Archives of physical medicine and rehabilitation
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Arch Phys Med Rehabil · Jun 2010
ReviewExpert opinion and controversies in musculoskeletal and sports medicine: preventing sudden cardiac death in young athletes.
Sudden cardiac death in young athletes has become a highly visible public health concern. Over the past 2 decades, unexplained or premature deaths of numerous athletes at the youth, collegiate, and professional levels have garnered extensive media coverage and stimulated a discussion centered on prevention of such tragic events. A number of issues related to the prevention and management of sudden cardiac arrest on the playing field are currently debated in the medical literature, including the true incidence of sudden death in the young athletic population, the adequacy of the preparticipation physical evaluation, and the emergency response and effectiveness of secondary prevention strategies such as use of automated external defibrillators in the athletic setting. Clinicians who care for competitive athletes and/or cover youth sporting events must be aware of the benefits and limitations of different preparticipation screening programs to identify at-risk athletes, and they must be prepared to respond to life-threatening emergencies during athletic participation.
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Arch Phys Med Rehabil · Jun 2010
Randomized Controlled TrialBrain injury coping skills group: a preventative intervention for patients with brain injury and their caregivers.
To determine whether training in coping strategies will improve psychologic functioning and self-efficacy in survivors of brain injury (BI) and caregivers. ⋯ Few CBT studies have included survivors of BI and caregivers together in group treatment or included a control group. No prior studies have examined the role of PSE specifically. Prior intervention studies show inconsistent effects on emotional functioning, raising questions regarding the role of intervening variables. This study offers a new conceptualization that PSE may moderate longer-term emotional adjustment after brain injury. Results indicate that PSE is an important and modifiable factor in helping persons better adjust to BI.
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Arch Phys Med Rehabil · May 2010
Randomized Controlled TrialA randomized, double-blinded, crossover pilot study assessing the effect of nabilone on spasticity in persons with spinal cord injury.
To determine whether nabilone, a synthetic cannabinoid, alleviates spasticity in people with spinal cord injury (SCI). ⋯ Nabilone may be beneficial to reduce spasticity in people with SCI. We recommend a larger trial with a more prolonged treatment period and an option to slowly increase the dosage further.
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Arch Phys Med Rehabil · May 2010
ReviewA systematic review of pharmacologic treatments of pain after spinal cord injury.
To conduct a systematic review of published research on the pharmacologic treatment of pain after spinal cord injury (SCI). ⋯ Most studies did not specify participants' types of pain, making it difficult to identify the type of pain being targeted by the treatment. Anticonvulsant and analgesic drugs had the highest levels of evidence and were the drugs most often studied. Gabapentin and pregabalin had strong evidence (5 level 1 RCTs) for effectiveness in treating post-SCI neuropathic pain as did intravenous analgesics (lidocaine, ketamine, and morphine), but the latter only had short-term benefits. Tricyclic antidepressants only showed benefit for neuropathic pain in depressed persons. Intrathecal baclofen reduced musculoskeletal pain associated with spasticity; however, there was conflicting evidence for the reduction in neuropathic pain. Studies assessing the effectiveness of opioids were limited and revealed only small benefits. Cannabinoids showed conflicting evidence in improving spasticity-related pain. Clonidine and morphine when given together had a significant synergistic neuropathic pain-relieving effect.
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Arch Phys Med Rehabil · May 2010
Randomized Controlled TrialElectrical stimulation therapy increases rate of healing of pressure ulcers in community-dwelling people with spinal cord injury.
To investigate whether electric stimulation therapy (EST) administered as part of a community-based, interdisciplinary wound care program accelerates healing of pressure ulcers in people with spinal cord injury (SCI). ⋯ These results demonstrate that EST can stimulate healing of pressure ulcers of people with SCI. EST can be incorporated successfully into an interdisciplinary wound care program in the community.