American journal of physical medicine & rehabilitation
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Am J Phys Med Rehabil · Nov 2011
Measuring body structures and body functions from the International Classification of Functioning, Disability, and Health perspective: considerations for biomedical parameters in spinal cord injury research.
The aims of this study were to provide a selection of biomedical domains based on the comprehensive International Classification of Functioning, Disability, and Health (ICF) core sets for spinal cord injury (SCI) and to present an overview of the corresponding measurement instruments. ⋯ An ICF-based measurement set for biomedical aspects of functioning with SCI was established. For some categories of the ICF core sets for SCI, there is a need to develop measurement instruments.
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Am J Phys Med Rehabil · Nov 2011
Comparative StudyCategory specification and measurement instruments in large spinal cord injury studies: a comparison using the International Classification of Functioning, Disability, and Health as a reference.
The objective of this paper was to examine whether large longitudinal studies have comprehensively covered the functioning of persons with spinal cord injuries (SCI), using the International Classification of Functioning, Disability and Health (ICF) as reference framework. First, the literature was reviewed to select relevant studies. Second, category specifications measured in the included studies were linked to the ICF and compared with the Brief ICF Core Sets for postacute and chronic situations. ⋯ Besides the International Standards for Neurological Classification of SCI (American Spinal Injury Association Impairment Scale), the areas of functioning were measured using the same measurement instruments in all studies. None of the included longitudinal studies comprehensively cover functioning. There is the need to develop truly comprehensive longitudinal studies in SCI.
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Am J Phys Med Rehabil · Nov 2011
Case ReportsDiagnosing Tapia syndrome using a videofluoroscopic swallowing study and electromyography after anterior cervical spine surgery.
A couple of the most common complications after anterior cervical spine surgery are dysphagia and hoarseness. This is often related to recurrent laryngeal nerve palsy and it can also be caused by injury to the branches of the lower cranial nerves. In general, Tapia syndrome is combined injuries of the recurrent laryngeal nerve of the vagus and the hypoglossal nerves. ⋯ We present here the case of a 42-yr-old man who complained of hoarseness, dysphagia, and right deviation of the tongue with an atrophic change for 2 mos after he underwent C3-4 discectomy and anterior fusion body. We found that he has a diagnosis of a variant of Tapia syndrome, although recurrent laryngeal nerve injury did not seem to be involved according to a videofluoroscopic swallowing study and electromyography. Our case report demonstrates that the combined diagnostic tools of videofluoroscopic swallowing study, electromyography, and laryngoscopy can be very useful in localizing and evaluating the level of lesions in patients with Tapia syndrome.
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Am J Phys Med Rehabil · Nov 2011
Reduction in average fluoroscopic exposure times for interventional spinal procedures through the use of pulsed and low-dose image settings.
A practice improvement project was completed with the goal of reducing radiation exposure times in a busy spinal intervention practice through the use of "pulsed" and "low-dose fluoroscopy." The goal was to quantify the reduction in fluoroscopy exposure times with these modes. ⋯ The use of pulsed and low-dose fluoroscopy in addition to lead shielding; increasing distance from the radiation source; collimation; limited use of magnification, boost, or digital subtraction; and proficiency with interventional techniques should be used to reduce radiation exposure in concordance with the principle of "as low as reasonably achievable."
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Am J Phys Med Rehabil · Nov 2011
Spinal muscular atrophy type 1: avoidance of hospitalization by respiratory muscle support.
The aim of this study was to report the outcomes of an oximetry protocol using up to continuous full ventilator-setting noninvasive ventilation (NIV) and mechanically assisted coughing (MAC) to avoid episodes of acute respiratory failure and hospitalizations for children with spinal muscular atrophy type 1 under 3 yrs of age. ⋯ A protocol including high span bilevel positive airway pressure along with MAC to expel airway secretions and normalize oxyhemoglobin saturation can be used by trained caregivers to avoid episodes of acute respiratory failure and hospitalization for children with spinal muscular atrophy type 1 under 3 yrs of age.