Archives of physical medicine and rehabilitation
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Arch Phys Med Rehabil · Aug 2004
Quantifying environmental factors: a measure of physical, attitudinal, service, productivity, and policy barriers.
To develop and test a new instrument to assess environmental barriers encountered by people with and without disabilities by using a questionnaire format. ⋯ The CHIEF has good test-retest and internal consistency reliability with evidence of content, construct, and discriminant validity resulting from its development strategy and psychometric assessments in samples of the general population and among people with a variety of disabilities.
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Arch Phys Med Rehabil · Aug 2004
Case ReportsCognitive behavioral therapy for insomnia associated with traumatic brain injury: a single-case study.
To test the efficacy of a cognitive behavioral therapy (CBT) for insomnia with a patient with traumatic brain injury (TBI). ⋯ These preliminary results suggest that sleep disturbances after TBI can be alleviated with a nonpharmacologic intervention. CBT for post-TBI insomnia is a promising therapeutic avenue deserving more scientific and clinical attention.
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Arch Phys Med Rehabil · Aug 2004
Comparative StudyPositive straight-leg raising in lumbar radiculopathy: is documentation affected by insurance coverage?
To evaluate whether differences exist in documentation of straight-leg raising (SLR), based on insurance coverage. ⋯ Reasons for reporting higher rates of positive SLR in the PIP group include an added incentive to treat, poor knowledge of proper interpretation of the SLR test, and/or an increased exaggeration of symptoms.
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Arch Phys Med Rehabil · Aug 2004
Relationship between strength, balance, and swallowing deficits and outcome after traumatic brain injury: a multicenter analysis.
To examine the relation among strength, balance, and swallowing deficits, as measured on rehabilitation admission, and functional outcome at discharge and 1 year after traumatic brain injury (TBI). ⋯ Assessments of physical strength, swallowing ability, and dynamic balance on acute rehabilitation admission are helpful as screening tests in predicting the need for assistance of another person for mobility and self-care at rehabilitation discharge. This association remains strong at 1 year after TBI. By using this information, clinicians should initiate therapeutic interventions that optimize rehabilitation of the identified impairments and should make necessary arrangement for the patient's anticipated postdischarge needs. Further studies are necessary to delineate the amount of unique variance that these early physical examination findings contribute to outcome prediction.
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Arch Phys Med Rehabil · Aug 2004
Patterns of recurrent pressure ulcers after spinal cord injury: identification of risk and protective factors 5 or more years after onset.
To identify risk and protective factors associated with a history of recurrent pressure ulcers among participants with spinal cord injury (SCI). ⋯ Pressure ulcer history is a more viable measure of pressure ulcer outcomes than measures taken at a single point in time (current), over a brief period (eg, 1y), or those relying on critical events occurring at any time since SCI onset (ie, surgeries to repair pressure ulcers). A healthy lifestyle appears to be strongly associated with avoiding pressure ulcers, whereas the efficacy of specific prevention behaviors was not demonstrated. Problem solving and coping strategies should be targets for further research.