Archives of physical medicine and rehabilitation
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Arch Phys Med Rehabil · Jul 1985
Case ReportsPhantom limb pain: relief by application of TENS to contralateral extremity.
Three adult patients with below-knee amputation of various etiologies were treated at Norristown's Sacred Heart Hospital and Rehabilitation Center in the fall of 1983. The patients ranged in age from 48 to 64 years and two were men. All three had complaints of phantom limb pain originating from various anatomic sites of the amputated extremity. ⋯ The patients were treated solely by application of the TENS unit to the contralateral extremity at the sites where the phantom pain originated on the amputated limb. All three patients responded to treatment and were able to continue their prosthetic training. A six-month follow-up showed no pain recurrence of phantom limb pain in all three cases.
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Arch Phys Med Rehabil · Jun 1985
Comparative StudyChest physical therapy: comparative efficacy of preoperative and postoperative in the elderly.
Although chest physical therapy (PT) immediately after surgery lowers the risk of postoperative pulmonary complications, several reports indicate preoperative chest PT results in further improvement. This study compares the effects of initiating chest PT either before and/or after chest surgery in patients over age 65. We studied two groups: 130 patients (the PRE group) undergoing both pre- and postoperative therapy and 150 patients (the POST group) undergoing only postoperative therapy, dividing them into four surgical subgroups: lung, cardiac and other thoracic surgery, upper abdominal, and lower abdominal (considered low risk compared with the other three). ⋯ PRE and POST pneumonia rates, however, were statistically equivalent in all surgical subgroups. Since the low rate of pulmonary complications for PRE-group patients undergoing thoracic or upper abdominal procedures is comparable to that for PRE-group therapy in much younger populations, advanced age alone does not appear to be a significant risk factor. The lack of effect on incidence of pneumonia indicates that preoperative chest PT only counters the altered pulmonary mechanics responsible for atelectasis, but has no effect on pulmonary complications due to infection.
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Arch Phys Med Rehabil · Feb 1985
Chronic pain: electromechanical recording device for measuring patients' activity patterns.
Many authors have recommended the development and use of automated recording devices as alternatives to self-report measures of activity patterns in chronic pain patients. An electromechanical device is described that can be used to measure downtime or uptime in chronic pain patients. ⋯ The device has high reliability (agreement coefficients of 1.0) and concurrent validity (r = 0.99) for both downtime and uptime assessments. Research applications and clinical use of this device are discussed as well as directions for the further development of automated recording devices.
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Arch Phys Med Rehabil · Dec 1984
Case ReportsTelephone communication system for handicapped individuals.
Simple low-cost telephone systems for independent use by individuals with limited upper extremity function are described. The systems can be easily assembled from readily available telephone components. ⋯ Use requires the manipulation of only two switches. One switch connects the amplifier to the phone line; the other dials the operator. "Dial (0)" telephone systems, costing less than $100, are readily affordable for many handicapped individuals.
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Arch Phys Med Rehabil · Jul 1984
Musculoskeletal and neurologic conditions in rural family practice: implications for physical medicine curriculums.
To help determine the educational needs of both students and practitioners, an inventory of musculoskeletal and neurologic disorders was made of eight rural family practices for one year. Data on 54,043 patients representing 152,482 visits was put into an automated information system at the time care was received and coded by diagnosis. ⋯ PM&R conditions were fairly evenly distributed throughout all age ranges, indicating a need for education in both pediatric and adult areas. The breakdown of PM&R conditions by category provides valuable insight for future curriculum development.