Archives of physical medicine and rehabilitation
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Arch Phys Med Rehabil · May 1998
Clinical TrialSide effects of chronic intrathecal baclofen on erection and ejaculation in patients with spinal cord lesions.
Assess modifications of sexual function in men treated with intrathecal baclofen for spinal spasticity. ⋯ Intrathecal baclofen may compromise erection and ejaculation. This effect is reversible. Patients should be informed of this effect.
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Arch Phys Med Rehabil · Apr 1998
Back and hip extensor fatigability in chronic low back pain patients and controls.
To compare the lumbar paraspinal and gluteus maximus muscle fatigability between chronic low back pain patients and healthy controls by using electromyographic (EMG) spectral analysis during a maximal isometric endurance task. ⋯ The chronic low back pain patients were weaker and fatigued faster than the healthy controls. The EMG fatigue analysis results suggest that the gluteus maximus muscles are more fatigable in chronic low back pain patients than in healthy control subjects during a sustained back extension endurance test.
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Arch Phys Med Rehabil · Mar 1998
Case ReportsHyperthermia, rhabdomyolysis, and disseminated intravascular coagulation associated with baclofen pump catheter failure.
A 29-year-old man with C6 tetraplegia (ASIA A) using an implanted baclofen pump and intrathecal catheter infusion system for spasticity control developed severe spasticity, hyperthermia, hypotension, rhabdomyolysis, and disseminated intravascular coagulation after catheter disconnection. Tracheal intubation and mechanical ventilation were necessary. Extensive workup for a concurrent infection was negative except for urine cultures. ⋯ Spasticity control and his clinical condition, including body temperature, did not improve until his catheter was surgically replaced and intrathecal baclofen administration was resumed. The pharmacopathology of abrupt baclofen withdrawal and the similarities between this presentation, sepsis, neuroleptic malignant syndrome, and malignant hyperthermia are discussed. High-dose dantrolene was not used; however, based on similarities between this patient's presentation and neuroleptic malignant syndrome, it may have been the drug of choice.
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Arch Phys Med Rehabil · Mar 1998
The predictive value of provocative sacroiliac joint stress maneuvers in the diagnosis of sacroiliac joint syndrome.
To determine the clinical validity of provocative sacroiliac joint (SIJ) maneuvers in making the diagnosis of sacroiliac joint syndrome (SIJS). ⋯ Our results do not support the use of provocative SIJ maneuvers to confirm a diagnosis of SIJS. Rather, these physical examination techniques can, at best, enter SIJS into the differential diagnosis.
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Arch Phys Med Rehabil · Mar 1998
Case ReportsMyofascial trigger points in intercostal muscles secondary to herpes zoster infection of the intercostal nerve.
Chronic pain in the chest wall is a major complication after herpes zoster infection of intercostal nerves. It is usually difficult to control pain of such origin. Two cases are reported of postherpetic neuralgia after herpes zoster infection involving the intercostal nerves. ⋯ One patient had complete pain relief after three series of injections. The effect of pain relief for the other patient lasted for 1 to 2 weeks after the initial injection and lasted progressively longer (up to 2 months) after repeated injections. It appears that many of the tender spots formed in intercostal muscles after herpes zoster are myofascial trigger points that respond to injection with referred pain, local twitch responses, and immediate pain relief.