American journal of physical medicine & rehabilitation
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Am J Phys Med Rehabil · Mar 2009
Randomized Controlled Trial Multicenter StudyMultisite trial on efficacy of constraint-induced movement therapy in children with hemiplegia: study design and methodology.
In the past decades, several treatment approaches have been used to improve upper limb function in hemiplegic cerebral palsy. Only recently has constraint-induced movement therapy emerged as a treatment approach for children with hemiplegic cerebral palsy with the aim of reversing the behavioral suppression of movement in the affected upper limb. To date, evidence on this treatment has been very poor and limited, because all currently available trials reveal methodological limitations and a need for additional research to support the application of this treatment technique. This article presents the methodological choices, design, and main characteristics of an ongoing controlled clinical trial on the effectiveness and safety of constraint-induced movement therapy combined with an intensive rehabilitation program and compared with two comparison groups: one treated with an intensive rehabilitation program and the other with standard treatment. ⋯ Discussing and working on pediatric research methods represents an urgent need in rehabilitation research.
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Am J Phys Med Rehabil · Mar 2009
Patients with chronic whiplash-associated disorders: relationship between clinical and psychological factors and functional health status.
To examine the relative contribution of cervical impairments and psychosocial factors to perceived disability among people with chronic whiplash-associated disorders. ⋯ Catastrophizing explained the variance in both perceived neck disability and, to a lesser extent, active range of cervical motion, which suggests that pain-related catastrophizing plays an important role in the physical complaints of patients with chronic whiplash-associated disorders when referred to a physical therapist.
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Am J Phys Med Rehabil · Mar 2009
MRI prediction of therapeutic response to epidural steroid injection in patients with cervical radiculopathy.
To analyze whether magnetic resonance imaging (MRI) findings can be used to predict therapeutic responses to cervical epidural steroid injections (CESI) in patients with cervical radiculopathy. ⋯ Patients with central canal stenosis achieved significantly better functional outcome after CESI than those without. Hence, the MRI finding of central canal stenosis is a potential indication that CESI may be merited.