Archives of physical medicine and rehabilitation
-
To determine if botulinum toxin type B (MyoBloc) decreases spasticity. ⋯ Botulinum toxin type B may be useful in treatment of spasticity.
-
Arch Phys Med Rehabil · Jan 2003
ReviewPharmacologic treatment of complex regional pain syndrome I: a conceptual framework.
Pain may be a leading symptom in complex regional pain syndrome type I (CRPS I) and may hinder functional recovery. In this case, a pharmacotherapeutic approach to pain should be part of the individually tailored interdisciplinary treatment regimen. However, operational criteria for determining which patient may profit from what therapeutic intervention are lacking. ⋯ Finally, relating the clinical picture to the underlying pathophysiology may help determine the pharmacotherapeutic approach for an individual patient. Pharmacologic options are discussed in this context. The presented framework does not aim to provide an evidence-based treatment algorithm, ready to be used in daily clinical practice; rather it offers a crude, first step toward a mechanism-based pharmacotherapy in CRPS I, in an effort to shift from a mainly empirical treatment paradigm toward theory-driven treatment procedures.
-
Stroke frequently results in psychologic distress and activity limitations across multiple domains of functioning. However, most stroke outcome measurement tools and clinical trial endpoints are narrowly focused on neurologic symptom status and physical aspects of functioning, and rarely assess other important components of health. In this article, I discuss the limitations in the measurement of nonfatal stroke outcomes; propose a minimum set of fundamental assessment domains comprising a comprehensive assessment of health status in stroke survivors; and describe the conceptual development of the Burden of Stroke Scale, a comprehensive, patient-reported measure of functioning and well-being for stroke survivors.
-
This article compares a traditional biomedical model with an outcomes model for evaluating medical and rehabilitation care. The traditional model emphasizes diagnosis and disease-specific outcomes. In contrast, the outcomes model emphasizes life expectancy and health-related quality of life (QOL). ⋯ The outcomes model has been applied widely in rehabilitation research, but few studies estimate the benefits of treatments using QALYs. These methodologies can also serve as a basis for approaches to sharing medical decisions between patients and providers. Opportunities to apply these new methods are discussed.
-
Arch Phys Med Rehabil · Dec 2002
Quality of life measurement in rehabilitation medicine: building an agenda for the future.
In November 2001, a conference convened to discuss the state of the science of measuring of quality of life (QOL) in rehabilitation medicine. The meeting brought together leading researchers in areas of behavioral health and physical medicine and rehabilitation to address the fragmentation that exists across specialty areas and disciplines. ⋯ The 5 topic areas included: (1) general versus targeted measurement, (2) QOL in policy development, (3) measuring QOL from the patient's perspective, (4) cultural aspects of QOL measurement, and (5) the future of QOL research. This introduction synthesizes the information presented at the conference and provides context to the articles contained in this 2-part supplement.