Archives of physical medicine and rehabilitation
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Arch Phys Med Rehabil · Jun 2009
Randomized Controlled TrialRationale of the combined use of inspiratory and expiratory devices in improving maximal inspiratory pressure and maximal expiratory pressure of patients with chronic obstructive pulmonary disease.
To examine the rationale of the combined use of a new expiratory device in association with a previously assessed inspiratory device in improving 3 indicators of the respiratory muscle strength, for example, maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and dyspnea grade. ⋯ This study suggests that home exercise with the combined use of our expiratory and inspiratory devices leads to a significant improvement of respiratory muscle function in patients with mild to very severe COPD.
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Arch Phys Med Rehabil · Jun 2009
Family functioning is associated with depressive symptoms in caregivers of acute stroke survivors.
To determine whether family functioning is uniquely associated with caregiver depressive symptoms in the immediate aftermath of stroke. ⋯ Forty-one percent of caregivers experienced prominent depressive symptoms after their family member's stroke. Higher depression severity in caregivers was associated with caring for a man, and having worse health and poor family functioning. After stroke, the assessment of caregivers' health and family functioning may help determine which caregivers are most at risk for a depressive syndrome.
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Arch Phys Med Rehabil · May 2009
Comparative StudyPatients with chronic disabling occupational musculoskeletal disorder failing to complete functional restoration: analysis of treatment-resistant personality characteristics.
To identify the risk factors for noncompletion of a functional restoration program for patients with chronic disabling occupational musculoskeletal disorders. ⋯ Although some risk factors associated with program noncompletion may be addressed in treatment, socially maladaptive personality disorders, long-neglected disability, and chronic opioid dependence are the major barriers to successful treatment completion. The patients identified with personality disorders may display resistance to treatment and may be difficult for the treatment staff to deal with. Early recognition of these treatment-resistant personality characteristics in the functional restoration process may assist the treatment team in developing more effective strategies to help this dysfunctional group.
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Arch Phys Med Rehabil · May 2009
Self-report of missteps in older adults: a valid proxy of fall risk?
To evaluate the relationship between missteps and falls and to identify factors associated with missteps, potentially to generate a broader picture of fall risk. ⋯ The self-report of missteps may be a valuable tool in the research of falls and fall risk and may provide a way to identify patients at risk for falls before they fall.
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Arch Phys Med Rehabil · May 2009
Clinical outcomes for patients classified by fear-avoidance beliefs and centralization phenomenon.
To (1) determine the prevalence of pain pattern classification subgroups (centralization, noncentralization, and not classified) observed during the initial evaluation of patients experiencing high versus low Fear-Avoidance Beliefs Questionnaire for physical activity (FABQ-PA) scores, (2) examine the association between discharge pain intensity and functional status (FS) outcomes based on FABQ-PA and pain pattern subgroups, and (3) compare minimal clinically important improvement for FS and pain intensity for FABQ-PA and pain pattern classification subgroups. ⋯ Pain pattern and FABQ-PA characteristics impacted rehabilitation outcomes. We recommend that both factors be considered when managing patients with low back pain in an effort to optimize rehabilitation outcomes.