Archives of physical medicine and rehabilitation
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Arch Phys Med Rehabil · Nov 2012
Current pain and fear of pain contribute to reduced maximum voluntary contraction of neck muscles in patients with chronic neck pain.
To assess a range of physical and psychological factors and determine which factors contribute the most to reduced strength in patients with neck pain. ⋯ The average maximum voluntary force produced in neck flexion, extension, and lateral flexion is inversely and moderately correlated with the pain experienced during maximal contraction, fear of movement, and aspects of neck disability in patients with chronic neck pain.
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Arch Phys Med Rehabil · Nov 2012
Review Meta AnalysisActivity pacing, avoidance, endurance, and associations with patient functioning in chronic pain: a systematic review and meta-analysis.
To systematically review the associations between different approaches to activity (ie, activity pacing, avoidance, or endurance) and indicators of patient functioning in chronic pain samples. ⋯ Although causation cannot be determined, results of this study suggest that both avoidance of activity and overactivity are associated with poorer patient outcomes. Unexpected results relating to pacing may reflect either the ineffectiveness of pacing if not used to gradually increase an individual's activity level or the notion that individuals with better psychological functioning but more pain and disability are more inclined to pace activity.
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Arch Phys Med Rehabil · Nov 2012
Clinical TrialChanges in objectively measured physical activity (performance) after epidural steroid injection for lumbar spinal stenosis.
To examine changes in objectively measured physical activity (performance) at 1 week following epidural steroid injection for lumbar spinal stenosis. ⋯ While patients perceived improvements in pain and function following injection, these improvements were not reflected in significant changes in performance or capacity. Future studies will continue to find value in subjective measures of pain and quality of life. However, with modern technology, performance is no longer a subjective variable. Use of activity monitors to objectively measure performance can result in more rigorous validation of treatment effects, while simultaneously highlighting the potential need for additional postinjection rehabilitation aimed at improving performance.
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Arch Phys Med Rehabil · Nov 2012
Health outcomes associated with military deployment: mild traumatic brain injury, blast, trauma, and combat associations in the Florida National Guard.
To determine the association between specific military deployment experiences and immediate and longer-term physical and mental health effects, as well as examine the effects of multiple deployment-related traumatic brain injuries (TBIs) on health outcomes. ⋯ Complex relationships exist between multiple deployment-related factors and numerous overlapping and co-occurring current adverse physical and psychological health outcomes. Various deployment-related experiences increased the risk for postdeployment adverse mental and physical health outcomes, individually and in combination. These findings suggest that an integrated physical and mental health care approach would be beneficial to postdeployment care.