Archives of physical medicine and rehabilitation
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Arch Phys Med Rehabil · Aug 1981
Chronic pain and the questionable use of the Minnesota Multiphasic Personality Inventory.
Several studies have observed that patients who complain of chronic pain have significantly elevated scores on the first 3 clinical scales of the Minnesota Multiphasic Personality Inventory (MMPI). Some studies imply that this profile allows one to conclude that such patients exaggerate their symptoms, have strong feelings of inadequacy, have emotional problems which are neurotic, with implications that this is functional pain. The present study and its results challenges the use of the MMPI in attempting to distinguish psychogenic from organic pain. ⋯ It is especially important to avoid dismissing the pain symptomatology as functional by simply giving the patient a psychiatric diagnosis consistent with the profile. The potential of the MMPI as an aid in developing the treatment plan and as a possible predictive tool for certain treatment procedures is discussed. It is suggested that MMPI data be collected on a comparison group of patients, who have had successful relief of pain through surgical intervention.
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A case of a 36-year-old man, with a history of traumatic amputation below the elbow on the left side, resulting in intractable phantom limb pain, is described. The patient failed to respond to a variety of medications including several analgesics, tranquilizers, and a beta-blocker. Other extended series of conventional treatment modalities, which included stellate ganglion and peripheral nerve blocks and neuromal excision with the anterior transposition of the ulnar nerve, did not relieve the pain. Acupuncture was then attempted with the subjective relief of phantom limb pain and the objective result that the patient could wear a prosthesis.
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Arch Phys Med Rehabil · Jun 1980
Aphasic patients in a rehabilitation program: scheduling speech and language services.
Eleven 10-item tests from the Porch Index of Communicative Ability (PICA), were administered to 14 aphasic adults participating in a rehabilitation program. Tests were given once in the morning and once in the afternoon. ⋯ The primary implication of these results is the importance of consistency in scheduling patient contacts when measuring the effects of treatments rendered. Considerations in determining optimum schedules and aiding individual patients in compensating for reduced efficiency due to time of day are discussed.
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Arch Phys Med Rehabil · Apr 1980
Health service developments: their impact on regulation and functions of rehabilitation personnel.
The boundaries and responsibilities of rehabilitation personnel are defined by direct regulation of personnel through licensure and certification and by indirect regulation through the system in which the health professions work. New regulatory measures governing health personnel in the United States and other countries indicate a trend towards innovative roles and increased autonomy for rehabilitation therapists. Current developments in the American health care system will have important impacts on the functions, education, and credentialing of members of the rehabilitation team.
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Arch Phys Med Rehabil · Sep 1979
Chronic pain states: their relationship to impairment and disability.
Chronic pain patients (101) were assigned ratings of impairment and disability and were assessed for organic pathology and pain behavior through comprehensive testing procedures. As predicted, higher ratings of impairment and disability were significantly associated with higher levels of both physical pathology and pain behaviors. ⋯ Many patients showed higher disability than impairment ratings, which suggests the possibility of gainful employment in less demanding jobs. However, the current disability system rewards sickness and dysfunction and discourages patients from resuming work.