Archives of physical medicine and rehabilitation
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Arch Phys Med Rehabil · Mar 2003
ReviewInterventions in chronic pain management. 2. New frontiers: invasive nonsurgical interventions.
Invasive nonsurgical techniques have a central role in the management of patients suffering from acute and chronic pain. This article surveys common percutaneous pain procedures: trigger point injections, intra-articular injections, spinal injections, nerve blocks, radiofrequency lesioning (thermocoagulation and pulsed-mode), epidural adhesiolysis and decompressive neuroplasty, neural mapping, intradiskal and intra-annular procedures, neuromodulation, continuous intrathecal analgesia, and deep brain stimulation. Physiatrists must understand the guiding principles behind these procedures before practicing interventional pain management. ⋯ To review invasive, nonsurgical pain management procedures.
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Arch Phys Med Rehabil · Mar 2003
Young traffic victims' long-term health-related quality of life: child self-reports and parental reports.
To describe the long-term health-related quality of life (HRQOL) reported by young traffic injury victims and to assess the child-parent agreement on the child's HRQOL. ⋯ Young traffic injury victims reported a reasonably good long-term HRQOL, and, surprisingly, few psychologic problems were revealed. Physicians who rely only on parental reports may overestimate the child's HRQOL, especially when assessing the physical functioning. The child's own reports should not be neglected in the assessment of a comprehensive picture of the child's HRQOL.
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This self-directed learning module highlights that the underlying problem in many types of muscle pain disorders is a distortion of critical structures that causes functional deficits and pain. An objective of treatment is to reverse this distortion, enabling repair of damaged tissues and strengthening of weakened muscles. ⋯ This article specifically focuses on pertinent review articles, results of controlled and open-trial data, and case reports to assess the role of BTX-A treatment in chronic pain disorders. OVERALL LEARNING To review the clinical trial data of the safety and efficacy of BTX-A for the treatment of chronic pain syndromes associated with muscle disorders.
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Arch Phys Med Rehabil · Mar 2003
Clinical Trial Controlled Clinical TrialAn assessment of gait and balance deficits after traumatic brain injury.
To assess the sensations of instability that many patients report after traumatic brain injury (TBI). ⋯ Patients' complaints of instability after TBI may have objective correlates and may be rectifiable. Balance and gait testing in these patients is warranted.
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Arch Phys Med Rehabil · Mar 2003
Clinical TrialChanges in movement characteristics of the spastic upper extremity after botulinum toxin injection.
To examine the longitudinal effects of botulinum toxin injection on movement characteristics of the spastic upper extremity in children by using motor control testing (MCT) techniques and standard clinical measures. ⋯ Although botulinum toxin reduced tone and increased ROM of the spastic upper extremity, the time course and degree of motor improvement appears to depend on the complexity of the task. Future research should focus on the value of adjunct therapy, such as task-specific training, in addition to botulinum toxin treatments to facilitate functional improvement of the spastic upper extremity.