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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
Andréane Richard-Denis, Debbie Ehrmann Feldman, Cynthia Thompson, Étienne Bourassa-Moreau, Jean-Marc Mac-Thiong
OBJECTIVE: Acute spinal cord injury (SCI) centers aim to optimize outcome following SCI. However, there is no timeframe to transfer patients from regional to SCI centers in order to promote cost-efficiency of acute care. Our objective was to compare costs and length of stay (LOS) following early and late transfer to the SCI center. DESIGN: A retrospective cohort study involving 116 individuals was conducted. Group 1 (n = 87) was managed in an SCI center promptly after the trauma, whereas group 2 (n = 29) was transferred to the SCI center only after surgery...
November 24, 2016: American Journal of Physical Medicine & Rehabilitation
Jonathan Kantor
Importance: Until recently, no ideal valid, feasible, and reliable scar scale existed to effectively assess the quality of postoperative linear scars. The Scar Cosmesis Assessment and Rating (SCAR) scale was developed and validated as a tool to assess the quality of postoperative scars in clinical and research settings. Objective: To assess the reliability of using photographs in lieu of live patient scar rating assessments, and to determine the interrater and intrarater reliability of the SCAR scale...
November 2, 2016: JAMA Dermatology
Shanti M Pinto, Gary Galang
OBJECTIVE: The aim of this study was to investigate the impact of venous thromboembolism (VTE) on rate of acute care hospital transfer, inpatient rehabilitation (IPR) length of stay (LOS), and functional outcomes. DESIGN: This was a retrospective cohort study of 2312 consecutive patient discharges from a single IPR facility over an 18-month period. RESULTS: When age, sex, reason for admission, and admission Functional Independence Measure (FIM) scores were controlled for, those with VTE had nearly 2 times greater odds for transfer to acute care hospital than did those without a diagnosis of VTE...
October 22, 2016: American Journal of Physical Medicine & Rehabilitation
Paul B Perrin, Lillian F Stevens, Megan Sutter, Anthony H Lequerica, Denise Krch, Stephanie A Kolakowsky-Hayner, Juan Carlos Arango-Lasprilla
OBJECTIVE: The research attempting to disentangle the directionality of relationships between mental health and functional outcomes after traumatic brain injury (TBI) is growing but has yielded equivocal findings or focused on isolated predictors or isolated outcomes. The purpose of the current study was to use cross-lagged panel and structural equation modeling (SEM) techniques to examine causality between comprehensive indices of mental health (depression, anxiety, and life satisfaction) and functional independence in a national sample of individuals with TBI over the first 2 years after injury...
October 13, 2016: American Journal of Physical Medicine & Rehabilitation
Jack B Fu, Melissa P Osborn, Julie K Silver, Benedict S Konzen, An Ngo-Huang, Rajesh Yadav, Eduardo Bruera
Because of their expertise, physiatrists provide disability insurance assistance for cancer survivors. In this brief report, we perform a descriptive retrospective analysis of all new (354) outpatient physiatry consultations from January 1, 2009, to December 31, 2013, at a National Cancer Institute Comprehensive Cancer Center. Disability and/or work accommodations were brought up at some point with the physiatrist during the duration of their care for 131 (37%) of 354 patients. More than 90% of the discussions took place during the first visit...
October 6, 2016: American Journal of Physical Medicine & Rehabilitation
Seema R Khurana, Alexandria G Beranger, Elizabeth R Felix
OBJECTIVE: This study investigates the direct comparison of energy cost, efficiency, and effort between an ankle-foot orthosis (AFO) and a functional electrical stimulation (FES) device for foot drop in ambulatory patients with multiple sclerosis. DESIGN: Twenty adults (32-74 years old; 55% female) with a diagnosis of multiple sclerosis resulting in foot drop participated in a crossover, counterbalanced preliminary study. Each participant was tested on different days, with each session consisting of a separate walk trial per prosthetic device...
September 26, 2016: American Journal of Physical Medicine & Rehabilitation
Charles A Odonkor, Asare B Christian, Andy Haig
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Anne H Eliason, William McKinley, Carolyn W Graham
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
David Berbrayer
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Nigar Dursun, Tugba Gokbel, Melike Akarsu, Erbil Dursun
OBJECTIVE: Physical therapy (PT) and botulinum toxin-A (BTX-A) injections are widely used in the treatment of spastic equinus foot due to cerebral palsy. The aim of this study was to show effects of intermittent serial casting (SC) in addition to standard treatment on spasticity, passive range of motion (PROM), and gait. DESIGN: Fifty-one ambulatory patients, treated by BTX-A to plantar flexor muscles, were randomly assigned to casting or control groups in a 2:1 ratio...
September 14, 2016: American Journal of Physical Medicine & Rehabilitation
Jaspal R Singh, Eliana Cardozo, George C Christolias
BACKGROUND: Epidural steroid injections have been used in combination with other modalities for the treatment of lumbar radicular pain. The literature has shown that 1-level lumbar fluoroscopically guided transforaminal epidural steroid injections (TFESIs) are effective in decreasing pain and morbidity; however, the efficacy of 2-level TFESIs has not been investigated, although they are performed by many practitioners in the treatment of lumbar radicular pain. OBJECTIVES: To assess the clinical effectiveness of 2-level TFESIs in patients with unilateral, single-level lumbar radicular pain...
September 7, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Lauri Bishop, Andrew M Gordon, Heakyung Kim
OBJECTIVE: The aim of this study was to understand the impact of training with a hand robotic device on hand paresis and function in a population of children with hemiparesis. METHODS: Twelve children with hemiparesis (mean age, 9 [SD, 3.64] years) completed participation in this prospective, experimental, pilot study. Participants underwent clinical assessments at baseline and again 6 weeks later with instructions to not initiate new therapies. After these assessments, participants received 6 weeks of training with a hand robotic device, consisting of 1-hour sessions, 3 times weekly...
July 6, 2016: American Journal of Physical Medicine & Rehabilitation
Chang-Yong Kim, Jung-Sun Lee, Hyeong-Dong Kim
OBJECTIVES: The purposes of the present study were to compare the effects of backward and lateral walking training and to identify whether additional backward or lateral walking training would be more effective in increasing the walking function of poststroke patients. DESIGN: Fifty-one subjects with hemiplegic stroke were randomly allocated to 3 groups, each containing 17 subjects: the control group, the backward walking training group, and the lateral walking training group...
June 17, 2016: American Journal of Physical Medicine & Rehabilitation
Brad E Dicianno, John Lovelace, Pamela Peele, Christopher Fassinger, Patricia Houck, Alexandra Bursic, Michael L Boninger
OBJECTIVE: To determine whether an evidence-based wellness program for individuals with spina bifida (SB) and spinal cord injury (SCI) would improve health outcomes and patient experience of care, result in a positive return on investment (ROI), and provide evidence for scalability. DESIGN: non-randomized, non-controlled cohort study; two years of enrollment SETTING: Academic hospital-based outpatient physiatry clinic partnered with an insurance division within an integrated healthcare delivery and financing system PARTICIPANTS: Sixty nine individuals with SB and SCI were consented, 4 were excluded, and the remaining 65 participated in the intervention...
June 13, 2016: Archives of Physical Medicine and Rehabilitation
Solomon Rojhani, Zan Qureshi, Akhil Chhatre
Chronic osteoarthritis (OA) is a widespread source of pain and disability and represents a growing economic burden across aging populations. Representing a major focus of arthritis care, OA of the knee is especially concerning as it has the potential to restrict mobility and significantly impair quality of life. Chronic OA is often poorly managed both pharmacologically and nonpharmacologically, with surgical management representing the definitive treatment. Those who are not surgical candidates or simply opt for minimally invasive treatments are usually faced with a lack of alternatives...
May 18, 2016: American Journal of Physical Medicine & Rehabilitation
Şule Şahin Onat, Seda Biçer, Zehra Şahin, Ayşegül Küçükali Türkyilmaz, Murat Kara, Sibel Özbudak Demir
OBJECTIVE: The aim of this study was to investigate whether kinesiotaping or subacromial corticosteroid injection provides additional benefit when used with nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with shoulder impingement syndrome. DESIGN: Patients with shoulder impingement syndrome were divided into 3 groups as follows: NSAID group (n = 33), kinesiotaping group (kinesiotaping + NSAID) (n = 33), and injection group (subacromial corticosteroid injection + NSAID) (n = 33)...
August 2016: American Journal of Physical Medicine & Rehabilitation
Carrie M Carr, Christopher T Plastaras, Matthew J Pingree, Matthew Smuck, Timothy P Maus, Jennifer R Geske, Christine A El-Yahchouchi, Zachary L McCormick, David J Kennedy
SETTING: Interventional procedures directed toward sources of pain in the axial and appendicular musculoskeletal system are performed with increasing frequency. Despite the presence of evidence-based guidelines for such procedures, there are wide variations in practice. Case reports of serious complications such as spinal cord infarction or infection from spine injections lack appropriate context and create a misleading view of the risks of appropriately performed interventional pain procedures...
April 15, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Rani Polak, Marie L Dacey, Edward M Phillips
Unhealthy nutrition is a leading factor in various rehabilitation diagnoses such as stroke and several musculoskeletal complications. Further, the association between nutrition, pain management, and brain plasticity support the importance of having rehabilitation patients follow healthy nutrition guidelines. The goal of this brief report is to emphasize the importance of nutritional counseling to physiatrists and to briefly describe recommended communication skills, behavioral change strategies, and opportunities for interprofessional collaborations...
April 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Nancy L Dudek, Suzan Dojeiji, Kathleen Day, Lara Varpio
PURPOSE: Research demonstrates that physicians benefit from regular feedback on their clinical supervision from their trainees. Several features of effective feedback are enabled by nonanonymous processes (i.e., open feedback). However, most resident-to-faculty feedback processes are anonymous given concerns of power differentials and possible reprisals. This exploratory study investigated resident experiences of giving faculty open feedback, advantages, and disadvantages. METHOD: Between January and August 2014, nine graduates of a Canadian Physiatry residency program that uses open resident-to-faculty feedback participated in semistructured interviews in which they described their experiences of this system...
September 2016: Academic Medicine: Journal of the Association of American Medical Colleges
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