Archives of physical medicine and rehabilitation
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To determine how often emergency department (ED) patients meeting the Centers for Disease Control and Prevention (CDC) mild traumatic brain injury (TBI) criteria were diagnosed with a mild TBI by the ED physician. ⋯ The diagnosis of mild TBI was frequently absent from ED medical records despite patients reporting findings consistent with a mild TBI diagnosis when interviewed by study personnel. Asking a few targeted questions of ED patients with likely mechanisms of injury that could result in mild TBI could begin to improve diagnosis and, in turn, begin to improve patient management and the accuracy of estimates of mild TBI incidence.
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To identify differences in conditional and unconditional earnings among participants with spinal cord injury (SCI) attributable to biographic, injury, educational, and employment factors by using a 2-part model (employment, earnings). ⋯ Efforts to improve employment outcomes should focus on facilitating return to work immediately after injury, returning to preinjury job, maintaining regular employment, and working for placement in government or private industry. Special efforts may be needed to promote vocational outcomes among women and nonwhites.
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Arch Phys Med Rehabil · Jul 2008
Spinal cord injury and co-occurring traumatic brain injury: assessment and incidence.
To examine prospectively the incidence and severity of co-occurring traumatic brain injury (TBI) in persons with traumatic spinal cord injury (SCI) and to describe a TBI assessment process for SCI rehabilitation professionals. ⋯ Findings from our prospective study provide strong support that TBI is a common co-occurring injury with traumatic SCI. Incomplete acute care medical record documentation of TBI in the traumatic SCI population remains a considerable issue, and there is a significant need to educate emergency department and acute care personnel on the TBI clinical data needs of acute rehabilitation providers. A systematic algorithm for reviewing acute care medical records can yield valid estimates of TBI severity in the traumatic SCI population.
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Arch Phys Med Rehabil · Jul 2008
Intradermal botulinum toxin type A injection effectively reduces residual limb hyperhidrosis in amputees: a case series.
To study the effectiveness of botulinum toxin type A (BTX-A) therapy for residual limb hyperhidrosis, prosthesis fit and function, and residual and phantom limb pain in patients with limb amputation. ⋯ BTX-A may be an effective treatment for residual limb hyperhidrosis, resulting in subjective improvement in prosthesis fit and functioning. BTX-A should be considered as a method to manage excessive sweating in the residual limb of traumatic amputees.
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Arch Phys Med Rehabil · Jul 2008
The efficacy of a multidisciplinary falls prevention clinic with an extended step-down community program.
To investigate the efficacy of a falls prevention clinic and a community step-down program in reducing the number of falls among community-dwelling elderly at high risk of fall. ⋯ The programs in the falls prevention clinic were effective in reducing the number of falls and injurious falls. The community step-down programs were crucial in maintaining the intervention effects of the falls prevention clinic.