American journal of physical medicine & rehabilitation
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Am J Phys Med Rehabil · Nov 2010
Randomized Controlled Trial Multicenter StudyEffect of transcranial direct current stimulation on motor recovery in patients with subacute stroke.
To test the hypothesis that 10 sessions of transcranial direct current stimulation combined with occupational therapy elicit more improvement in motor function of the paretic upper limb than sham stimulation in patients with subacute stroke. ⋯ Our results suggest a potentially beneficial effect of noninvasive cortical stimulation during rehabilitative motor training of patients who have suffered from subacute strokes.
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Am J Phys Med Rehabil · Nov 2010
Meta AnalysisBotulinum toxin type A injections for treatment of spastic equinus in cerebral palsy: a secondary analysis of factors predictive of favorable response.
To investigate markers predicting favorable botulinum toxin injection outcomes in treating spastic equinus gait in children with cerebral palsy. ⋯ These results suggest that children with less severe functional deficit, fair to good selective motor control in the ankle, and mild equinus gait respond best to focal botulinum toxin type A treatment, with an eye to flatfoot or heel strike contact. Likewise, children with higher cognitive level seem to derive functional benefit from the treatment.
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Am J Phys Med Rehabil · Nov 2010
Case ReportsUltrasound evaluation of a spontaneous plantar fascia rupture.
Plantar fascia rupture is an occasional complication in patients with chronic plantar fasciitis or in patients with plantar fasciitis treated with steroid injection. Very few cases of spontaneous plantar fascia rupture have been reported in the literature (Herrick and Herrick, Am J Sports Med 1983;11:95; Lun et al, Clin J Sports Med 1999;9:48-9; Rolf et al, J Foot Ankle Surg 1997;36:112-4; Saxena and Fullem, Am J Sports Med 2004;32:662-5). Spontaneous medial plantar fascia rupture in a 37-yr-old man with no preceding symptoms or steroid injections was confirmed with diagnostic ultrasound, which revealed severe fasciitis at the calcaneal insertion with partial tearing. ⋯ We discuss the anatomy, risk factors, examination findings, and treatment for this condition, as well as the unique benefits that ultrasound offers over magnetic resonance imaging. It is important to consider plantar fascia rupture in patients with hindfoot pain and medioplantar ecchymosis, particularly if an injury occurred during acceleration maneuvers. Ultrasound in these cases can be used to diagnose a plantar fascia tear quickly, accurately, and cost-effectively.
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Am J Phys Med Rehabil · Nov 2010
Reassessing physical disability among graduating US medical students.
Before the 1970s, many potential college and graduate students were denied admission or prevented from graduating because of their disabilities. Legislation such as the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990 has sought to end such discrimination. In two previous studies, the proportion of graduating medical students with physical disabilities (MSPD) was found to be 0.23% (1980) and 0.19% (1990). This study sought to learn what effect passage of the Americans with Disabilities Act of 1990 has had on the graduation of MSPD and the proportion of MSPD whose physical disability was identified before or after admission to medical school. ⋯ The findings suggest a continuing decline in the proportion of graduating MSPD. Implications of these findings are discussed.