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Physical Medicine and Rehabilitation Clinics of North America

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https://www.readbyqxmd.com/read/27913004/cancer-rehabilitation-forging-consensus
#1
EDITORIAL
Andrea L Cheville
No abstract text is available yet for this article.
February 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27913003/foreword
#2
EDITORIAL
Santos F Martinez
No abstract text is available yet for this article.
February 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27913002/clinical-evaluation-and-management-of-radiation-fibrosis-syndrome
#3
REVIEW
Michael D Stubblefield
Radiation fibrosis syndrome describes the multiple neuromuscular, musculoskeletal, visceral, and other late effects that result from radiation-induced fibrosis. Radiation can damage the spinal cord, nerve roots, plexus, local peripheral nerves, and muscles within the radiation field. This constellation is known as a "myelo-radiculo-plexo-neuro-myopathy" and can result in pain, sensory loss, weakness, and other signs and symptoms. Although there is no curative treatment for radiation damage, supportive management of symptoms can be helpful in restoring and maintaining function and quality of life...
February 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27913001/cancer-related-fatigue-persistent-pervasive-and-problematic
#4
REVIEW
Lynn H Gerber
Cancer-related fatigue (CRF) is commonly reported by patients with cancer before, during, and after treatment. It is a persistent sense of tiredness that interferes with function, is distressing, and requires monitoring and, possibly, treatment. Fatigue assessment requires objective measures and self-reports, such as Functional Assessment of Cancer Therapy-Fatigue. Significant contributors to CRF include anemia, pain, insomnia, depressive symptoms, and elevated BMI. Elevated inflammatory cytokines, diabetes mellitus, cortisol, and cellular dysregulation have been associated with CRF...
February 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27913000/surgical-prehabilitation-in-patients-with-cancer-state-of-the-science-and-recommendations-for-future-research-from-a-panel-of-subject-matter-experts
#5
REVIEW
Francesco Carli, Julie K Silver, Liane S Feldman, Andrea McKee, Sean Gilman, Chelsia Gillis, Celena Scheede-Bergdahl, Ann Gamsa, Nicole Stout, Bradford Hirsch
This review by a 10-member panel of experts in surgical prehabilitation addresses processes that may improve oncologic care. Surgical prehabilitation is the process on the continuum of care that occurs between the time of cancer diagnosis and the beginning of surgical treatment. The panel focused on the current state-of-the-science and recommended future research that would help to identify the elements that enhance preoperative physical, nutritional, and psychological health in anticipation of surgery, mitigate the burden of disease, facilitate the return of patient health status to baseline values, decrease postoperative morbidity, and reduce health care costs...
February 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27912999/palliative-care-and-physiatry-in-the-oncology-care-spectrum-an-opportunity-for-distinct-and-collaborative-approaches
#6
REVIEW
Vishwa S Raj, Julie K Silver, Terrence M Pugh, Jack B Fu
As cancer evolves from a terminal illness to a chronic medical condition, so too does the view of clinical services. Palliative care and physical medicine and rehabilitation (PM&R) will increase in acceptance because they provide a valuable resource. The overarching theme is improving cancer-related symptoms or treatment-related side effects, improving patient health-related quality of life, lessening caregiver burden, and valuing patient-centered care and shared decision making. Managing symptom burden may improve therapy participation/performance...
February 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27912998/electrodiagnosis-in-cancer-rehabilitation
#7
REVIEW
Christian M Custodio
With numerous advancements in early detection and multimodal therapy, cancer has become a chronic disease. As the number of cancer survivors continues to increase, physiatrists and other neuromuscular disease specialists are more likely to encounter individuals with residual impairments, disabilities, and/or handicaps resulting from cancer or related treatments. The patient with cancer is especially prone to injury directed at the peripheral nervous system at multiple anatomic levels. Electrodiagnosis is an invaluable tool in the evaluation of neuromuscular disorders in this patient population...
February 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27912997/postacute-care-in-cancer-rehabilitation
#8
REVIEW
Ying Guo, Jack B Fu, Hong Guo, Jennifer Camp, Ki Y Shin, Shi-Ming Tu, Lynn J Palmer, Rajesh Yadav
Acute care is usually associated with disease progression, treatments for cancer, and medical comorbidities. Patients with cancer may develop sudden functional deficits that require rehabilitation. Some of these patients benefit from acute rehabilitation, others benefit from subacute rehabilitation. After acute rehabilitation, continuous care for these patients has not been well described. Three studies are presented to demonstrate that cancer rehabilitation is a continuous process. Rehabilitation professionals should know how to detect fall risk, monitor symptoms, and render symptom management...
February 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27912996/alternative-exercise-traditions-in-cancer-rehabilitation
#9
REVIEW
Kathryn J Ruddy, Daniela L Stan, Anjali Bhagra, Mary Jurisson, Andrea L Cheville
Alternative exercise traditions (AETs) such as Pilates, yoga, Tai Chi Chuan, Qigong, and various forms of dance offer the potential to improve diverse outcomes among cancer survivors by reducing adverse symptoms and mood disorders, and by enhancing function. Additionally AETs have emerged as a potential means to address deficits in current disease-focused care delivery models which are marked by prevalent under-treatment of symptoms and physical impairments. Relative to therapeutic exercise in allopathic models, many AETs are comparatively affordable and accessible...
February 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27912995/rehabilitation-strategies-and-outcomes-of-the-sarcoma-patient
#10
REVIEW
Sean Robinson Smith
Sarcomas are a relatively rare cancer that, depending on the location, can cause significant neuromusculoskeletal dysfunction and require rehabilitation interventions to reduce pain, restore function, and improve quality of life. This review focuses on sarcoma subtypes that frequently cause these complications: bony and soft tissue sarcomas leading to limb salvage or amputation, desmoid tumors, and malignant peripheral nerve sheath tumors. Rehabilitation approaches and outcomes are discussed, as well as considerations for childhood sarcoma survivors transitioning to adulthood...
February 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27912994/deconstructing-postmastectomy-syndrome-implications-for-physiatric-management
#11
REVIEW
Eric Wisotzky, Nicole Hanrahan, Thomas P Lione, Susan Maltser
Postmastectomy pain syndrome is a common sequela of breast cancer treatment that can lead to impairments and limited participation in work, recreational, and family roles. Pain can originate from multiple anatomic sites. A detailed evaluation to determine the specific cause or causes of pain will help guide the clinician to successfully manage this pain syndrome. There are many available treatments, but more evidence is needed for the efficacy of rehabilitation, pharmacologic, and nonpharmacologic therapy. There is evidence for some effective treatments to prevent this syndrome, but, here also, more research is needed...
February 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27912993/rehabilitation-in-chronic-graft-versus-host-disease
#12
REVIEW
Sean Robinson Smith, Arash Asher
Chronic graft-versus-host disease is a potentially debilitating complication of allogeneic hematopoietic stem cell transplantation. Due to the direct inflammatory effects of the disease on tissue, and the impact on muscle and bone of the high-dose glucocorticoid immunosuppression used to treat the disease, patients are at risk of developing multifactorial functional impairment. This review outlines the clinical assessment and rehabilitation interventions to manage aspects of the disease that cause the most impairment: involvement of the skin/fascial and cardiopulmonary organ systems, as well as steroid-induced myopathy and bone and joint destruction...
February 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27912992/brain-tumors-and-metastases
#13
REVIEW
Mary M Vargo
Patients with brain tumor exhibit wide-ranging prognoses and functional implications of their disease and treatments. In general, the supportive care needs of patients with brain tumor, including disabling effects, have been recognized to be high. This review (1) briefly summarizes brain tumor types, treatments, and prognostic information for the rehabilitation clinician; (2) reviews evidence for rehabilitation, including acute inpatient rehabilitation and cognitive rehabilitation, and the approaches to selected common symptom and medical management issues; and (3) examines emerging data about survivorship, such as employment, community integration, and fitness...
February 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27912991/malignant-spinal-cord-compression-adapting-conventional-rehabilitation-approaches
#14
REVIEW
Lisa Marie Ruppert
Spinal tumors are classically grouped into 3 categories: extradural, intradural extramedullary, and intradural intramedullary. Spinal tumors may cause spinal cord compression and vascular compromise resulting in pain or neurologic compromise. They may also alter the architecture of the spinal column, resulting in spinal instability. Oncologic management of spinal tumors varies according to the stability of the spine, neurologic status, and presence of pain. Treatment options include surgical intervention, radiation therapy, chemotherapy, and hormonal manipulation...
February 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27912990/cancer-rehabilitation-an-overview-of-current-need-delivery-models-and-levels-of-care
#15
REVIEW
Andrea L Cheville, Karen Mustian, Kerri Winters-Stone, David S Zucker, Gail L Gamble, Catherine M Alfano
The relevance of cancer rehabilitation as a public health issue grows steadily as cancer incidence, survival, and mean patient age increase. Reported rates of physical impairment and disability are already high, prior to the anticipated influx of aged cancer survivors. Despite the high prevalence of cancer-related disablement, treatment rates, even for readily remediable physical impairments, are as low as 1-2%. In addition to low referral rates, a challenge to patient-centric cancer rehabilitation is a fractured system that requires multiple visits to a range of specialists to address even a single issue, and cancer survivors generally have several...
February 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27788911/maybe-there-is-an-alternative-treatment-option
#16
EDITORIAL
Santos F Martinez
No abstract text is available yet for this article.
November 2016: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27788910/orthobiologics-and-knee-osteoarthritis-a-recent-literature-review-treatment-algorithm-and-pathophysiology-discussion
#17
REVIEW
David M Crane, Kristin S Oliver, Matthew C Bayes
This article reviews the current options in orthobiologics for the clinical treatment of knee osteoarthritis (OA). We describe a new model of knee OA that fills the gap in our understanding of it as a purely traumatic and/or inflammation-induced cartilage degenerative condition, to a current model of multinodal pathophysiology. We discuss graft choice and patient selection in the current state of understanding of the treatment of knee OA in a tissue engineering model with orthobiologics. We present a sample treatment algorithm and decision nest for deciding how to proceed with patient care...
November 2016: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27788909/regenerative-approaches-to-tendon-and-ligament-conditions
#18
REVIEW
Michael N Brown, Brian J Shiple, Michael Scarpone
Tendon and ligament injuries and degenerative conditions of these soft tissues have poor healing potential and healing is often incomplete. Biocellular and orthobiologic approaches including PRP and stem cell therapies are reviewed. A review of some of the regenerative medicine science and difficulties facing physicians exploring these methods is presented. A series of cases are reviewed demonstrating the application of these principles. Clinical experience with many of these biocellular interventions is outpacing validation in basic science studies...
November 2016: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27788908/performing-a-better-bone-marrow-aspiration
#19
REVIEW
Mayo F Friedlis, Christopher J Centeno
Bone marrow aspiration (BMA) is increasingly being used to harvest stem cells for use in regenerative medicine. The focus of BMA in interventional orthopedics is to maximize the yield of mesenchymal stem cells. The authors present an improved method for BMA that involves fluoroscope or ultrasound guidance combined with anesthesia; in the authors' experience, it produces the highest possible stem cell yield and is well tolerated by patients. The authors provide a step-by-step guide to the process, along with a discussion of technical and other considerations and quick reference guides for ultrasound- and fluoroscope-guided BMA...
November 2016: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27788907/%C3%AE-2-macroglobulin-autologous-protease-inhibition-technology
#20
REVIEW
Jason M Cuéllar, Vanessa Gabrovsky Cuéllar, Gaetano J Scuderi
α2-Macroglobulin (A2M) is a plasma glycoprotein best known for its ability to inhibit a broad spectrum of serine, threonine, and metalloproteases as well as inflammatory cytokines by a unique bait-and-trap method. A2M has emerged as a unique potential treatment of cartilage-based pathology and inflammatory arthritides. This article describes the unique method by which A2M not only inhibits the associated inflammatory cascade but also disrupts the catabolic process of cartilage degeneration. Autologous concentrated A2M from plasma is currently in use to successfully treat various painful arthritides...
November 2016: Physical Medicine and Rehabilitation Clinics of North America
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