Economic Review (Q 2006), pp. 7-41.
Social Security---and the solvency of its Trust Fund---have increasingly become a focus of discussion in the media and policy circles. The basic problem is that promised benefits will soon exceed program revenues. Without changes in benefits or funding, the Trustees of Social Security project that assets in the Trust Fund will be depleted in 2041. While Social Security is a serious problem for taxpayers and beneficiaries, Medicare poses an even greater challenge. Together, the two programs' benefits currently amount to about 6 percent of GDP. By 2080 they are projected to swell to 20 percent. With spending on these two programs projected to grow faster than the nation's GDP, the Board of Trustees of Social Security and Medicare have concluded that “We do not believe the currently projected long-run growth rates of Social Security and Medicare are sustainable under current financing arrangements.” To keep the programs solvent without slashing benefits or increasing tax revenues, the federal budget deficit would need to grow drastically. Thus changes will likely be needed to the structure of the two programs. In fact, any viable solution is likely to involve changes in government spending and taxes. Hakkio and Wiseman provide a framework for understanding the nature of the fiscal challenges posed by Social Security and Medicare---a prerequisite for finding specific solutions
Craig Hakkio, Elisha Wiseman
Economic Review (Q 2006), pp. 7-41.A New Approach to Retrain Gait in Stroke Patients Through Body Weight Support and Treadmill Stimulation
Stroke, Syndicated
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Jan 162008
Stroke, Vol. 29, No. 6. (1 June 1998), pp. 1122-1128.
Background and Purpose--A new gait training strategy for patients with stroke proposes to support a percentage of the patient's body weight while retraining gait on a treadmill. This research project intended to compare the effects of gait training with body weight support (BWS) and with no body weight support (no-BWS) on clinical outcome measures for patients with stroke. Methods--One hundred subjects with stroke were randomized to receive one of two treatments while walking on a treadmill: 50 subjects were trained to walk with up to 40% of their body weight supported by a BWS system with overhead harness (BWS group), and the other 50 subjects were trained to walk bearing full weight on their lower extremities (no-BWS group). Treatment outcomes were assessed on the basis of functional balance, motor recovery, overground walking speed, and overground walking endurance. Results--After a 6-week training period, the BWS group scored significantly higher than the no-BWS group for functional balance (P=0.001), motor recovery (P=0.001), overground walking speed (P=0.029), and overground walking endurance (P=0.018). The follow-up evaluation, 3 months after training, revealed that the BWS group continued to have significantly higher scores for overground walking speed (P=0.006) and motor recovery (P=0.039). Conclusions--Retraining gait in patients with stroke while a percentage of their body weight was supported resulted in better walking abilities than gait training while the patients were bearing their full weight. This novel gait training strategy provides a dynamic and integrative approach for the treatment of gait dysfunction after stroke.
Martha Visintin, Hugues Barbeau, Nicol Korner-Bitensky, Nancy Mayo
Background and Purpose--A new gait training strategy for patients with stroke proposes to support a percentage of the patient's body weight while retraining gait on a treadmill. This research project intended to compare the effects of gait training with body weight support (BWS) and with no body weight support (no-BWS) on clinical outcome measures for patients with stroke. Methods--One hundred subjects with stroke were randomized to receive one of two treatments while walking on a treadmill: 50 subjects were trained to walk with up to 40% of their body weight supported by a BWS system with overhead harness (BWS group), and the other 50 subjects were trained to walk bearing full weight on their lower extremities (no-BWS group). Treatment outcomes were assessed on the basis of functional balance, motor recovery, overground walking speed, and overground walking endurance. Results--After a 6-week training period, the BWS group scored significantly higher than the no-BWS group for functional balance (P=0.001), motor recovery (P=0.001), overground walking speed (P=0.029), and overground walking endurance (P=0.018). The follow-up evaluation, 3 months after training, revealed that the BWS group continued to have significantly higher scores for overground walking speed (P=0.006) and motor recovery (P=0.039). Conclusions--Retraining gait in patients with stroke while a percentage of their body weight was supported resulted in better walking abilities than gait training while the patients were bearing their full weight. This novel gait training strategy provides a dynamic and integrative approach for the treatment of gait dysfunction after stroke.
Martha Visintin, Hugues Barbeau, Nicol Korner-Bitensky, Nancy Mayo
Posted by Martha Visintin at 6:40 am Tagged with: Barbeau, Bws, clinical outcome, Conclusions, Endurance Training, functional balance, gait training, group treatment, Hugues, integrative approach, lower extremities, Martha, Martha Visintin, Nancy Mayo A New, new approach, Nicol, outcome measures, stroke patients, training period, Treadmill, treatment outcomes, walking speed
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