Archives of physical medicine and rehabilitation
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Arch Phys Med Rehabil · Sep 1997
Definition of agitation following traumatic brain injury: I. A survey of the Brain Injury Special Interest Group of the American Academy of Physical Medicine and Rehabilitation.
To determine national patterns of defining agitation after traumatic brain injury (TBI) by physiatrists with expressed interest in treating TBI survivors. ⋯ There is considerable variation among physiatrists in their rating of characteristics that define agitation. Many define agitation during the acute recovery phase as posttraumatic amnesia plus an excess of behavior such as aggression, disinhibition, and/or emotional lability. Less support was given to defining agitation by the DSM-IIIR or DSM-IV diagnostic criteria for delirium. Delirium appears related to, but is not sufficient for, a diagnosis of agitation.
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Arch Phys Med Rehabil · Sep 1997
Measurement and treatment of agitation following traumatic brain injury: II. A survey of the Brain Injury Special Interest Group of the American Academy of Physical Medicine and Rehabilitation.
Determine national patterns of measuring and treating agitation after traumatic brain injury (TBI) by physiatrists with expressed interest in treating TBI survivors. ⋯ The majority of physiatrists surveyed did not formally measure agitation. Treatment strategies differ significantly between general physiatrists and those who specialize in the treatment of patients with TBI. The breadth of pharmacologic agents and strategies identified in this survey probably reflects the lack of research specific to the pathophysiology of the disorder of posttraumatic agitation.
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Arch Phys Med Rehabil · Sep 1997
Stroke rehabilitation management in the Department of Veterans Affairs: impact of patient referral source on outcomes.
To assess the relation between the source of stroke patients' referral to the rehabilitation unit and rehabilitation outcome. ⋯ VA administrators and clinicians need to consider referral source when evaluating and comparing unit performance in stroke rehabilitation. Patients referred from Acute Other and long-term care settings may require more intensive management to offset their functional and social deficits, and to reduce LOS and increase home discharge rates. Referral source also identified highly functional patients who possibly could be cared for approximately in less costly rehabilitation settings. These issues warrant further research especially as the VA seeks to achieve cost savings in this era of reduced funding.
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Arch Phys Med Rehabil · Sep 1997
Comparative StudyReferred pain elicited by palpation and by needling of myofascial trigger points: a comparison.
To investigate the occurrence of referred pain (ReP) elicited by palpation (Pal-ReP) or by needle injection (Inj-ReP) of myofascial trigger point (MTrP), and to assess the correlated factors, including the pain intensity of an active MTrP and the occurrence of local twitch response (LTR). ⋯ ReP could be elicited more frequently by needling than by palpation. The frequency of occurrence in ReP mainly depends on pain intensity of an active MTrP.
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Arch Phys Med Rehabil · Sep 1997
Case ReportsMalignant secondary deposit in the iliac crest masquerading as meralgia paresthetica.
Meralgia paresthetica is an entrapment neuropathy from compression of lateral femoral cutaneous nerve of the thigh as it passes under the inguinal ligament. The entrapment produces pain, paresthesia, and sensory loss over the anterolateral aspect of the thigh, without motor loss. The etiology of this condition is often obscure and the pathogenesis is thought to be an entrapment of this nerve at the inguinal ligament where it pierces the fascia to reach the skin. ⋯ We report a case of a 60-year-old man who presented with clinical features of meralgia paresthetica. On investigation, he was found to have a secondary malignant deposit in the iliac crest from an adenocarcinoma of the lung. This neuropathy, although often caused by a benign lesion, can at times be the presenting symptom of a malignancy.