Archives of physical medicine and rehabilitation
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Arch Phys Med Rehabil · Mar 2008
ReviewInterventions in chronic pain management. 4. Monitoring progress and compliance in chronic pain management.
This self-directed learning module highlights the monitoring of progress and compliance in chronic pain management. It is part of the chapter on chronic pain in the Self-Directed Physiatric Education Program for practitioners in physical medicine and rehabilitation. Specifically, the first module focuses on the use of pain rating scales to monitor progress, and the second and third learning objectives focus on evaluating abuse potential and interpreting drug screens. The fourth objective discusses issues pertaining to closure of a workers' compensation complaint, including when to declare that a patient meets the requirements for the designation maximal medical improvement. ⋯ To discuss monitoring of a patient's progress and compliance by describing how pain rating scales are used, what screening procedures are available to help identify patients at risk for drug abuse, and what the basis is for declaring a patient as having reached maximal medical improvement.
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Arch Phys Med Rehabil · Mar 2008
Fluoroscopic analysis of lumbar epidural contrast spread after lumbar interlaminar injection.
To describe and answer questions concerning the spread of contrast in patients receiving correctly placed lumbar epidural steroid injections (ESIs) under fluoroscopy. ⋯ Contrast spread is affected by needle placement, with other variables kept equal, in the performance of an interlaminar lumbar ESI. These data support the performance of interlaminar lumbar ESIs with fluoroscopic guidance and provide some parameters with which to guide the injectionist.
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Arch Phys Med Rehabil · Mar 2008
Hospital disposition after stroke in a national survey of acute cerebrovascular diseases in Israel.
To investigate predictive factors for disposition after acute stroke. ⋯ This nationwide survey shows that most stroke survivors in Israel are discharged home from the acute primary hospital. Good functional status before the index stroke is an important predictor for being sent to acute inpatient rehabilitation. Severity of neurologic impairment and level of disability after the stroke at discharge from the primary hospital are strong predictors for disposition after stroke in Israel. Our data may be useful in discharge planning for stroke patients by policy-makers and health care providers in Israel.
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Arch Phys Med Rehabil · Mar 2008
Spinal cord injury management and rehabilitation: highlights and shortcomings from the 2005 earthquake in Pakistan.
Recent natural disasters have highlighted the lack of planning for rehabilitation and disability management in emergencies. A review of our experience with spinal cord injury (SCI) after the Pakistan earthquake of 2005, plus a review of other literature about SCI after natural disasters, shows that large numbers of people will incur SCIs in such disasters. The epidemiology of SCI after earthquakes has not been well studied and may vary with location, severity of the disaster, available resources, the expertise of the health care providers, and cultural issues. ⋯ Successful rehabilitation of victims of the Pakistan earthquake has important implications. The experience suggests that dedicated SCI centers are essential after a natural disaster. Furthermore, government and aid agency disaster planners are advised to consult with rehabilitation specialists experienced in SCI medicine in planning for the inevitable large number of people who will have disabilities after a natural disaster.
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Arch Phys Med Rehabil · Feb 2008
Validation of an adapted falls efficacy scale in older rehabilitation patients.
To determine the psychometric properties of an adapted version of the Falls Efficacy Scale (FES) in older rehabilitation patients. ⋯ This adapted FES is reliable and valid in older patients undergoing postacute rehabilitation. The independent association between poor falls efficacy and increased length of stay has not been previously described and needs further investigations.