Archives of physical medicine and rehabilitation
-
Arch Phys Med Rehabil · Oct 2001
Randomized Controlled Trial Multicenter Study Clinical TrialTwo configurations of static magnetic fields for treating rheumatoid arthritis of the knee: a double-blind clinical trial.
To assess the efficacy of a nonpharmacologic, noninvasive static magnetic device as adjunctive therapy for knee pain in patients with rheumatoid arthritis (RA). ⋯ Both devices demonstrated statistically significant pain reduction in comparison to baseline, with concordance across multiple indices. However, a significant difference was not observed between the 2 treatment groups (p < .23). In future studies, the MagnaBloc treatment should be compared with a nonmagnetic placebo treatment to characterize further its therapeutic potential for treating RA. This study did elucidate methods for conducting clinical trials with magnetic devices.
-
Arch Phys Med Rehabil · Oct 2001
ReviewCurrent concepts: diffuse axonal injury-associated traumatic brain injury.
To review the probable physical, physiologic mechanisms that result in the medical and neuropsychologic complications of diffuse axonal injury (DAI)-associated traumatic brain injury (TBI). ⋯ The term DAI is a misnomer. It is not a diffuse injury to the whole brain, rather it is predominant in discrete regions of the brain following high-speed, long-duration deceleration injuries. DAI is a consistent feature of TBI from transportation-related injuries as well as some sports injuries. The pathology of DAI in humans is characterized histologically by widespread damage to the axons of the brainstem, parasagittal white matter of the cerebral cortex, corpus callosum, and the gray-white matter junctions of the cerebral cortex. Computed tomography and magnetic resonance imaging scans taken initially after injury are often normal. The deformation of the brain due to plastic flow of the neural structures associated with DAI explains the micropathologic findings, radiologic findings, and medical and neuropsychologic complications from this type of injury mechanism. There is evidence that the types of cellular injury in TBI (DAI, anoxic, contusion, hemorrhagic, perfusion-reperfusion) should be differentiated, as all may involve different receptors and biochemical pathways that impact recovery. These differing mechanisms of cellular injury involving specific biochemical pathways and locations of injury may, in part, explain the lack of success in drug trials to ameliorate TBI.
-
Arch Phys Med Rehabil · Oct 2001
Vastus medialis obliquus and vastus lateralis activity in open and closed kinetic chain exercises in patients with patellofemoral pain syndrome: an electromyographic study.
To evaluate the electromyographic activities of vastus medialis obliquus (VMO) and vastus lateralis (VL) muscles in open and closed kinetic chain exercises in subjects with patellofemoral pain syndrome (PFPS). ⋯ In closed kinetic chain exercises, more selective VMO activation can be obtained at 60 degrees knee flexion. Maximal VMO/VL ratio was observed at this knee flexion angle, and muscle contraction intensity was also greatest.
-
Arch Phys Med Rehabil · Oct 2001
Neuromuscular electric stimulation in heart transplantation candidates with cardiac pacemakers.
Twenty percent of heart transplantation candidates have cardiac pacemakers. Application of neuromuscular electric stimulation (NMES) in patients with pacemakers is controversial because of potential electromagnetic field interference and subsequent failure of the pacemaker. We present a safety protocol as a procedure before applying NMES in pacemaker patients. ⋯ No changes in the clinical state and no complications secondary to electromagnetic field interference were observed. A check of pacemaker function after this 20-minute stimulation revealed no changes in the pacemaker parameters. After a thorough safety protocol, NMES of knee extensor muscles in patients with pacemakers appears to be safe.