Archives of physical medicine and rehabilitation
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Arch Phys Med Rehabil · Jul 2005
Predictors of prescriptions for management of fatigue among veterans with multiple sclerosis.
To determine predictors of fatigue-modifying medication use. ⋯ Fatigue is undertreated among veterans with MS. However, there is considerable variability in the provision of fatigue care. Interventions to improve the quality and uniformity of fatigue care are warranted.
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Arch Phys Med Rehabil · Jul 2005
Case ReportsSegmental zoster paresis of the upper extremity: a case report.
Segmental zoster paresis, a rare complication of herpes zoster, is characterized by focal, asymmetric motor weakness in the myotome that corresponds to the dermatome of the rash. The pathogenesis of segmental zoster paresis is inflammation caused by the spread of the herpes virus. ⋯ Recognition of herpes zoster as a cause of acute motor weakness is important in avoiding unnecessary interventions as well as in determining the treatment and outcome of the patient. This case is presented to emphasize that herpes zoster infection may be complicated by segmental paresis, which should be considered in the differential diagnosis of acute painful motor weakness of the upper extremity.
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Arch Phys Med Rehabil · Jul 2005
ReviewA critical appraisal of the evidence for selective nerve root injection in the treatment of lumbosacral radiculopathy.
To critically review the best available trials of the utility of transforaminal epidural steroid injections (TFESIs) or selective nerve root blocks (SNRBs) to treat lumbosacral radiculopathy. ⋯ The evidence for TFESIs reveals level III (moderate) evidence in support of these minimally invasive and safe procedures in treating painful lumbar radicular symptoms. Current studies support use of TFESIs as a safe and minimally invasive adjunct treatment for lumbar radicular symptoms. However, more prospective, randomized, placebo-controlled studies using sham procedures are needed to provide conclusive evidence for the efficacy of TFESIs in treating lumbar radicular symptoms.
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Arch Phys Med Rehabil · Jul 2005
Review Case ReportsDisk entry: a complication of transforaminal epidural injection--a case report.
Correctly identifying the etiology of low back pain can be challenging. The importance of making an expedient, accurate diagnosis of lumbar radicular pain cannot be overemphasized, as proper treatment is based on the outcome. The application of fluoroscopically guided, contrast enhancement during spinal injections is commonly performed, but is not without complications. ⋯ This case report reviews the literature on complications of transforaminal steroid injection and presents the first documentation of intradiskal placement of contrast dye in the United States. A 72-year-old man presenting with a right L4 radiculopathy underwent a fluoroscopically guided, contrast-enhanced lumbar transforaminal epidural steroid injection and experienced intradiskal placement of contrast as a complication of this procedure. Although the patient was treated prophylactically and achieved good results, the need for fluoroscopy and contrast enhancement during performance of spinal injections is reemphasized.
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Arch Phys Med Rehabil · Jun 2005
Factor structure of the pain disability index in workers compensation claimants with low back injuries.
To examine the factor structure of a telephone-administered Pain Disability Index (PDI) and the effects of race and sex on the PDI. ⋯ The results support use of the PDI as a bidimensional measure of pain-related disability, with strong psychometric properties. They also support its administration by telephone.