Archives of physical medicine and rehabilitation
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Arch Phys Med Rehabil · Jun 2001
Case ReportsComplex regional pain syndrome type I treated with topical capsaicin: a case report.
This report describes the case of a multitrauma patient who underwent an amputation of the left arm and had a complicated left crural fracture with a delayed union. He was treated in an inpatient setting for preprosthetic training for a myoelectric prosthesis and to regain walking abilities. After consolidation of the crural fracture, complex regional pain syndrome type I (CRPS I) developed in the left foreleg, which hindered mobilization. ⋯ Capsaicin is a well-accepted and documented treatment modality in neuropathic pain states such as postherpetic neuralgia. However, it has rarely been described in CRPS I. Capsaicin is discussed within the framework of recent insights in the neurobiology of nociception, and it is concluded that it may provide a theory-driven treatment for CRPS I, especially in the acute stage, that facilitates physical therapy and prevents peripheral and spinal sensitization.
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Arch Phys Med Rehabil · May 2001
Randomized Controlled Trial Comparative Study Clinical TrialChronic lateral epicondylitis of the elbow: A prospective study of low-energy shockwave therapy and low-energy shockwave therapy plus manual therapy of the cervical spine.
To compare the effects of extracorporeal shockwave therapy (ESWT) alone with a combination of ESWT and manual therapy of the cervical spine in treating chronic tennis elbow. ⋯ ESWT may be an effective conservative treatment method for unilateral chronic tennis elbow. The efficacy of additional cervical manual therapy for lateral epicondylitis remains questionable.
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Arch Phys Med Rehabil · May 2001
Case ReportsUsing gabapentin to treat failed back surgery syndrome caused by epidural fibrosis: A report of 2 cases.
Failed back surgery syndrome (FBSS) is a long-lasting, often disabling, and relatively frequent (5%-10%) complication of lumbosacral spine surgery. Epidural fibrosis is among the most common causes of FBSS, and it is often recalcitrant to treatment. Repeated surgery for fibrosis has only a 30% to 35% success rate, whereas 15% to 20% of patients report worsening of their symptoms. ⋯ In both cases, functional status improved markedly and pain was significantly diminished. Gabapentin has an established, favorable safety profile and has been shown to be effective in various animal models and human studies of chronic neuropathic pain. Clinicians should consider gabapentin as a pharmacologic treatment alternative in the management of FBSS caused by epidural fibrosis.
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Arch Phys Med Rehabil · May 2001
Comparative StudyElectrodiagnostic changes of the lower limbs in subjects with chronic complete cervical spinal cord injury.
To assess the electrodiagnostic changes in the lower limbs as measured by nerve conduction studies (NCSs) and electromyography in individuals with chronic complete tetraplegia. ⋯ A statistically significant difference in NCS responses in the lower limbs in chronic tetraplegia was found relative to normal control values. However, only the frequency of responses elicited and the decreased CMAP of the peroneal nerve are clinically significant. SA was present in many of the lower extremity muscles in the subjects. Predominantly axonal changes were evident in individuals with chronic complete tetraplegia.
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Arch Phys Med Rehabil · May 2001
Comparative StudyQuantifying swallowing function after stroke: A functional dysphagia scale based on videofluoroscopic studies.
To develop a sensitive, specific scale for quantifying functional dysphagia in stroke patients, using results obtained from videofluoroscopic swallowing studies. ⋯ This functional dysphagia scale, which was based on a videofluoroscopic swallowing study in stroke patients, is a sensitive and specific method for quantifying the severity of dysphagia.