Archives of physical medicine and rehabilitation
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Arch Phys Med Rehabil · Sep 2012
Multicenter StudyLongitudinal patterns of functional recovery in patients with incomplete spinal cord injury receiving activity-based rehabilitation.
To model the progression of 3 functional outcome measures from patients with incomplete spinal cord injury (SCI) receiving standardized locomotor training. ⋯ Locomotor training, as implemented in the NRN, results in significant improvement in functional outcome measures as treatment sessions accumulate. Variability in patterns of recovery over time suggest that time since SCI and patient functional status at enrollment, as measured by the Neuromuscular Recovery Scale, are important predictors of performance and recovery as measured by the targeted outcome measures.
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Arch Phys Med Rehabil · Sep 2012
Randomized Controlled TrialEffect of topical anesthetics on needle insertion pain during botulinum toxin type A injections for limb spasticity.
To compare pain perception using 3 anesthetics (eutectic mixture of local anesthetics [EMLA], vapocoolant spray, and ice) compared with a control (no anesthetic) during botulinum toxin type A (BTX-A) injections for lower limb spasticity. ⋯ Pain relief offered by EMLA and ice was comparable, suggesting that ice is a more convenient option because of brief application time (compared with EMLA). Spray may have made the patients more sensitive to pain and alternative approaches for using vapocoolant should be considered.
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Arch Phys Med Rehabil · Sep 2012
Randomized Controlled Trial Multicenter StudyEffects of a multifactorial falls prevention program for people with stroke returning home after rehabilitation: a randomized controlled trial.
To determine whether a multifactorial falls prevention program reduces falls in people with stroke at risk of recurrent falls and whether this program leads to improvements in gait, balance, strength, and fall-related efficacy. ⋯ This multifactorial falls prevention program was not effective in reducing falls in people with stroke who are at risk of falls nor was it more effective than usual care in improving gait, balance, and strength in people with stroke. Further research is required to identify effective interventions for this high-risk group.
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Arch Phys Med Rehabil · Sep 2012
Multicenter StudyRelationship between ASIA examination and functional outcomes in the NeuroRecovery Network Locomotor Training Program.
To determine the effects of locomotor training on: (1) the International Standards for Neurological Classification of Spinal Cord Injury examination; (2) locomotion (gait speed, distance); (3) balance; and (4) functional gait speed stratifications after chronic incomplete spinal cord injury (SCI). ⋯ Locomotor training improves gait speed to levels sufficient for independent in-home or community ambulation after chronic motor incomplete SCI. Changes in lower extremity motor and sensory scores do not capture the full extent of functional recovery, nor predict responsiveness to locomotor training. Functional classification based on gait speed may provide an effective measure of treatment efficacy or functional improvement after incomplete SCI.
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Arch Phys Med Rehabil · Sep 2012
Multicenter Study Clinical TrialAssessment of functional improvement without compensation reduces variability of outcome measures after human spinal cord injury.
To develop a scale (Neuromuscular Recovery Scale [NRS]) for classification of functional motor recovery after spinal cord injury (SCI) based on preinjury movement patterns that would reduce variability of the populations' level of function within each class, because assessment of functional improvement after SCI is problematic as a result of high variability of the populations' level of function and the insensitivity to change within the available outcome measures. ⋯ Assessment with the NRS provides a classification for functional motor recovery without compensation, which reduces variability in performance and improvements for individuals with injuries classified as AIS grades C and D.