Archives of physical medicine and rehabilitation
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Arch Phys Med Rehabil · Mar 2000
Stretch reflex adaptation in elbow flexors during repeated passive movements in unilateral brain-injured patients.
To evaluate the effects of repeated, externally imposed, flexion-extension movements of the elbow on the resulting stretch reflex response in hemiparetic spastic brain-injured patients. These effects were compared within a recording session and across sessions for the same subject to determine the impact of movement history on the quantification of spastic hypertonia using the stretch reflex response. ⋯ Stretch reflex adaptation must be taken into consideration when spastic hypertonia is quantified using repeated joint motion, as is often the case. The magnitude of intersession variation in spastic hypertonia measures suggests that ideally, such measurements should be made across multiple sessions before conclusions are made regarding the efficacy of spastic hypertonia interventions. This study provides quantitative evidence that repeated joint movements may have a significant short-term beneficial effect on spastic hypertonia.
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Arch Phys Med Rehabil · Mar 2000
Randomized Controlled Trial Clinical TrialA controlled study on the effects of transcutaneous electrical nerve stimulation and interferential therapy upon the RIII nociceptive and H-reflexes in humans.
To study the effect of transcutaneous electrical nerve stimulation (TENS) and interferential therapy (IFT) upon the RIII nociceptive reflex and H-reflex. ⋯ These results suggest that neither type of electrical stimulation (TENS or IFT) affects the RIII or H-reflexes, at least using the parameters and application time in this study.
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Over the past three decades there has been increasing interest in acute weakness syndromes in critically ill mechanically ventilated patients. Many of these patients require rehabilitation, and some understanding of potential etiologies and functional outcomes for these syndromes is useful to rehabilitation practitioners. A clearer understanding of these syndromes has evolved over time, as has the terminology to describe these conditions. This article will review commonly encountered causes of acute weakness in critically ill patients, including disorders of the peripheral nerves, the neuromuscular junction, and muscle.
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Epidural steroid injections for the treatment of low back pain and associated leg pain have been used for half a century. Initial use was empirical and not without controversy. ⋯ A growing body of literature suggests that they exert some of their clinical effect by reducing epidural and perineural inflammation. More current studies using fluoroscopy with radiographic contrast and precise epidural steroid placement suggests they may obviate surgery in some patients with true radicular pain.
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Arch Phys Med Rehabil · Mar 2000
Interexaminer reliability of the palpation of trigger points in the trunk and lower limb muscles.
To determine the interexaminer reliability of palpation of three characteristics of trigger points (taut band, local twitch response, and referred pain) in patients with subacute low back pain, to determine whether training in palpation would improve reliability, and whether there was a difference between the physiatric and chiropractic physicians. ⋯ Among nonexpert physicians, physiatric or chiropractic, trigger point palpation is not reliable for detecting taut band and local twitch response, and only marginally reliable for referred pain after training.