Archives of physical medicine and rehabilitation
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Arch Phys Med Rehabil · Jan 1984
Case ReportsNerve entrapment syndromes in the upper extremity contralateral to amputation.
Five cases are reported of upper extremity amputation with no metabolic disease. Patients experienced pain, paresthesia and weakness in the intact extremity associated with electrophysiologic evidence of entrapment neuropathies. All patients did heavy manual work, and all had carpal tunnel syndrome. ⋯ Patients who did not use a prosthesis felt relief of symptoms following surgical release. Possible mechanisms which produce nerve entrapment syndromes in patients with upper extremity amputations are use of one limb for heavy manual work over prolonged periods, direct compression of neural structures from the axilla loop of a figure-8 harness, and compression of neural structures in the axilla resulting in entrapment at a distal site. Changing the figure-8 harness should be considered prior to surgical decompression for patients who have upper extremity amputations with entrapment syndromes.
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Arch Phys Med Rehabil · Nov 1983
Comparative Study Clinical Trial Controlled Clinical TrialHypnosis compared to relaxation in the outpatient management of chronic low back pain.
Chronic low back pain (CLBP) presents a problem of massive dimensions. While inpatient approaches have been evaluated, outpatient treatment programs have received relatively little examination. Hypnosis and relaxation are two powerful techniques amenable to outpatient use. ⋯ Self-Hypnosis subjects reported less time to sleep onset, and physicians rated their use of medication as less problematic after treatment. While both treatments were effective, neither proved superior to the other. The placebo treatment produced nonsignificant improvement.
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Coincident with the recent development of more effective acute care of burn injured patients, has been the growth of dynamic, integrated rehabilitative efforts. The physical, emotional, and social problems that face the thermally injured patient must be solved in a constructive, coordinated manner within the matrix of total patient care. Most burns are minor burns, which may be optimally treated on an outpatient basis in a physical medicine department. ⋯ We describe a comprehensive approach to the rehabilitative care of the thermally injured, including the techniques of wound management, positioning, splinting, and exercise at all chronologic phases of care. The psychosocial component of patient care is also discussed and the importance of counseling and relaxation methods addressed. Specialized problems and therapeutic techniques associated with hand burns are explained and appropriate splinting methods are illustrated.
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Arch Phys Med Rehabil · Nov 1981
Reflex sympathetic dystrophy syndrome of the upper extremity: analysis of total outcome of management of 125 cases.
Case histories of 125 patients with reflex sympathetic dystrophy syndrome of the upper extremity seen from July 1973 to March 1976 were reviewed. There was a 2.9:1 female preponderance. Twenty-four patients had documented litigation pending; however, it did not alter the final outcome significantly. ⋯ Thirty-five percent were officially disabled, 30% were back at their same jobs and 29/59 female patients (49%) were able to do all the housework. Eighteen patients (23%) were able to return to 100% daily activity, 23 patients (30%) to 75% activity. Eleven patients (14%) had modified their activities considerably and were not able to do well.