Archives of physical medicine and rehabilitation
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Review the existing literature on the incidence, neurobiological and psychosocial correlates, and methods of assessment and treatment of depression following traumatic brain injury (TBI). ⋯ Depression occurs with sufficient frequency to be considered a significant consequence after TBI. Depression can impede the achievement of optimal functional outcome, whether in the acute or chronic stages of recovery. It appears that a combination of neuroanatomic, neurochemical, and psychosocial factors is responsible for the onset and maintenance of depression. Its treatment is typically psychopharmacologic, with best results obtained from nontricyclic antidepressants. These results have not been confirmed in double-blind clinical trials, however. Future research should use comprehensive, integrative models of depression that include demographic, biologic, and psychosocial factors; enhanced functional neuroimaging techniques; controlled studies of psychopharmacologic and other interventions; and prospective designs with long-term follow-up.
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Arch Phys Med Rehabil · Jan 1998
Randomized Controlled Trial Clinical TrialPrevention of postoperative pulmonary complications through respiratory rehabilitation: a controlled clinical study.
To investigate the efficacy of respiratory rehabilitation in preventing postoperative pulmonary complications (PPC) and to define which patients can benefit. ⋯ Respiratory rehabilitation protects against PPC and is more effective in moderate- and high-risk patients, but does not affect surgery-induced functional alterations.
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Arch Phys Med Rehabil · Jan 1998
Functional outcome following spinal cord injury: significance of motor-evoked potentials and ASIA scores.
Prediction of outcome of ambulatory capacity and hand function in tetraplegic patients with spinal cord injury (SCI) using neurologic examination, according to the protocol of the American Spinal Injury Association (ASIA) and motor-evoked potentials (MEP). ⋯ Both ASIA scores and MEP recordings are similarly related to the outcome of ambulatory capacity and hand function in patients with SCI. MEP recordings are of additional value to the clinical examination in uncooperative or incomprehensive patients. The combination of clinical examination and MEP recordings allows differentiation between the recovery of motor function (hand function, ambulatory capacity) and that of impulse transmission of descending motor tracts.
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Arch Phys Med Rehabil · Jan 1998
Status of physiatry and physical medicine and rehabilitation departments in adult level I trauma centers.
To determine the involvement of physiatrists and physical medicine and rehabilitation (PM&R) departments in the acute care of patients admitted to level I trauma centers. ⋯ Physiatrists and other allied health personnel are integral members of the trauma care team in most level I trauma centers participating in this study. Further expansion should be encouraged to facilitate early and comprehensive rehabilitative care in all level I centers.