Archives of physical medicine and rehabilitation
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Arch Phys Med Rehabil · Nov 2018
Cluster Analysis of Vulnerable Groups in Acute Traumatic Brain Injury Rehabilitation.
To analyze the complex relation between various social indicators that contribute to socioeconomic status and health care barriers. ⋯ Application of clustering techniques to inpatient data identified distinct clusters of patients who may experience differences in their rehabilitation outcome due to their membership in various "at-risk" groups. The results identified patients (ie, cluster B, with minority patients; and cluster D, with elderly patients) who attain below-average gains in brain injury rehabilitation. The results also suggested that systemic (eg, duration of stay) or clinical service improvements (eg, staff's language skills, ability to offer substance abuse therapy, provide appropriate referrals, liaise with intensive social work services, or plan subacute rehabilitation phase) could be beneficial for acute settings. Stronger recruitment, training, and retention initiatives for bilingual and multiethnic professionals may also be considered to optimize gains from acute inpatient rehabilitation after traumatic brain injury.
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Arch Phys Med Rehabil · Nov 2018
Observational StudyRobot-Guided Neuronavigated Repetitive Transcranial Magnetic Stimulation (rTMS) in Central Neuropathic Pain.
To confirm and extend previous results involving repetitive transcranial magnetic stimulation (rTMS) aimed at alleviating refractory central neuropathic pain (CNP). To evaluate pain relief in detail and to assess ongoing benefits after one year of treatment. ⋯ These results confirm that multiple rTMS sessions are both safe and have potential as a treatment for CNP. An ongoing randomized controlled trial will allow teasing out of this effect from placebo analgesia.
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Arch Phys Med Rehabil · Oct 2018
Multicenter StudyEffectiveness of Home-Based Exercises Without Supervision by Physical Therapists for Patients With Early-Stage Amyotrophic Lateral Sclerosis: A Pilot Study.
To verify the effects of structured home-based exercises without supervision by a physical therapist in patients with early-stage amyotrophic lateral sclerosis (ALS). ⋯ Structured home-based exercises without supervision by a physical therapist could be used to alleviate functional deterioration in patients with early-stage ALS.
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Arch Phys Med Rehabil · Oct 2018
Personality, High-Risk Behaviors, and Elevated Risk of Unintentional Deaths Related to Drug Poisoning Among Individuals With Spinal Cord Injury.
To identify risk and protective factors for unintentional death related to drug poisoning from prescription medications, including opioid-related deaths, and death due to all other causes among participants with spinal cord injury (SCI). ⋯ Unintentional deaths related to prescription drug overdose are associated with a set of risk factors that differs in meaningful ways from risk of death due to other causes after SCI, and these differences hold the key to prevention strategies.