PM & R : the journal of injury, function, and rehabilitation
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Multicenter Study Comparative Study
Determinants of postacute care discharge destination after dysvascular lower limb amputation.
To examine the factors affecting postacute care discharge decisions among persons undergoing major lower limb amputations as a result of dysvascular causes. ⋯ Postacute care decisions largely appear to be made on the basis of medical and family support factors. The findings of this research provide a necessary first step in the challenging task of assessing and quantitatively modeling the long-term functional outcomes of persons who receive postacute care in alternative settings by allowing more optimal case mix adjustment for factors that simultaneously influence rehabilitation setting and outcomes.
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This article aims to examine pediatric concussion literature with respect to epidemiology, etiology, return to play, and recurrent concussions, and to provide recommendations for future research. We conducted a review of pediatric concussion literature regarding incidence, etiology, return to play, and recurrent concussive injury by using MEDLINE, CINAHL, Sport-Discus, and PsychInfo databases from 1995-2010. A review of reference lists in the aforementioned articles was also performed. ⋯ Evidence exists that children and adolescents take longer to recover than adults after a concussion, which underscores the need for a more conservative approach to management and return to physical and cognitive activities. Concussion in the young athlete is of specific concern because of the continuing cognitive maturation, therefore, the recovery may be more difficult to track when using the standard assessment tools currently available. Until future studies can better delineate the mechanisms of, response to, and recovery from concussion in the young athlete, it is prudent to act in a conservative manner when dealing with pediatric athletes with concussion.
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Comparative Study
Early mobilization in critically ill patients: patients' mobilization level depends on health care provider's profession.
To evaluate whether the level of mobilization achieved and the barriers for progressing to the next mobilization level differ between nurses and physical therapists. ⋯ This study showed that physical therapists mobilize their critically ill patients to higher levels compared with nurses. Nurse and physical therapists identify different barriers for mobilization. Routine involvement of physical therapists in directing mobilization treatment may promote early mobilization of critically ill patients.
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Comparative Study
Obesity and knee osteoarthritis are not associated with impaired quadriceps specific strength in adults.
To assess whether adults, aged 50-59 years, who are obese or moderately to severely obese have impaired quadriceps strength and muscle quality in comparison with adults who are not obese, both groups with and without knee osteoarthritis (OA). ⋯ Individuals who were obese and at risk for knee OA did not appear to have altered muscle strength or muscle quality compared with adults who were not obese and were aged 50-59 years. The absence of a difference in the relationship between peak quadriceps strength and CSA provided further evidence that there was not an impairment in quadriceps muscle quality in this cohort, which suggests that factors other than strength might mediate the association between obesity and knee OA.