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Current Physical Medicine and Rehabilitation Reports

Nathan K Evanson, Andrea L Paulson, Brad G Kurowski
Traumatic brain injury (TBI) is the most common cause of long-term disability in the United States. A significant proportion of children who experience a TBI will have moderate or severe injuries, which includes a period of decreased responsiveness. Both pharmacological and non-pharmacological modalities are used for treating disorders of consciousness after TBI in children. However, the evidence supporting the use of potential therapies is relatively scant, even in adults, and overall, there is a paucity of study in pediatrics...
March 2016: Current Physical Medicine and Rehabilitation Reports
Katharina Stibrant Sunnerhagen
PURPOSE OF REVIEW: Spasticity is a part of the upper motor neuron syndrome and can result in reduced function. Reduction of the complications may be facilitated by early intervention, making identification of stroke patients at high risk for developing spasticity essential. RECENT FINDING: Different predictors of poststroke spasticity (PSS) have been suggested in different studies, including development of increased muscle tone, greater severity of paresis, sensory impairment, and low Barthel Index score...
2016: Current Physical Medicine and Rehabilitation Reports
Hermano Igo Krebs, Bruce T Volpe
No abstract text is available yet for this article.
December 2015: Current Physical Medicine and Rehabilitation Reports
Elizabeth R Skidmore
One of the major foci of rehabilitation after traumatic brain injury is the design and implementation of interventions to train individuals to learn new knowledge and skills or new ways to access and execute previously acquired knowledge and skills. To optimize these interventions, rehabilitation professionals require a clear understanding of how traumatic brain injury impacts learning, and how specific approaches may enhance learning after traumatic brain injury. This brief conceptual review provides an overview of learning, the impact of traumatic brain injury on explicit and implicit learning, and the current state of the science examining selected training approaches designed to advance learning after traumatic brain injury...
June 1, 2015: Current Physical Medicine and Rehabilitation Reports
Dai Sugimoto, Gregory D Myer, Lyle J Micheli, Timothy E Hewett
Anterior cruciate ligament (ACL) injury is a major concern in physically active females. Although ACL reconstruction techniques have seen significant advances in recent years, risk associated with re-injury and future osteoarthritis remains a major concern. Thus, prevention of ACL injury is a logical step to protect and preserve healthy knee joints in young athletes. The current report aims to summarize a list of evidence-based prevention strategies to reduce ACL injury in female athletes. A list of six critical principles, which come from documented, large scale clinical trial studies and further analyses, were presented with ABC format including age, biomechanics, compliance, dosage, exercise, and feedback...
March 1, 2015: Current Physical Medicine and Rehabilitation Reports
Alicia Vose, Jodi Nonnenmacher, Michele L Singer, Marlís González-Fernández
Swallowing dysfunction is common after stroke. More than 50% of the 665 thousand stroke survivors will experience dysphagia acutely of which approximately 80 thousand will experience persistent dysphagia at 6 months. The physiologic impairments that result in post-stroke dysphagia are varied. This review focuses primarily on well-established dysphagia treatments in the context of the physiologic impairments they treat. Traditional dysphagia therapies including volume and texture modifications, strategies such as chin tuck, head tilt, head turn, effortful swallow, supraglottic swallow, super-supraglottic swallow, Mendelsohn maneuver and exercises such as the Shaker exercise and Masako (tongue hold) maneuver are discussed...
December 1, 2014: Current Physical Medicine and Rehabilitation Reports
Amy A Blank, James A French, Ali Utku Pehlivan, Marcia K O'Malley
Stroke is one of the leading causes of long-term disability today; therefore, many research efforts are focused on designing maximally effective and efficient treatment methods. In particular, robotic stroke rehabilitation has received significant attention for upper-limb therapy due to its ability to provide high-intensity repetitive movement therapy with less effort than would be required for traditional methods. Recent research has focused on increasing patient engagement in therapy, which has been shown to be important for inducing neural plasticity to facilitate recovery...
September 2014: Current Physical Medicine and Rehabilitation Reports
Maria T Schultheis, Elizabeth Whipple
The ability to return to driving is a common goal for individuals who have sustained a traumatic brain injury. However, specific and empirically validated guidelines for clinicians who make the return-to-drive decision are sparse. In this article, we attempt to integrate previous findings on driving after brain injury and detail the cognitive, motor, and sensory factors necessary for safe driving that may be affected by brain injury. Various forms of evaluation (both in clinic and behind-the-wheel) are discussed, as well as driver retraining and modifications that may be necessary...
September 2014: Current Physical Medicine and Rehabilitation Reports
Elizabeth E Galletta, A M Barrett
Aphasia, a cognitive-linguistic disorder secondary to stroke, is a frequent and often chronic consequence of stroke with detrimental effects on autonomy and health-related quality of life. Treatment of aphasia can be approached in a number of ways. Impairment-based approaches that focus on training a specific linguistic form can be implemented. Additionally, functionally oriented intervention such as supported conversation and aphasia groups are also frequently utilized when providing a treatment program for an individual with aphasia...
June 1, 2014: Current Physical Medicine and Rehabilitation Reports
Anusha Venkatakrishnan, Gerard E Francisco, Jose L Contreras-Vidal
Stroke is a leading cause of disability, significantly impacting the quality of life (QOL) in survivors, and rehabilitation remains the mainstay of treatment in these patients. Recent engineering and technological advances such as brain-machine interfaces (BMI) and robotic rehabilitative devices are promising to enhance stroke neu-rorehabilitation, to accelerate functional recovery and improve QOL. This review discusses the recent applications of BMI and robotic-assisted rehabilitation in stroke patients. We present the framework for integrated BMI and robotic-assisted therapies, and discuss their potential therapeutic, assistive and diagnostic functions in stroke rehabilitation...
June 1, 2014: Current Physical Medicine and Rehabilitation Reports
Paul F Pasquina, Matthew Miller, A J Carvalho, Michael Corcoran, James Vandersea, Elizabeth Johnson, Yin-Ting Chen
It has been estimated that more than 1.6 million individuals in the United States have undergone at least one amputation. The literature abounds with research of the classifications of such injuries, their etiologies, epidemiologies, treatment regimens, average age of onset (average age of amputation), and much more. The subpopulation that is often overlooked in these evaluations, however, is comprised of individuals who have suffered multiple limb loss. The challenges faced by those with single-limb loss are amplified for those with multiple limb loss...
2014: Current Physical Medicine and Rehabilitation Reports
Marlís González-Fernández, Maggi-Lee Huckabee, Sebastian H Doeltgen, Yoko Inamoto, Hitoshi Kagaya, Eichii Saitoh
Although the goal of dysphagia rehabilitation is the same, population needs, clinical practice patterns, availability of resources, and dysphagia research varies greatly around the world. The goal of this review is to introduce the reader to the context in which dysphagia rehabilitation is practiced, to describe practice patterns, and to highlight the dysphagia research being performed in three distinct regions of the world: North America, New Zealand and Australia, and Japan.
December 2013: Current Physical Medicine and Rehabilitation Reports
Teresa C Drulia, Christy L Ludlow
Clinical trials published in 2012 and the first six months of 2013 were reviewed. These involved either traditional dysphagia therapy, indirect methods not involving dysphagia therapy or a combination of direct and indirect methods. Of 27 studies, 7 were RCTs, 5 were controlled clinical trials and the remainder were uncontrolled case series. Sixteen studies combined an indirect treatment with traditional dysphagia therapy; only one study examined one technique for direct swallowing therapy. Effect sizes were computed and contrasted for each trial...
December 2013: Current Physical Medicine and Rehabilitation Reports
Ann Parker, Thiti Sricharoenchai, Dale M Needham
Survivors of critical illness often experience new or worsening impairments in physical, cognitive and/or mental health, referred to as post-intensive care syndrome (PICS). Such impairments can be long-lasting and negatively impact survivors' quality of life. Early rehabilitation in the intensive care unit (ICU), while patients remain on life-support therapies, may reduce the complications associated with PICS. This article addresses evidence-based rehabilitation interventions to reduce the physical and mental health impairments associated with PICS...
December 2013: Current Physical Medicine and Rehabilitation Reports
Marlís González-Fernández, Lauren Ottenstein, Levan Atanelov, Asare B Christian
Dysphagia affects the vast majority of acute stroke patients. Although it improves within 2 weeks for most, some face longstanding swallowing problems that place them at risk for pneumonia, malnutrition, dehydration, and significantly affect quality of life. This paper discusses the scope, the disease burden, and the tools available for screening and formal evaluation of dysphagia. The most common and recently developed treatment interventions that might be useful in the treatment of this population are discussed...
September 2013: Current Physical Medicine and Rehabilitation Reports
Jonah W Saltzman, Ricardo Battaglino, Helen Stott, Leslie R Morse
Controversy exists regarding the autoimmune response that has been observed following traumatic spinal cord injury (SCI). It is not clear if this represents a protective response by the immune system to prevent further tissue damage, a pathological reaction of the immune system to central nervous system antigens released by the injury, or a combination of both. Experimental evidence indicates that B cells produce auto-antibodies following SCI and that the presence of self-reactive antibodies is associated with tissue damage...
September 2013: Current Physical Medicine and Rehabilitation Reports
Gerard G Fluet, Judith E Deutsch
Developments over the past 2 years in virtual reality (VR) augmented sensorimotor rehabilitation of upper limb use and gait post-stroke were reviewed. Studies were included if they evaluated comparative efficacy between VR and standard of care, and or differences in VR delivery methods; and were CEBM (center for evidence based medicine) level 2 or higher. Eight upper limb and two gait studies were included and described using the following categories hardware (input and output), software (virtual task and feedback and presentation) intervention (progression and dose), and outcomes...
March 2013: Current Physical Medicine and Rehabilitation Reports
Julie A Y Cichero, Catriona Steele, Janice Duivestein, Pere Clavé, Jianshe Chen, Jun Kayashita, Roberto Dantas, Caroline Lecko, Renee Speyer, Peter Lam, Joseph Murray
Conservative estimates suggest that dysphagia (difficulty swallowing) affects approximately 8 % of the world's population. Dysphagia is associated with malnutrition, dehydration, chest infection and potentially death. While promising treatments are being developed to improve function, the modification of food texture and liquid thickness has become a cornerstone of dysphagia management. Foods are chopped, mashed or puréed to compensate for chewing difficulties or fatigue, improve swallowing safety and avoid asphyxiation...
2013: Current Physical Medicine and Rehabilitation Reports
Michiko Furuta, Yoshihisa Yamashita
Oral health impacts systemic health. Therefore, oral care is an important consideration in maintaining quality of life (QOL). Previously, maintenance and improvement of oral hygiene was considered essential for achieving oral health. In addition to oral hygiene, oral care in terms of oral function is now considered to maintain QOL. Ingestion of exogenous nutrients via the oral cavity is fundamental to the function of all higher animals, not only human beings. Chewing and swallowing processes are critical for normal food intake, and adequate saliva supply and oral care to allow proper functioning of these processes are indispensable for maintaining QOL...
2013: Current Physical Medicine and Rehabilitation Reports
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