Journal of rehabilitation research and development
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Quantitative sensory testing (QST) has been used to assess neurological function in various chronic pain patient populations. In the present study, we investigated the ability of QST to reliably characterize somatosensory dysfunction in subjects with spinal cord injury (SCI) and neuropathic pain by measuring mechanical, vibration, and thermal detection and pain thresholds. Test-retest reliability was determined based on data collected from 10 subjects with SCI and neuropathic pain who underwent QST on two occasions approximately 3 weeks apart. ⋯ To determine the validity of QST in persons with SCI-related neuropathic pain, we evaluated the relationship between somatosensory thresholds and severity of neuropathic pain symptoms with multiple linear regression analysis. Thermal pain threshold was the only QST variable significantly related to the severity of neuropathic pain symptoms. The present study provides preliminary evidence that QST is a reliable and valid adjunct measurement strategy for quantifying the neurological dysfunction associated with neuropathic pain in persons with SCI.
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Randomized Controlled Trial
Transcutaneous electrical nerve stimulation for treatment of spinal cord injury neuropathic pain.
The aim of the study was to assess the short-term effects of high- and low-frequency (HF and LF, respectively) transcutaneous electrical nerve stimulation (TENS) for neuropathic pain following spinal cord injury (SCI). A total of 24 patients participated in the study. According to the protocol, half of the patients were assigned to HF (80 Hz) and half to LF (burst of 2 Hz) TENS. ⋯ However, 29% of the patients reported a favorable effect from HF and 38% from LF stimulation on a 5-point global pain-relief scale. Six of the patients (25%) were, at their request, prescribed TENS stimulators for further treatment at the end of the study. In conclusion, TENS merits consideration as a com plementary treatment in patients with SCI and neuropathic pain.
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Altered sensations, including pain, are well-documented consequences associated with spinal cord injury (SCI). Although loss of sensory and motor functions at and below the level of injury is commonly thought to affect individuals with SCI most significantly, secondary consequences that include spasticity, bladder and bowel dysfunctions, infertility, and pain rank among the most difficult conditions to deal with following injury. ⋯ Over the past 15 years, a systematic examination related to the pathophysiology, clinical characteristics, and treatment of pain associated with SCI has provided insights into the spinal and supraspinal mechanisms associated with the development of at- and below-level pain. In this review, experimental studies focusing on the spinal and supraspinal mechanisms associated with pain at and below level will be discussed.
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To assess physical activity and disability in chronic obstructive pulmonary disease (COPD), we evaluated the use of an accelerometer and checklist to measure free-living physical activity. Seventeen males with stable COPD completed a daily activity checklist for 14 days. Ten subjects concurrently wore an Actiped accelerometer (FitSense, Southborough, Massachussetts) that records steps per day. ⋯ A higher number of daily checklist activities performed was associated with a higher force expiratory volume in 1 s percent predicted and lowerbody mass index, airflow obstruction, dyspnea, exercise capacity (BODE) index. Prospectively measuring free-living physical activity in COPD using an unobtrusive accelerometer and simple activity checklist is feasible. Low intrasubject variation was found in free-living physical activity, which is significantly associated with clinical measures of COPD status.
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Targeted muscle reinnervation (TMR) is a surgical intervention to improve the control of myoelectric prostheses in high-level upper-limb amputation. This article briefly describes the procedure and presents the protocol for postoperative, preprosthetic care. ⋯ This material is based on more than 6 years of experience treating patients with TMR in a research setting. Detailed results of this research are reported elsewhere.