Archives of physical medicine and rehabilitation
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Arch Phys Med Rehabil · Nov 2001
Circulatory hypokinesis and functional electric stimulation during standing in persons with spinal cord injury.
To evaluate the effects of functional electric stimulation (FES) of lower limb muscles during 30 minutes of upright standing on the central and peripheral hemodynamic response in persons with spinal cord injury (SCI). ⋯ FES of the lower extremity could be used by persons with SCI as an adjunct during standing to prevent orthostatic hypotension and circulatory hypokinesis. This effect may be more beneficial to those with tetraplegia who have a compromised autonomic nervous system and may not be able to adjust their hemodynamics to the change in position.
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Arch Phys Med Rehabil · Nov 2001
Functional outcomes and quality of life in patients with brain tumors: a preliminary report.
To determine the relationship between functional outcome and quality of life (QOL) in patients with brain tumors receiving inpatient rehabilitation, and to assess the sensitivity of 4 assessment tools in measuring changes in that population. ⋯ Although patients make functional gains during and after inpatient rehabilitation, gains in QOL are not significant until 1 month postdischarge. QOL does not appear to correlate well with functional outcomes. Further, the KPS is less sensitive than the FIM and DRS in detecting change in functional status.
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Arch Phys Med Rehabil · Nov 2001
Chronic pain after spinal injury: interference with sleep and daily activities.
To determine how chronic pain after spinal cord injury (SCI) interfered with sleep, exercise, work, household chores, and other daily activities and to define which clinical aspects of pain and psychosocial factors best predicted the extent of interference. ⋯ Reported extent of pain interference in various areas of activity is related to clinical symptoms of pain as well as to psychologic and psychosocial factors rather than level of injury. The relationship between frequent interference, pain intensity, and multiple descriptors indicate that individuals experiencing several types of pain of high intensity are more likely than others to experience frequent interference with a variety of daily activities including sleep.
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Arch Phys Med Rehabil · Oct 2001
Randomized Controlled Trial Multicenter Study Clinical TrialTwo configurations of static magnetic fields for treating rheumatoid arthritis of the knee: a double-blind clinical trial.
To assess the efficacy of a nonpharmacologic, noninvasive static magnetic device as adjunctive therapy for knee pain in patients with rheumatoid arthritis (RA). ⋯ Both devices demonstrated statistically significant pain reduction in comparison to baseline, with concordance across multiple indices. However, a significant difference was not observed between the 2 treatment groups (p < .23). In future studies, the MagnaBloc treatment should be compared with a nonmagnetic placebo treatment to characterize further its therapeutic potential for treating RA. This study did elucidate methods for conducting clinical trials with magnetic devices.
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Arch Phys Med Rehabil · Oct 2001
ReviewCurrent concepts: diffuse axonal injury-associated traumatic brain injury.
To review the probable physical, physiologic mechanisms that result in the medical and neuropsychologic complications of diffuse axonal injury (DAI)-associated traumatic brain injury (TBI). ⋯ The term DAI is a misnomer. It is not a diffuse injury to the whole brain, rather it is predominant in discrete regions of the brain following high-speed, long-duration deceleration injuries. DAI is a consistent feature of TBI from transportation-related injuries as well as some sports injuries. The pathology of DAI in humans is characterized histologically by widespread damage to the axons of the brainstem, parasagittal white matter of the cerebral cortex, corpus callosum, and the gray-white matter junctions of the cerebral cortex. Computed tomography and magnetic resonance imaging scans taken initially after injury are often normal. The deformation of the brain due to plastic flow of the neural structures associated with DAI explains the micropathologic findings, radiologic findings, and medical and neuropsychologic complications from this type of injury mechanism. There is evidence that the types of cellular injury in TBI (DAI, anoxic, contusion, hemorrhagic, perfusion-reperfusion) should be differentiated, as all may involve different receptors and biochemical pathways that impact recovery. These differing mechanisms of cellular injury involving specific biochemical pathways and locations of injury may, in part, explain the lack of success in drug trials to ameliorate TBI.