PM & R : the journal of injury, function, and rehabilitation
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Distal biceps tendinopathy is an uncommon but increasingly diagnosed condition in persons with elbow pain. When traditional treatments are unsuccessful, practitioners have performed ultrasound (US)-guided tendon injections in this region using an anterior approach. ⋯ The patient had an excellent clinical outcome with no adverse events. This outcome suggests that a US-guided posterior percutaneous tendon injection might be a safe, viable, nonsurgical option for recalcitrant distal biceps tendinopathy.
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Review
Physical Medicine Interventions to Avoid Acute Respiratory Failure and Invasive Airway Tubes.
This article describes the use of physical medicine noninvasive inspiratory and expiratory muscle aids to prevent ventilatory/respiratory failure and to permit the extubation and tracheostomy tube decannulation of patients with little or no autonomous ability to breathe (ie, those who cannot be weaned from ventilator support). Noninvasive airway pressure aids can provide continuous ventilatory support and effective cough flows for patients with severely dysfunctional respiratory muscles.
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Review Historical Article
Myofascial Trigger Points Then and Now: A Historical and Scientific Perspective.
The intent of this article is to discuss the evolving role of the myofascial trigger point (MTrP) in myofascial pain syndrome (MPS) from both a historical and scientific perspective. MTrPs are hard, discrete, palpable nodules in a taut band of skeletal muscle that may be spontaneously painful (i.e., active) or painful only on compression (i.e., latent). MPS is a term used to describe a pain condition that can be acute or, more commonly, chronic and involves the muscle and its surrounding connective tissue (e.g. fascia). ⋯ To address these deficiencies, investigators have recently applied clinical, imaging (of skeletal muscle and brain), and biochemical analyses to systematically and objectively study the MTrP and its role in MPS. Data suggest that the soft tissue milieu around the MTrP, neurogenic inflammation, sensitization, and limbic system dysfunction may all play a role in the initiation, amplification, and perpetuation of MPS. The authors chronicle the advances that have led to the current understanding of MTrP pathophysiology and its relationship to MPS, and review the contributions of clinicians and researchers who have influenced and expanded our contemporary level of clinical knowledge and practice.