a swallowing signal from the glossal or temporalis surface electromyography (SEMG). When a swallowing signal is recognized, a trigger signal is sent to the stimulation generation unit to release high voltage stimuli sequentially to the suprahyoid muscles or the masseter muscles and the pharyngeal muscles in order to assist in the elevation of the larynx. This enables the pharyngeal lumen to open more widely so that food can pass through the patient's pharynx and into the oesophagus more easily during swallowing. Thus the sequential stimulator is a device for assisting swallowing in patients with dysphagia due to a variety of causes, for instance, brain injury, cerebrovascular accident, injury of the cervical nerves, muscles weakness, or old age. The stimulator is operative only when the patient attempts to swallow and provides a physiologic stimulus and provides a means of immediate relief of the swallowing difficulty. The device is also useful for physical therapy whereby the muscles under the chin, the masseter muscles and the pharyngeal muscles can be re- educated to contract in the normal coordinated sequence. Excerpt(s): The present invention relates generally to a method and an apparatus for treating poor laryngeal-elevation disorder with sequential-high voltage electrical stimulation. Phase 1: is the oral phase, during which food in the oral cavity is masticated and mixed. Phase 2: is the pharyngeal phase, during which the masticated and mixed food bolus is propelled from the oral cavity into the pharyngeal lumen and thence into the upper oesophagus. The second phase of swallowing involves the use of the glossal muscles and the pharyngeal muscles (suprahyoid and thyrohyoid) and a lowering of the base of the tongue. The tongue muscles then propel food bolus from the oral cavity into the pharyngeal lumen. At this stage, the muscles of the pharynx contract in sequence, raising elevating the larynx and moving it forward in order to open the pharyngeal lumen and the upper oesophageal sphincter so that the bolus can pass readily into the upper oesophagus. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html • Method and system for creating customized exercise routines Inventor(s): Leeds, Gary; (Rancho Santa Fe, CA) Correspondence: Neil K. Nydegger; Nydegger & Associates; 348 Olive Street; San Diego; CA; 92103; US Patent Application Number: 20020082143 Date filed: October 23, 2001 Abstract: A method for creating a customized visual presentation of a physical therapy routine includes an initial step of evaluating the capability of the individual for performing the routine. Once the evaluation is complete, the individual is categorized according to the evaluated performance capability. Based on the category of the individual, the physical therapist identifies a sequence of physical exercises for the individual which defines the individualized physical therapy routine. The therapist then accesses an archives which includes a plurality of digital excerpts that each demonstrate the performance of a particular physical exercise. The physical therapist selectively retrieves digital excerpts from the archives which visually demonstrate the physical exercises that will make up the routine. These digital excerpts are edited appropriately and are provided to the individual over the Internet, in a printout, on a CD or on a videotape.

158 Physical Therapy Excerpt(s): This application is a continuation-in-part of U.S. Pat. Application Ser. No. 09/360,225 filed Jul. 23, 1999, which is currently pending. The contents of U.S. Pat. Application Ser. No. 09/360,225 are incorporated herein by reference. The present invention pertains generally to instructional aids for work and exercise routines. More particularly, the present invention pertains to a method and a system for using an Internet type communication system to automatically create a customized presentation of a work and exercise routine for an individual tailored to the specific physical characteristics of the individual and that is commensurate with the capabilities of the individual. The present invention, is particularly, but not exclusively, useful as an automated method for creating a customized visual presentation of a physical therapy routine for an individual that can be viewed over the Internet, in a printout, on a CD or on a videotape. Physical therapy routines for individuals are well known in the prior art and typically consist of a series of physical exercises. They are usually prescribed and assigned to an individual by physical therapists for rehabilitation from a disease and/or injury. When determining a proper routine, the physical therapist or exercise instructor also needs to account for individual factors such as age, fitness level, and medical history, in addition to the type of diseases or injury, the individual may be experiencing. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html • Patient positioning device Inventor(s): Murphy, Edward T.; (Douglasville, GA), Murphy, George W.; (Franklin, MA), Murphy, Stephen P.; (Westfield, MA) Correspondence: Woodcock Washburn Llp; One Liberty Place - 46th Floor; Philadelphia; PA; 19103; US Patent Application Number: 20030154550 Date filed: February 21, 2002 Abstract: The patient positioning device of this invention relates to an apparatus used to assist a patient into a supine position and additionally through which traction is applied to the spine, such as physical therapy and chiropractic treatment. The patient positioning device is preferably a stand alone portable device that can be readily transported and adapted to almost any horizontal surface, such as a treatment table. A primary application of the leg support of this invention is in raising and supporting a patient's lower legs during before, during, and after traction is applied to a patient. The device includes a lower support frame, vertical supports, and a leg support coupled to a top frame. The patient positioning device may also have a motor which powers the leg support to rotate from a lowered position, in which a patient's lower legs rest on the leg support, to an elevated position in which a patient's lower legs are elevated. Once in the elevated position, traction can be applied to the lower back preferably with a cable and a board that is placed across the front of a patient's thighs. Excerpt(s): The invention relates to an apparatus used to position a patient into the supine position. This invention also relates to a system that positions a patient and applies traction to the spine, such as physical therapy and chiropractic treatment. In order to place a patient in the supine position, the clinician first places the patient on a treatment table with the patient's back resting on the table and with the patient's legs extended straight and essentially level. The clinician then assists the patient in raising his/her legs onto a stool that is placed on the table between the patient's lower legs and the table such that the upper legs are close to vertical and the lower legs are parallel to the plane of the table. Stools are available from the Chattanooga Group, Inc. The

Patents 159 clinician can then adjust the patient's lower legs' elevation by loosening and then retightening a vertical adjustment clamp while supporting the patient's legs so the stool does not collapse to its minimum height. Difficulties arise with this treatment method in the case of obese, elderly or pregnant patients. With obese patients, for instance, the harness belt is frequently difficult to tighten sufficiently to capture the pelvis, which results in the force from the traction head being distributed through the soft tissues throughout the pelvis. This results in (1) discomfort to the patient; (2) slippage of the belts; and (3) uncertainty as to the actual spinal treatment force. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html • Physical therapy chair-bed for paralytic patients Inventor(s): Charoenchit, Chakri; (Bangkok, TH) Correspondence: MR. Chakri Charoenchit; 6/77 Moo 5 Boromrajchonnee Road; Bangkok; 10170; TH Patent Application Number: 20030224915 Date filed: June 4, 2002 Abstract: A physical therapy chair-bed is a patient bed consisting of three parts, the first, the second and the third parts. The first can also be used as backrest of a physical therapy chair with its flanking parts arranged as armrests. The second part can also form a seat. The third part can be kept inside a case underneath the first and the second parts. All the other components are kept inside the case. There are wheels and wheel- locks mounted under the case at each corner. The chair-bed is equipped with a foot-leg exercise set having a footwear set to help the seat occupant exercise his feet and legs in a bicycling manner. The armrests can move to have the patient's arms exercise. Rack guards and footrests are provided. The chair-bed can be mechanically or electrically and electronically controlled where a remote control may be applied. Excerpt(s): This invention is designed to help paralyzed patients or partially paralyzed patients developing or maintaining the muscle tone of their arms and legs, in addition to preventing joint stiffness. There are a lot of exercise machines using variable resistance mechanisms such as fluid types which use the viscosity of fluid and a turbine to create resistance and friction. Some machines use magnets in close proximity to a piece of metal. Many exercise machines are mostly designed for users who is standing or sitting or stay beside the machines, for example, U.S. Pat. No. 5,820,532. Only large stationary overhead beams and levers are used which is not sufficient for bedridden patients to permit bending and flexing of the knees and elbows. U.S. Pat. No. 5,820,519 has combined a `nordic type` exercise with a feature of adjustable rope mechanisms in small increments by means of the special handles and stirrups to apply the drum friction type resistance machine. Yet the machine still is too hard for those paralytic or partially paralytic patients to do the exercise to maintain their muscle tone. The present invention describes a machine using electrical and mechanical system to help paralytic or unconscious patients who can not perform a normal exercise on their own to move gently the parts of their body and improve their blood circulation, in addition to maintain or improve their muscle tone of their extremities. A physical therapy chair-bed consists of three parts, the first, the second and the third parts. The first can either lie flat and be used as part of a patient bed or be held up and used as backrest of a physical therapy chair with its flanking parts on the left and right side arranged as armrests. The second part forms a middle part of a patient bed or a seat of the physical therapy chair. The third part forms the other end of the patient bed which can be slid to be kept in a

160 Physical Therapy case underneath the first and the second parts. All the other components except the first and the second parts of the bed are kept inside the case. There mounted under the case at each corner a wheel to assist moving where wheel-lock may be installed to fix the case in place when in use. The chair-bed is further equipped with a foot-leg exercise set comprising a motor to drive a shaft to rotate a footwear set that helps the seat occupant wearing the footwear exercise his feet and legs in a bicycling manner where the level of footwear can be adjusted for each individual. The armrests can move to have the patient arms exercise to prevent stiff-joint. Rack guards and footrests are also provided. The chair-bed can be mechanically or electrically and electronically controlled where a remote control system may also be applied. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html • Recumbent total body exerciser Inventor(s): Hildebrandt, Mark D.; (Ann Arbor, MI), Sarns, Steve W.; (Dexter, MI), Sutton, Todd A.; (Grand Rapids, MI) Correspondence: Brinks Hofergilson & Lione; P.O. Box 10395; Chicago; IL; 60610; US Patent Application Number: 20020151415 Date filed: February 19, 2002 Abstract: A recumbent apparatus for exercise and physical therapy providing a lower body workout, an upper body workout, and cardiovascular conditioning having an improved seat mechanism for mounting and dismounting the recumbent apparatus. The seat mechanism comprises a plurality of levers and pins that restrict seat motion in a longitudinal direction along the recumbent apparatus while permitting the rotation of the seat for mounting and dismounting. Excerpt(s): This application is a divisional application of Ser. No. 09/492,556, filed Jan. 27, 2000, allowed on Jan. 16, 2002, which is a divisional application of Ser. No. 09/162,607, filed Sep. 29, 1998, now U.S. Pat. No. 6,042,518, issued on Mar.28, 2000. The present invention generally relates to equipment for physical therapy and/or general exercise. More particularly, this invention relates to a recumbent exercise machine which provides for the exercising and strengthening of major muscle groups in addition to cardiovascular conditioning. In so doing, the present invention includes lower body exercises coordinated with upper body exercising. Elderly patients, patients undergoing physical therapy, and other patients in similar circumstances, whether at home, in the hospital or in another clinical setting, have special needs when it comes to physical therapy equipment. Often, the patients have limited mobility, age related illnesses, decreased ranges of appendage movement, disabilities, low endurance and need for therapy with respect to more than one particular movement or muscle group. All of these factors must be taken into consideration when designing or providing equipment for their use. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Patents 161 • Training apparatus for physical therapy, therapeutic riding in particular Inventor(s): Ettenhofer, Michael; (Ann Arbor, MI) Correspondence: John G. Posa; Gifford, Krass, Groh; Suite 400; 280 N. Old Woodward AVE.; Birmingham; MI; 48009; US Patent Application Number: 20030073504 Date filed: October 15, 2001 Abstract: Apparatus to qualify individuals for equine-assisted physical therapy is controlled entirely by a trainer or therapist, thereby regimenting the process for consistent and transferable results. The preferred embodiment includes a rigid frame with a plurality of upright, spaced-apart vertical members, and a rideable body within the frame, preferably suspended from the vertical uprights using multiple springs. At least one handle, rigidly affixed to the rideable body, enables the trainer or therapist to direct the motion of the body with a rider thereon, to determine how the individual will adapt to riding on a living horse, or to train the client with no actual riding experience. The rideable body is horseback shaped, enabling a saddle to be received thereon. The outer surface of the rideable body is also substantially smooth, however, enabling the individual to mount the body in bareback-style, if so desire. The apparatus preferably further includes a structure connecting the vertical members relative to their lower ends, such that the spaces between the vertical members remains open to the ground, enabling the trainer/therapist to stand close to or away from the rider without physical impediment. Attachment points are preferably provided, enabling a plurality of springs or other elastic members to be attached from each vertical member to the body, thereby facilitating adjustment for different riders of varying weight. Excerpt(s): This invention relates generally to physical therapy and, in particular, to apparatus and methods for qualifying candidates for equine-assisted therapeutic regimes. Equine activities are now recognized for providing valuable physical and psychological therapeutic benefits. Such activities include hippotherapy (physical therapy on horseback, using the horse as the therapist) and therapeutic riding, which is particularly directed to the disabled and handicapped. Therapeutic riding, also known as equine assisted therapy, equine facilitated therapy, and riding for the disabled, may be used to achieve a variety of therapeutic milestones, including cognitive, physical, emotional, social, educational and behavioral goals. Horseback riding has been found to be particularly beneficial for nonambulatory persons, who have no natural means of locomotion. The action of the horse relaxes and stimulates unused muscles, building muscle tone and improving coordination and balance. The action of a horse mimics that of human body action, such that when a person rides a horse, they are forced to move their trunk, arms, shoulders, head and the rest of their body to maintain balance. In other words, as the horse moves, the rider's muscles move in synchronization. To maximize the derived benefits, it is not uncommon for physical and occupational therapists to integrate therapeutic exercise techniques with the movement of the horse to stimulate unused or underused muscles. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

162 Physical Therapy Keeping Current In order to stay informed about patents and patent applications dealing with physical therapy, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “physical therapy” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on physical therapy. You can also use this procedure to view pending patent applications concerning physical therapy. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

163 CHAPTER 6. BOOKS ON PHYSICAL THERAPY Overview This chapter provides bibliographic book references relating to physical therapy. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on physical therapy include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan. Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “physical therapy” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on physical therapy: • Physical Therapy in Craniomandibular Disorders Source: Carol Stream, IL: Quintessence Publishing Company, Inc. 1992. 80 p. Contact: Available from Quintessence Publishing Company, Inc. 551 North Kimberly Drive, Carol Stream, IL 60188-1881. (800) 621-0387 or (630) 682-3223; Fax (630) 682-3288; E-mail: [email protected]; http://www.quintpub.com. PRICE: $36.00 plus shipping and handling. ISBN: 0867151927. Summary: This book on physical therapy (PT) in craniomandibular disorders (CMD) outlines practical strategies for physical therapists and dentists who strive to provide treatment using a team approach. The authors hope to help standardize the management of CMD, and familiarize dentists with the positive role of the PT in CMD therapy. The three main chapters each start with a textual description, then provide extensive black and white clinical photographs illustrating the concepts covered. Topics

164 Physical Therapy include protocol; treatment of hypermobility, hypomobility, bruxism, and the abused protrusion; and specific problems, including the anterior displacement of the temporomandibular joint (TMJ) disc without reduction, postoperative pain, osteoarthritis, and acute TMJ arthritis. The authors focus on the pure mechanical corrections for determined unilateral overloading of the stomatognathic system. The authors emphasize that the patient should be actively involved in the treatment with the emphasis at first on posture, stretching, and strengthening. One appendix provides recordkeeping forms for the physical therapy examination. 144 figures. 18 references. (AA-M). Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “physical therapy” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “physical therapy” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “physical therapy” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): • A Guide to Success: Review for Licensure in Physical Therapy by Scott M. Giles (2002); ISBN: 1890989126; http://www.amazon.com/exec/obidos/ASIN/1890989126/icongroupinterna • Birth Balls : Use of Physical Therapy Balls in Maternity Care by Paulina Perez; ISBN: 0964115964; http://www.amazon.com/exec/obidos/ASIN/0964115964/icongroupinterna • Cardiopulmonary Physical Therapy: A Guide to Practice by Scot Irwin, Jan S. Tecklin (2004); ISBN: 0323018408; http://www.amazon.com/exec/obidos/ASIN/0323018408/icongroupinterna • Differential Diagnosis in Physical Therapy by Catherine Cavallaro Goodman, Teresa E. Kelly Snyder (2000); ISBN: 0721681840; http://www.amazon.com/exec/obidos/ASIN/0721681840/icongroupinterna • Documenting Physical Therapy: The Reviewer Perspective by Angela M. Baeten, et al; ISBN: 0750699507; http://www.amazon.com/exec/obidos/ASIN/0750699507/icongroupinterna • Examination in Physical Therapy Practice: Screening for Medical Disease by William G. Boissonnault (Editor); ISBN: 0443089566; http://www.amazon.com/exec/obidos/ASIN/0443089566/icongroupinterna • Geriatric Physical Therapy: A Clinical Approach by Carole B. Lewis, Jennifer M. Bottomley; ISBN: 0838588751; http://www.amazon.com/exec/obidos/ASIN/0838588751/icongroupinterna • Handbook of Pediatric Physical Therapy by Toby M. Long, et al (2001); ISBN: 0781727995; http://www.amazon.com/exec/obidos/ASIN/0781727995/icongroupinterna

Books 165 • Introduction to Physical Therapy by Michael A. Pagliarulo (Editor), Mosby Publishing; ISBN: 0323010571; http://www.amazon.com/exec/obidos/ASIN/0323010571/icongroupinterna • Management of Common Musculoskeletal Disorders: Physical Therapy Principles and Methods by Darlene Hertling, Randolph M. Kessler; ISBN: 0397551509; http://www.amazon.com/exec/obidos/ASIN/0397551509/icongroupinterna • Opportunities in Physical Therapy Careers by Bernice R. Krumhansl, Kathy Siebel; ISBN: 0844218049; http://www.amazon.com/exec/obidos/ASIN/0844218049/icongroupinterna • Orthopedic and Sports Physical Therapy by Terryy R. Malone (Editor), et al; ISBN: 0815158866; http://www.amazon.com/exec/obidos/ASIN/0815158866/icongroupinterna • Pediatric Physical Therapy by Jan Stephen Tecklin (Editor); ISBN: 0781710103; http://www.amazon.com/exec/obidos/ASIN/0781710103/icongroupinterna • PHYSICAL THERAPY AND MASSAGE FOR THE HORSE by Jean-Marie Denoix, et al; ISBN: 1570762031; http://www.amazon.com/exec/obidos/ASIN/1570762031/icongroupinterna • Physical Therapy Board Review by Michael Dunaway, Brad Fortinberry (2002); ISBN: 1560534974; http://www.amazon.com/exec/obidos/ASIN/1560534974/icongroupinterna • Physical Therapy for Children by Suzanne Campbell (Editor), et al; ISBN: 0721683169; http://www.amazon.com/exec/obidos/ASIN/0721683169/icongroupinterna • Physical Therapy of the Shoulder by Robert Donatelli (Editor); ISBN: 0443087318; http://www.amazon.com/exec/obidos/ASIN/0443087318/icongroupinterna • Physical Therapy Professional Foundations: Keys to Success in School and Career by Kathleen A. Curtis; ISBN: 1556424116; http://www.amazon.com/exec/obidos/ASIN/1556424116/icongroupinterna • Physical Therapy Research: Principles and Applications by Elizabeth Domholdt; ISBN: 0721669638; http://www.amazon.com/exec/obidos/ASIN/0721669638/icongroupinterna • Pocket Atlas of the Moving Body: For All Students of Human Biology, Medicine, Sports and Physical Therapy by Mel Cash (2000); ISBN: 0091865123; http://www.amazon.com/exec/obidos/ASIN/0091865123/icongroupinterna • Principles and Practice of Cardiopulmonary Physical Therapy by Donna L. Frownfelter (Editor), Elizabeth Dean (Contributor) (1996); ISBN: 0815133405; http://www.amazon.com/exec/obidos/ASIN/0815133405/icongroupinterna • Quick Reference Dictionary for Physical Therapy by Jennifer M., Ph.D. Bottomley (Editor) (2003); ISBN: 1556425805; http://www.amazon.com/exec/obidos/ASIN/1556425805/icongroupinterna • The American Physical Therapy Association Book of Body Maintenance and Repair by Marilyn Moffat, et al (1999); ISBN: 0805055711; http://www.amazon.com/exec/obidos/ASIN/0805055711/icongroupinterna

166 Physical Therapy The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “physical therapy” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:10 • Courses of training, scholarships and bursaries in countries represented in the World Confederation for Physical Therapy. Author: World Confederation for Physical Therapy.; Year: 1965; [London?] 1961 • Handbook for physical therapy teachers. Author: American Physical Therapy Association (1921- ); Year: 1962; New York [1967] • Handbook of physical therapy. Author: Shestack, Robert.; Year: 1964; New York, Springer [1967] • Opportunities in physical therapy. Author: Krumhansl, Bernice.; Year: 1965; New York, Universal Pub. and Distributing Corp. [c1968] • Physical Therapy Department of New York University Medical Center, Institute of Rehabilitation Medicine: organization programs, information. A handbook for affiliates and staff. Author: New York University. Medical Center. Institute of Rehabilitation Medicine. Physical Therapy Dept.; Year: 1964; [New York, 1967] • Physical therapy practice act with rules and regulations. Author: California. Laws, statutes, etc.; Year: 1964; Sacramento, 1968 • Physician's physical therapy manual [by] Robert Shestack [and] Edward W. Ditto. Author: Shestack, Robert.; Year: 1964; Englewood Cliffs, N. J., Prentice-Hall [c1964] • The Illinois physical therapy registration act. Author: Illinois. Laws, statutes, etc.; Year: 1965; Springfield, Dept. of Registration and Education, 1965 • Your career in physical therapy, by Patricia Darby and Ray Darby. Author: Darby, Patricia.; Year: 1965; New York, Julian Messner [c1969]; ISBN: 67132179X Chapters on Physical Therapy In order to find chapters that specifically relate to physical therapy, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and physical therapy using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “physical 10 In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a \"Books\" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.

Books 167 therapy” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on physical therapy: • Pros and Cons of Passive Physical Therapy Modalities for Neck Disorders Source: in Allen, M.E., Ed. Musculoskeletal Pain Emanating From the Head and Neck: Current Concepts in Diagnosis, Management and Cost Containment. Binghamton, NY: The Haworth Medical Press. 1996. p. 125-134. Contact: Haworth Document Delivery Service, Haworth Press, Inc., 10 Alice Street, Binghamton, NY 13904-1580. (800) 342-9678. (800) 895-0582 (fax). Summary: This chapter for health professionals presents the pros and cons of passive physical therapy modalities, on the basis of the existing body of evidence, for the management of neck disorders. Evidence suggests that the pros of these modalities are that they provide a unique occasion to reassure the patient and to remind him or her about the necessity of keeping active and staying at work as long as it does not further harm the neck condition. The cons of passive modalities are that they may lead the patient into adopting a passive role and reinforce inactivity and disability behavior. Of all the passive physical therapy modalities, only mobilization/manipulation have shown some evidence of effectiveness. The impression that manual therapy and physiotherapy may be more efficacious than medicine in the management of neck disorders may be explained by the patient's desire for a more holistic approach which includes personal and physical contact. 18 references and 4 tables. (AA-M).



169 CHAPTER 7. MULTIMEDIA ON PHYSICAL THERAPY Overview In this chapter, we show you how to keep current on multimedia sources of information on physical therapy. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine. Video Recordings An excellent source of multimedia information on physical therapy is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “physical therapy” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “physical therapy” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on physical therapy: • Health Care Professionals' Guide to Oral Cancer Source: Fairburn, GA: Oral Health Education Foundation. 1996. (videocassette). Contact: Available from American Dental Hygienists' Association (ADHA). 444 North Michigan Avenue, Suite 3400, Chicago, IL 60611. (800) 243-2342 (press 2) or (312) 440- 8900. Fax (312) 467-1806. Website: www.adha.org. PRICE: $15.00 each. Item Number 3673 DEV. Summary: The diagnosis, treatment, rehabilitation, and maintenance of oral cancer patients are explored in this multi-disciplinary educational video for health care professionals. Throughout the video, the importance of early detection and diagnosis is emphasized. The program discusses risk factors, including age and lifestyle factors such as alcohol and tobacco use. The video reviews epidemiology, including the most common types of oral cancer. The program describes typical symptoms, appearance, and classification of oral cancers and precancerous conditions including leukoplakia and erythroplakia. The potential role of diet in reducing risk for oral cancer is discussed. The

170 Physical Therapy program addresses diagnostic issues, including step-by-step guidelines for performing an oral cancer examination, the common presenting signs of oral cancer, the role of histologic confirmation of suspected lesions, and the use of imaging. Treatment considerations discussed include radiation therapy, surgery, chemotherapy, indications for surgery, the benefits and disadvantages of surgery, the importance of speech and swallowing assessments prior to surgery, and the need for dental evaluation and possible treatment before surgery. Rehabilitation and maintenance issues described includes prostheses, cosmetic surgery, speech and swallowing rehabilitation, audiologic monitoring, physical therapy, psychological testing and counseling, and ongoing oral health and dental care. The program briefly mentions the SPOHNC (Support for People with Oral and Head and Neck Cancer) organization and its newsletter. Each segment provides recommendations for referral services and the program concludes by reiterating the importance of coordination among health care providers involved in the care of patients with oral cancer. • AIDS: Issues for Health Care Workers Contact: Churchill Media, 6677 North NW Hwy, Chicago, IL, 60631, (773) 775-9550. Summary: This videorecording addresses the issues that will be faced by health care workers in treating Acquired immunodeficiency syndrome (AIDS) patients. The importance of treating patients with courtesy and respect is stressed. Attitudes toward AIDS patients and the fear of accidentally contracting the Human immunodeficiency virus (HIV) are explored. Good technique, cleanliness and hand washing, and reporting accidents are all important in protecting health care workers. The universal guidelines for handling blood and body fluids are explained, as are the guidelines for patients in isolation. Proper techniques are given for blood collection, laboratory and pathology tests, respiratory and physical therapy, housekeeping, surgical cleanup, food handling, and dishwashing. • Chronic Myofascial Pain Syndrome. A Guide to the Trigger Points Contact: Available from New Harbinger Publications, Inc., 5674 Shattuck Avenue, Oakland, CA 94609. PRICE: $49.95 in the U.S. Summary: This videorecording for health professionals and individuals with chronic myofascial pain syndrome is a companion to a book on fibromyalgia and chronic myofascial pain syndrome, and it serves as a guide to trigger points. The video begins by demonstrating trigger points and their specific pain patterns, focusing on the head; shoulder and neck; elbow to finger; torso; lower back and pelvis; hip, thigh, and knee; and the lower leg and foot. It identifies perpetuating factors, including Morton's foot, paradoxical breathing, and repetitious exercise. In addition, the video offers guidelines for assessing the severity of one's condition, presents examples of self-care physical therapy techniques, and provides suggestions for designing a treatment program. • Controlling Pain Source: Princeton, NJ: Films for the Humanities and Sciences. 199x. (videocassette). Contact: Available from Films for the Humanities and Sciences. P. O. Box 2053, Princeton, NJ 08543-2053. (800) 257-5126; (609) 452-1128. PRICE: $149.00 for purchase; $75.00 for rental. Order Number TF-2052. Summary: This videotape focuses on the nature of pain and on pain control, showing how nerve impulses travel through the spinal cord to the brain, explaining the function

Multimedia 171 of pain, and discussing the role of endorphins in pain control. The program explains the differences between pain relieving medicines, and demonstrates various methods and techniques such as physical therapy, exercise, ice massage, ultrasound, and biofeedback. (AA-M). • Managing Your Symptoms Source: Portland, OR: Vestibular Disorders Association. 2000. (videocassette). Contact: Available from Vestibular Disorders Association. P.O. Box 4467, Portland, OR 97208-4467. (800) 837-8428. E-mail: [email protected]. Website: www.vestibular.org. PRICE: $25.00 plus shipping and handling. Summary: This videotape program on vestibular disorders helps viewers understand dizziness and vertigo; related problems with memory and concentration, vision, and imbalance; and how to cope with recurring symptoms. The video features interviews with patients who have overcome most of their vestibular symptoms. The video also includes interviews with professionals in the areas of diagnosis, treatment, diet, vision, and physical therapy. The program encourages viewers to become active in their own recovery process and to allow enough time for compensation to occur. The videotape is closed captioned. Bibliography: Multimedia on Physical Therapy The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. To access the multimedia database, go to the following Web site: http://locatorplus.gov/. Select “Search LOCATORplus.” Once in the search area, simply type in physical therapy (or synonyms). Then, in the option box provided below the search box, select “Audiovisuals and Computer Files.” From there, you can choose to sort results by publication date, author, or relevance. The following multimedia has been indexed on physical therapy: • A New approach to physical therapy in Parkinsonism [motion picture] Source: Eaton [Laboratories]; Year: 1971; Format: Motion picture; Norwich, N. Y.: Eaton; [for loan by Norwich-Eaton Pharmaceuticals, Film Library], 1971 • Attitudes in physical therapy for the patient with cancer [videorecording] Source: New York University, Department of Physical Therapy in cooperation with Memorial Sloan-Kettering Cancer Center; produced by Visual Information Systems; Year: 1975; Format: Videorecording; New York: The University: [for sale by Bernard Weiss & Associates, c1975] • Chest physical therapy [videorecording] Source: George Washington University, Medical Center; Year: 1977; Format: Videorecording; [Washington]: The University: [for sale by its Medical Center Audio-Visual Services Dept., 1977] • Physical therapy for ulnar nerve lesion [videorecording] Source: Dept. of Rehabilitation Medicine, Faculty of Medicine, University of Toronto and the Workmen's Compensation Board of Ontario; Year: 1976; Format: Videorecording; [Toronto]: Division of Instructional Media Services, Faculty of Medicine, University of Toronto, c1976 • Physical therapy management of the pre- and post-operative open heart patient [motion picture] Source: Institute of Physical Medicine and Rehabilitation, New York University Medical Center; produced by Public Health Service Audiovisual Facility;

172 Physical Therapy Year: 1966; Format: Motion picture; [New York]: The Institute; [Atlanta: for loan by National Medical Audiovisual Center], 1966

173 CHAPTER 8. PERIODICALS AND NEWS ON PHYSICAL THERAPY Overview In this chapter, we suggest a number of news sources and present various periodicals that cover physical therapy. News Services and Press Releases One of the simplest ways of tracking press releases on physical therapy is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “physical therapy” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to physical therapy. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “physical therapy” (or synonyms). The following was recently listed in this archive for physical therapy: • U.S. Physical Therapy sees profit below estimates Source: Reuters Industry Breifing Date: September 22, 2003

174 Physical Therapy • Physical therapy as good as corticosteroid injection for acute shoulder pain Source: Reuters Industry Breifing Date: May 16, 2003 • Bush Administration to delay Medicare physical therapy caps Source: Reuters Industry Breifing Date: December 30, 2002 • Bush admin. to delay Medicare physical therapy caps Source: Reuters Health eLine Date: December 30, 2002 • Physical therapy slows functional decline in frail elderly Source: Reuters Medical News Date: October 02, 2002 • Physical therapy helps elderly stave off disability Source: Reuters Health eLine Date: October 02, 2002 • Physical therapy better in classes than at home Source: Reuters Health eLine Date: April 25, 2002 • Physical therapy classes better than home-based program for knee rehab Source: Reuters Medical News Date: April 24, 2002 • Weight loss, physical therapy can help back pain Source: Reuters Health eLine Date: December 05, 2001 • Benefit sustained from short-term physical therapy for rheumatoid arthritis Source: Reuters Medical News Date: February 12, 2001 • Physical therapy, exercise program helps knee arthritis Source: Reuters Health eLine Date: February 01, 2000 • Physical therapy, exercise improves osteoarthritis of the knee Source: Reuters Medical News Date: February 01, 2000 • Early physical therapy cost-effective for work-related acute low back injuries Source: Reuters Medical News Date: January 18, 2000 • Early physical therapy helps work-related back injuries Source: Reuters Health eLine Date: January 12, 2000 The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date

Periodicals and News 175 at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “physical therapy” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “physical therapy” (or synonyms). If you know the name of a company that is relevant to physical therapy, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “physical therapy” (or synonyms). Newsletters on Physical Therapy Find newsletters on physical therapy using the Combined Health Information Database (CHID). You will need to use the “Detailed Search” option. To access CHID, go to the following hyperlink: http://chid.nih.gov/detail/detail.html. Limit your search to “Newsletter” and “physical therapy.” Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter.” Type “physical therapy” (or synonyms) into the “For these words:” box. The following list was generated using the options described above:

176 Physical Therapy • Pain and the Cervical Spine Source: Bulletin on the Rheumatic Diseases. 50(10): 1-4. 2001. Contact: Available from Arthritis Foundation. 1330 West Peachtree Street, Atlanta, GA 30309. (800) 268-6942 or (404) 872-7100. Fax (404) 872-9559. Website: www.arthritis.org. Summary: This newsletter provides health professionals with information on the diagnosis and treatment of neck pain. The most important historical items in the initial approach to a neck pain problem are duration, trauma history, and musculoskeletal symptoms elsewhere. Physical examination maneuvers consist of range of motion and pain on motion in flexion extension, lateral flexion, and rotation. Plain radiographs of the cervical spine may indicate degenerative disease and subluxations resulting from inflammatory arthritis and the results of serious trauma. Computed tomography may be helpful when plain films are inadequate. Conservative therapies are used to treat uncomplicated joint diseases, soft tissue injuries, and poorly understood pain syndromes in the neck. Soft collars and contour pillows may be helpful. Physical therapy may also help, but interrupted traction is typically the most beneficial therapy. The article describes the features of special neck syndromes, including whiplash, degenerative disc and joint disease, inflammatory arthritis, rheumatoid arthritis, ankylosing spondylitis, and juvenile polyarthritis. 1 table and 25 references. Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “physical therapy” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on physical therapy: • Role of Physical Therapy in the Rehabilitation of Patients with Oral and Head and Neck Cancer Source: News from SPOHNC. News from Support for People with Oral and Head and Neck Cancer, Inc. 9(3): 4-5. November 1999. Contact: Available from Support for People with Oral and Head and Neck Cancer, Inc. (SPOHNC). P.O. Box 53, Locust Valley, NY 11560-0053. (516) 759-5333. E-mail: [email protected]. Website: www.spohnc.org. Summary: This newsletter article reviews the role of physical therapy in the rehabilitation of patients with oral and head and neck cancer. Despite the likelihood of an eventual return to normalcy, patients enduring neck dissections may face many possible physical challenges. The physical therapist can play an important role in helping a survivor to meet these challenges and to overcome many limitations. The author reports a case study of a 68 year old female who was treated for cancer of the jaw and floor of the mouth. The author describes her rehabilitation and then offers suggestions to support patients who may proceed through rehabilitation with problems. For example, arm exercises are described, as are strategies for exercising in bed (for patients having difficulty beginning an exercise program). The author reminds readers

Periodicals and News 177 that preventing muscle atrophy and long term disability requires hard, persistent work from the patient with the guidance of a physical therapist. Academic Periodicals covering Physical Therapy Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to physical therapy. In addition to these sources, you can search for articles covering physical therapy that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”



179 CHAPTER 9. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources. U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for physical therapy. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a non-profit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI Advice for the Patient can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with physical therapy. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.).

180 Physical Therapy The following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to physical therapy: Baclofen • Systemic - U.S. Brands: Lioresal http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202080.html Cyclobenzaprine • Systemic - U.S. Brands: Flexeril http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202172.html Dantrolene • Systemic - U.S. Brands: Dantrium http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202181.html Orphenadrine • Systemic - U.S. Brands: Antiflex; Banflex; Flexoject; Mio-Rel; Myolin; Myotrol; Norflex; Orfro; Orphenate http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202426.html Skeletal Muscle Relaxants • Systemic - U.S. Brands: Carbacot; EZE-DS; Maolate; Paraflex; Parafon Forte DSC; Relaxazone; Remular; Remular-S; Robaxin; Robaxin-750; Skelaxin; Skelex; Soma; Strifon Forte DSC; Vanadom http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202523.html Tizanidine • Systemic - U.S. Brands: Zanaflex http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/207060.html Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library. Mosby’s Drug Consult Mosby’s Drug Consult database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/. PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information

Researching Medications 181 adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.



183 APPENDICES



185 APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience. NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute11: • Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm • National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/ • National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html • National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c- 714a9f7c8d25 • National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm • National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm • National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375 • National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/ 11 These publications are typically written by one or more of the various NIH Institutes.

186 Physical Therapy • National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm • National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/ • National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm • National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm • National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/ • National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/ • National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm • National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html • National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm • National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm • National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm • National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html • National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm • Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp • National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/ • National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp • Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html • Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

Physician Resources 187 NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.12 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:13 • Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html • HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html • NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html • Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/ • Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html • Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html • Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/ • Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html • Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html • Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html • MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html 12 Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 13 See http://www.nlm.nih.gov/databases/databases.html.

188 Physical Therapy • Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html • Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html The Combined Health Information Database A comprehensive source of information on clinical guidelines written for professionals is the Combined Health Information Database. You will need to limit your search to one of the following: Brochure/Pamphlet, Fact Sheet, or Information Package, and “physical therapy” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For the publication date, select “All Years.” Select your preferred language and the format option “Fact Sheet.” Type “physical therapy” (or synonyms) into the “For these words:” box. The following is a sample result: • Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report Source: Obesity Research. 6(Supplement 2): 51S-209S. September 1998. Contact: Available from North American Association for the Study of Obesity (NAASO). 8630 Fenton Street, Suite 412, Silver Spring, MD 20910. (301) 563-6526. Fax (301) 587-2365. Summary: This journal provides clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. The guidelines offer a state of the art review of the scientific basis of the relationship between obesity and major disease endpoints and of the scientific rationale for the management of overweight and obese patients. Section one presents the rationale for guidelines development, the objectives of the guidelines, guidelines development methodology, and a statement of assumptions. Intended users of the guidelines are also identified. Section two provides background information on overweight and obesity, focusing on the health and economic costs of overweight and obesity, the prevention of overweight and obesity, the health risks of overweight and obesity, weight loss and mortality, and environmental and genetic influences on the development of overweight and obesity. Section three examines randomized controlled trial evidence demonstrating the effect of weight loss on blood pressure, serum and plasma lipids and lipoproteins, fasting blood glucose and fasting insulin, and abdominal fat. This section also reviews evidence on the effectiveness of dietary therapy, physical therapy, combined diet and physical therapy, behavior therapy, pharmacotherapy, surgery, and other interventions for overweight and obesity treatment. Section four presents treatment guidelines. Topics include assessment and classification of overweight and obesity, assessment of risk status, evaluation of treatment strategy, exclusion from weight loss therapy, patient motivation, goals of weight loss and management, strategies for weight loss and management, smoking cessation, and the role of health professionals in weight loss therapy. Section five presents a summary of recommendations. Section six addresses the issue of future research, focusing on intervention approaches; causes and mechanisms of overweight and obesity; abdominal fat, body weight, and disease risk; and assessment methods. Section seven presents appendices. The journal also includes evidence report

Physician Resources 189 endorsements, a reference list, North American Association for the Study of Obesity (NAASO) standards of conducts, and NAASO policies and procedures for membership discipline. 8 appendices. 7 figures. 17 tables. 769 references. • Specialty Home Health and Hospice: Physician's Guide Contact: Specialty Home Health and Hospice, Corporate Office, 311 W Idaho St, Boise, ID, 83702, (208) 336-1331. Summary: This physician-education pamphlet discusses the benefits of home health care and hospice services for patients. The pamphlet lists the skilled nursing, physical therapy, occupational therapy, speech therapy, medical social work, and home health aide activities that can be provided at home and presents criteria to help the physician determine which patients would benefit from home health care. Information on paperwork, insurance coverage, and eligibility is included. • Special Report: Arthritis Source: Boston, MA: Harvard Medical School. 1999. 46 p. Contact: Available from Harvard Medical School. Health Publications Group, Department SR, P.O. Box 380, Boston, MA 02117-0380. PRICE: $16.00 plus shipping and handling. Summary: This report provides people who have arthritis with information on the features, diagnosis, and treatment of osteoarthritis (OA), rheumatoid arthritis (RA), and ankylosing spondylitis (AS). The report begins by explaining the difference between arthritis and rheumatism. This is followed by an overview of the joints and the immune system in rheumatic diseases. Topics include types of joints, joint design, the functioning of the immune system, the occurrence of inflammation in arthritis, and the role of genetics. The report then discusses OA, RA, and AS in terms of their evolution, symptoms, possible causes, diagnosis, and treatment. Other seronegative spondyloarthropathies, including Reiter's syndrome, psoriatic arthritis, and enteropathic arthritis, are described. A section of the report is devoted to the diagnosis of rheumatic diseases, focusing on obtaining a medical history; assessing pain and stiffness; conducting a physical examination by observing how the patient moves, examining the joints for abnormalities, and moving the joints through their range of motion to detect pain, resistance, unusual sounds, and instability; and performing studies such as blood tests, radiography, other imaging techniques, and arthrocentesis. Another section focuses on using physical therapy to treat people who have arthritis. Modalities discussed are heat and cold therapy, exercise, diathermy, and transcutaneous electrical nerve stimulation. In addition, the report provides suggestions on living with arthritis. They focus on diet; rest during periods of acute inflammation; exercise; joint protection; and ways of coping with depression, stress, and sexual needs. The report also includes a glossary and a list of resources. 1 appendix and 8 figures. The NLM Gateway14 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, 14 Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

190 Physical Therapy providing one-stop searching for many of NLM’s information resources or databases.15 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “physical therapy” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Items Found Journal Articles 98099 Books / Periodicals / Audio Visual 2876 Consumer Health 1329 Meeting Abstracts 77 Other Collections 24 102405 Total HSTAT16 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.17 These documents include clinical practice guidelines, quick- reference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.18 Simply search by “physical therapy” (or synonyms) at the following Web site: http://text.nlm.nih.gov. Coffee Break: Tutorials for Biologists19 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.20 Each report is about 400 words and is usually based on a discovery reported in one or 15 The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 16 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 17 The HSTAT URL is http://hstat.nlm.nih.gov/. 18 Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations. 19 Adapted from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html. 20 The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story.

Physician Resources 191 more articles from recently published, peer-reviewed literature.21 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/. Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: • CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/. • Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/. 21 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.