Archives of physical medicine and rehabilitation
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Arch Phys Med Rehabil · Mar 1998
Incidence, acute care length of stay, and discharge to rehabilitation of traumatic amputee patients: an epidemiologic study.
To examine patterns of trauma-related amputations over time by age and gender of the patient and by level and type of amputation, and to explore factors affecting acute care length of stay and discharge to inpatient rehabilitation. ⋯ Findings suggest a substantial decline in incidence rates of both major and minor amputations over the 15-year study period, a low rate of disposition to inpatient rehabilitation services of patients sustaining major amputations, and an apparent role of firearms as a cause of trauma-related amputations in patients younger than 25 years of age. The consequences of increasingly shorter acute care hospital stays and low rates of discharge to inpatient rehabilitation on the long-term outcomes of persons who have had traumatic amputation should be examined.
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Arch Phys Med Rehabil · Feb 1998
Comparative Study Clinical TrialDepressive effects of segmental and heterotopic application of transcutaneous electrical nerve stimulation and piezo-electric current on lower limb nociceptive flexion reflex in human subjects.
To evaluate quantitatively the effectiveness and clinical relevance of various parameters of electrical stimulation used to relieve acute and chronic pain and to further knowledge of the mechanisms that may underlie the physiologic response produced by the transcutaneous application of each type of current. ⋯ These data are discussed in terms of possible spinal and supraspinal mechanisms involving inhibitory descending controls and underline the potential clinical use of PECs1 in the treatment of pain.
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Arch Phys Med Rehabil · Feb 1998
Comparative StudyMuscle strength in individuals with healed burns.
To quantify the long-term effects of burns on muscle strength and to investigate the impact of the initial severity of the trauma on muscle strength. ⋯ Patients who had severe burns (TBSA of > 30%) had weaker muscles even years after the trauma, suggesting either an inability to fully recover or insufficient rehabilitation.
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Review the existing literature on the incidence, neurobiological and psychosocial correlates, and methods of assessment and treatment of depression following traumatic brain injury (TBI). ⋯ Depression occurs with sufficient frequency to be considered a significant consequence after TBI. Depression can impede the achievement of optimal functional outcome, whether in the acute or chronic stages of recovery. It appears that a combination of neuroanatomic, neurochemical, and psychosocial factors is responsible for the onset and maintenance of depression. Its treatment is typically psychopharmacologic, with best results obtained from nontricyclic antidepressants. These results have not been confirmed in double-blind clinical trials, however. Future research should use comprehensive, integrative models of depression that include demographic, biologic, and psychosocial factors; enhanced functional neuroimaging techniques; controlled studies of psychopharmacologic and other interventions; and prospective designs with long-term follow-up.
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Arch Phys Med Rehabil · Jan 1998
Randomized Controlled Trial Clinical TrialPrevention of postoperative pulmonary complications through respiratory rehabilitation: a controlled clinical study.
To investigate the efficacy of respiratory rehabilitation in preventing postoperative pulmonary complications (PPC) and to define which patients can benefit. ⋯ Respiratory rehabilitation protects against PPC and is more effective in moderate- and high-risk patients, but does not affect surgery-induced functional alterations.