Journal of rehabilitation research and development
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Improved diagnosis and treatment of traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) are needed for our military and veterans, their families, and society at large. Advances in brain imaging offer important biomarkers of structural, functional, and metabolic information concerning the brain. This article reviews the application of various imaging techniques to the clinical problems of TBI and PTSD. For TBI, we focus on findings and advances in neuroimaging that hold promise for better detection, characterization, and monitoring of objective brain changes in symptomatic patients with combat-related, closed-head brain injuries not readily apparent by standard computed tomography or conventional magnetic resonance imaging techniques.
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This article applies a biopsychosocial perspective to a mechanisms-based approach to the assessment and treatment of the heterogeneous and persistent pain conditions associated with spinal cord injury (SCI). This article presents an overview of the types of pains experienced after SCI and some of the research on the mechanisms, diagnostic issues, and psychosocial factors relevant for the development of treatments targeting specific underlying mechanisms of pain. This review also discusses several diagnostic challenges of determining the underlying causes of pain in each individual patient.
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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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This article is the second in a series of evidence-based systematic reviews. Data reported cover the impact of dysphagia behavioral interventions on swallow physiology in healthy adults. The behavioral treatments investigated were three postural interventions--side lying, chin tuck, and head rotation--and four swallowing maneuvers--effortful swallow, the Mendelsohn maneuver, supraglottic swallow, and super-supraglottic swallow. ⋯ For non disordered populations, the existing evidence demonstrates differential effects of postural changes and maneuvers on swallowing physiology. Some effects reinforced existing recommendations for the applications of the interventions, while others suggested new ways that the treatments may impact swallow function. Avenues for future research are suggested.
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This article is the second in a series of evidence-based systematic reviews. Data reported cover the impact of dysphagia behavioral interventions on swallow physiology in healthy adults. The behavioral treatments investigated were three postural interventions--side lying, chin tuck, and head rotation--and four swallowing maneuvers--effortful swallow, the Mendelsohn maneuver, supraglottic swallow, and super-supraglottic swallow. ⋯ For non disordered populations, the existing evidence demonstrates differential effects of postural changes and maneuvers on swallowing physiology. Some effects reinforced existing recommendations for the applications of the interventions, while others suggested new ways that the treatments may impact swallow function. Avenues for future research are suggested.