Archives of physical medicine and rehabilitation
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Arch Phys Med Rehabil · Nov 1996
Review Comparative StudyRandomized controlled trials in industrial low back pain relating to return to work. Part 2. Discogenic low back pain.
The purpose of this review was to determine the efficacy of treatments for discogenic low back pain (LBP) by examining all randomized controlled trials (RCTs) of discogenic LBP published in the English language literature between 1975 and 1993 with "return to work" (RTW) as the end point. From more than 4,000 LBP citations, nearly 600 articles were initially reviewed; 35 studies met our selection criteria. Twenty-two studies were discussed in Part 1 (Acute Interventions) or will be discussed in Part 3 (Chronic Interventions). ⋯ The treatments assessed included chemonucleolysis, surgical discectomy, and epidural steroid injection. A 26-point system to assess the quality of methodologic rigor was used for each article. Our literature survey found a need for additional studies comparing surgery, conservative care, epidural steroids, traction, and other approaches to determine their individual effects for RTW after discogenic disease.
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Arch Phys Med Rehabil · Nov 1996
Case Reports Clinical Trial Controlled Clinical TrialImplanted Functional Neuromuscular Stimulation systems for individuals with cervical spinal cord injuries: clinical case reports.
To determine the feasibility of providing the ability to stand and to facilitate the performance of standing transfers to individuals with cervical-level spinal cord injuries via functional neuromuscular stimulation (FNS). The applicability of implantable technology to this population was investigated, and the characteristics of the potential system users were explored. The effects of FNS on the effort and assistance required to stand and complete standing transfers were examined. ⋯ FNS can provide the ability to exercise, stand, and transfer to individuals with tetraplegia, even in the presence of medical complications and upper extremity impairment. FNS facilitates standing transfers by eliminating the heavy lifting usually required by a caregiver, thus decreasing the effort and assistance necessary to gain access to places impossible to approach with conventional sliding transfers.
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Arch Phys Med Rehabil · Nov 1996
Comparative StudyDifference in pain relief after trigger point injections in myofascial pain patients with and without fibromyalgia.
To compare responses to trigger point (TrP) injection between patients having both myofascial pain syndrome (MPS) caused by active TrPs and fibromyalgia syndrome (FMS) and patients with MPS due to TrPs but without FMS. ⋯ Trigger point injection is a valuable procedure for pain relief for patients in both group. Patients with FMS are likely to experience significant but delayed and attenuated pain relief following injection of their active TrPs compared to myofascial pain patients with similar TrPs but without FMS. Also, FMS patients are likely to experience significantly more postinjection soreness for a longer period of time.
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Arch Phys Med Rehabil · Sep 1996
Multicenter Study Comparative Study Clinical Trial Controlled Clinical TrialFunctional outcomes of older adults with traumatic brain injury: a prospective, multicenter analysis.
To investigate improvement rates and medical services costs in older brain injured adults relative to younger patients. ⋯ Although older persons demonstrated functional changes, the cost of change was substantially higher than for younger patients, coincident with longer lengths of stay. These higher overall charges and slower rates of change may effect changes in referral and management patterns.
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Arch Phys Med Rehabil · Sep 1996
Randomized Controlled Trial Clinical TrialExpiratory training in multiple sclerosis.
To compare the effects of expiratory muscle training and sham training on respiratory muscle strength in patients with multiple sclerosis (MS). ⋯ The results of this pilot study suggest that the strength of the expiratory muscles of persons with MS can be increased through respiratory muscle training targeted to the expiratory muscles. Further research is indicated to determine if increasing the strength of the expiratory muscles in MS has an effect on clinical outcomes in this patient population.