Archives of physical medicine and rehabilitation
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Epidural steroid injections for the treatment of low back pain and associated leg pain have been used for half a century. Initial use was empirical and not without controversy. ⋯ A growing body of literature suggests that they exert some of their clinical effect by reducing epidural and perineural inflammation. More current studies using fluoroscopy with radiographic contrast and precise epidural steroid placement suggests they may obviate surgery in some patients with true radicular pain.
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Arch Phys Med Rehabil · Mar 2000
Interexaminer reliability of the palpation of trigger points in the trunk and lower limb muscles.
To determine the interexaminer reliability of palpation of three characteristics of trigger points (taut band, local twitch response, and referred pain) in patients with subacute low back pain, to determine whether training in palpation would improve reliability, and whether there was a difference between the physiatric and chiropractic physicians. ⋯ Among nonexpert physicians, physiatric or chiropractic, trigger point palpation is not reliable for detecting taut band and local twitch response, and only marginally reliable for referred pain after training.
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Arch Phys Med Rehabil · Mar 2000
Rehabilitation and the long-term outcomes of persons with trauma-related amputations.
To examine the long-term outcomes of persons undergoing trauma-related amputations, and to explore factors affecting their physical, social, and mental health and the role of inpatient rehabilitation in improving such outcomes. ⋯ These findings suggest a substantial effect of inpatient rehabilitation in improving long-term outcomes of persons with trauma-related amputations.
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To determine the patterns of pain referral from the sacroiliac joint. ⋯ Pain referral from the sacroiliac joint does not appear to be limited to the lumbar region and buttock. The variable patterns of pain referral observed may arise for several reasons, including the joint's complex innervation, sclerotomal pain referral, irritation of adjacent structures, and varying locations of injury with the sacroiliac joint.
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Arch Phys Med Rehabil · Feb 2000
Comparative StudySpasticity in spinal cord injury: self- and clinically rated intrinsic fluctuations and intervention-induced changes.
(1) To determine patterns of intrinsic fluctuations in spasticity, using repeated self-ratings, in subjects with spinal cord injury (SCI); and (2) To determine the relation between self-ratings of spasticity using a visual analogue scale (VAS) and clinical ratings of spasticity using the Modified Ashworth Scale (MAS) before and after spasticity-reducing treatment. ⋯ Repetitive passive movement intervention decreased spasticity when performed regularly, as assessed by VAS and MAS ratings. VAS and MAS ratings were significantly correlated. It is recommended that SCI patients repeatedly rate their spasticity to establish a baseline before and to track changes after interventions aimed at reducing spasticity. The time of day when spasticity is measured seems more important in cervically injured individuals, because of their more pronounced intrinsic fluctuations.