Archives of physical medicine and rehabilitation
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Arch Phys Med Rehabil · Jan 2005
Randomized Controlled Trial Clinical TrialRandomized controlled trial of nocturnal splinting for active workers with symptoms of carpal tunnel syndrome.
To determine whether nocturnal splinting of workers identified through active surveillance with symptoms consistent with carpal tunnel syndrome (CTS) would improve symptoms and median nerve function as well as impact medical care. ⋯ Workers identified with CTS symptoms in an active symptom surveillance tended to benefit from a 6-week nocturnal splinting trial, and the benefits were still evident at the 1-year follow-up. The splinted group improved in terms of hand discomfort regardless of the degree of median nerve impairment, whereas the controls showed improvement only among subjects with normal median nerve function. Results suggest that a short course of nocturnal splinting may reduce wrist, hand, and/or finger discomfort among active workers with symptoms consistent with CTS.
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Arch Phys Med Rehabil · Jan 2005
The reliability and validity of a self-report version of the FIM instrument in persons with neuromuscular disease and chronic pain.
To evaluate the reliability and validity of a self-report version of the FIM instrument (FIM-SR). ⋯ The FIM-SR scales appear to be reliable and valid measures of independence in 6 specific (self-care, sphincter control, mobility, locomotion, communication, social cognition), and 3 global (motor, cognition, total) areas of functioning in persons with NMD.
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Arch Phys Med Rehabil · Jan 2005
Case ReportsCobalamin deficiency and subacute combined degeneration after nitrous oxide anesthesia: a case report.
We report on a diabetic man in his early forties with a history of disabling left-hemisphere stroke and hyperhomocystinemia who developed new sensorimotor symptoms and urinary incontinence 4 weeks after prolonged exposure to nitrous oxide (N(2)O) related to arterial occlusive disease and amputation. Physical examination at rehabilitation hospital admission showed preexisting severe nonfluent multimodality language impairment, new ataxic quadriparesis superimposed on static spastic right hemiparesis, diffusely blunted muscle stretch reflexes, impaired cutaneous sensation and proprioception, diminished alternating motion rates, and impaired truncal balance. Laboratory tests revealed low serum cobalamin and hyperhomocystinemia. ⋯ Treatment included vitamin replacement and comprehensive rehabilitation. His response to hospital-based and outpatient treatment led to successful prosthetic fitting. This case shows the importance of screening for and treating cobalamin deficiency before exposing patients with known risk to N(2)O and highlights the potential diagnostic and therapeutic challenges of subacute combined degeneration when it occurs with a setting of preexisting disabling neurologic impairment.