European journal of physical and rehabilitation medicine
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In this review we will describe newly developed techniques that are being used to recover levels of motor function after a severe spinal cord injury that have not been observed previously. These new approaches include pharmacological neuromodulation and/or epidural stimulation of the spinal cord circuitries in combination with motor training. By combining the increased levels of excitability of the interneuronal spinal circuitries using these interventions and the ability of the spinal circuitries to interpret and respond appropriately to ongoing complex ensembles of sensory input, the peripheral sensory system can become an effective source for the control of motor function. ⋯ In fact, some level of voluntary control of movement has been observed in subjects with complete paralysis in the presence of epidural stimulation. The biological mechanisms thought to underlie the recovery of motor function after a severe spinal cord injury are based on decades of research on a wide range of animal models. Fortunately the extensive conservation of neural mechanisms of motor control has provided a window for gaining considerable insight into the mechanisms of recovery of motor function in humans.
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Eur J Phys Rehabil Med · Mar 2012
Multicenter Study Comparative StudyCardiorespiratory comorbidity: a new challenge for physical and rehabilitation medicine specialist.
The cardiorespiratory comorbidity can reduce the participation in the rehabilitation project of patients with motor disorders. ⋯ The results of the survey suggest that rehabilitation is useful even in patients with motor disorders and cardiorespiratory comordibity.
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Eur J Phys Rehabil Med · Mar 2012
Comparative StudySimultaneous treatment of intractable pain and spasticity: observations of combined intrathecal baclofen-morphine therapy over a 10-year clinical experience.
Intrathecal therapy has separate indications for refractory pain and spasticity. Both entities have a relatively high prevalence in neurologic diseases. This study examines the potential efficacy of utilizing additive intrathecal morphine (ITM) therapy to a group of patients who had previously stabilized on intrathecal baclofen (ITB) therapy. ⋯ Reduction is pain intensity with combined therapy was variable. Intrathecal morphine can be a safe and effective adjunct pain therapy to patients utilizing intrathecal baclofen for spasticity.
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Eur J Phys Rehabil Med · Dec 2011
Controlled Clinical TrialAdaptive physical activity and back pain: a non-randomised community-based intervention trial.
Back pain is a significant problem due to the high healthcare utilization, rising costs of care and low effectiveness of many current treatments. ⋯ This study suggests that a community-based APA program can improve back pain and health status in persons with chronic, non-specific low back pain. CLINICA REHABILITATION IMPACT: These findings highlight the potential for new approaches to manage chronic disease and disability by facilitating a healthy lifestyle and promoting physical activity through implementation of community-based exercise programs.