Archives of physical medicine and rehabilitation
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Arch Phys Med Rehabil · Aug 1996
Case ReportsIntrathecal clonidine and baclofen in the management of spasticity and neuropathic pain following spinal cord injury: a case study.
Spasticity and pain are common disabling sequelae following spinal cord injury (SCI) and are often difficult to manage. The two problems are also not infrequently related. A variety of pharmacological and other approaches have been described for management of these problems in SCI. ⋯ This resulted in an immediate improvement in anal sphincter spasm and pain relief, allowing rapid reestablishment of her normal bowel pattern without need for any supplemental analgesia. It appears that intrathecal clonidine may have an important role in the treatment of spasticity, either as a single or an adjuvant agent, when intrathecal baclofen alone is ineffective or there is increasing tolerance to baclofen. Intrathecal clonidine may also prove useful in the management of intractable neuropathic pain.
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To describe a body cast modification that allows rapid chest exposure for cardiopulmonary resuscitation and alert the medical community to the 3% to 5% incidence of cardiopulmonary arrest in the hospital while wearing such a cast. DESIGN. Single trial timed cast cutting, multiple trial cast shell loading, and clinical observations of perforated casts for cracking or breakage. ⋯ Perforated body casts reduced removal time to 15 seconds without weakening of the cast and provide lifesaving time to perform effective CPR.
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Arch Phys Med Rehabil · Jul 1996
Neck flexor muscle strength, efficiency, and relaxation times in normal subjects and subjects with unilateral neck pain and headache.
To determine the test-retest reliability of a new method for measuring muscular strength, efficiency, and relaxation times of the neck flexor musculature of healthy adults, and to compare these neck flexor muscle properties in subjects who have unilateral neck pain and headache with those in controls. ⋯ The technique was found to be highly reliable for the measurement of neck flexor peak force, peak force/body weight, average force, and force relaxation time, and moderately reliable for the quantitation of SCM EMG relaxation times and SCM efficiency. All force values were significantly lower in the neck pain population compared with the controls. In the neck pain population, force and SCM EMG relaxation times, as well as efficiencies, suggested abnormalities. Neck pain subjects showed no significant differences in SCM EMG relaxation time or SCM efficiency between affected and unaffected SCM muscles.
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Arch Phys Med Rehabil · Jul 1996
Identification of static and dynamic postural instability following traumatic brain injury.
Quantitative evaluation of static and dynamic aspects of postural instability as a long-term consequence of traumatic brain injury (TBI). ⋯ A long-term overall reduction in both static and dynamic control of posture can be present after TBI, even in patients without clear neurological deficits. Force-plate recordings can identify such (latent) balance problems. Visual deprivation during quiet standing appears a simple, sensitive test for postural instability related to sensory integration deficits.
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Arch Phys Med Rehabil · Jun 1996
Randomized Controlled Trial Clinical TrialSubacute methylphenidate treatment for moderate to moderately severe traumatic brain injury: a preliminary double-blind placebo-controlled study.
To determine the effect of subacute administration of methylphenidate on recovery from moderate to moderately severe closed head injury. ⋯ Subacute administration of methylphenidate after moderately severe head injury appeared to enhance the rate but not the ultimate level of recovery as measured by the DRS and tests of vigilance. Problems with possible selection bias and small sample size limit generalization of results.