American journal of physical medicine & rehabilitation
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Am J Phys Med Rehabil · Sep 2020
ReviewPhysical Medicine and Rehabilitation and Pulmonary Rehabilitation for COVID-19.
This analysis extrapolates information from previous studies and experiences to bring physical medicine and rehabilitation perspective and intervention to the multidisciplinary treatment of COVID-19. The purpose of pulmonary rehabilitation in COVID-19 patients is to improve symptoms of dyspnea, relieve anxiety, reduce complications, minimize disability, preserve function, and improve quality of life. Pulmonary rehabilitation during the acute management of COVID-19 should be considered when possible and safe and may include nutrition, airway, posture, clearance technique, oxygen supplementation, breathing exercises, stretching, manual therapy, and physical activity. Given the possibility of long-term disability, outpatient posthospitalization pulmonary rehabilitation may be considered in all patients hospitalized with COVID-19.
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Am J Phys Med Rehabil · Sep 2020
Review Case ReportsParalysis following Lumbar Interlaminar Epidural Steroid Injection in the Absence of Hematoma: A Case of Congestive Myelopathy due to Spinal Dural Arteriovenous Fistula and a Review of the Literature.
Paraplegia after interlaminar epidural steroid injection is a rare event and has typically been described after epidural hematoma or direct spinal cord injury. We present a case of an 87-yr-old man who experienced transient lower limb weakness after a lumbar interlaminar epidural steroid injection due to an alternative cause, congestive myelopathy related to an underlying vascular malformation, namely, a spinal dural arteriovenous fistula. ⋯ Notably, this case of paralysis occurred in association with the lowest volume of epidural injectate reported in the literature to date (4 ml); importantly, this volume is consistent with the current clinical practice guideline standards for the safe performance of interlaminar epidural steroid injections. Physicians should be aware of this potential complication of epidural steroid injection and remain vigilant for the possibility after a procedure, even when performed according to current practice standards.
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Am J Phys Med Rehabil · Sep 2020
Meta AnalysisNoninvasive Brain Stimulation Does Not Improve Neuropathic Pain in Individuals With Spinal Cord Injury: Evidence From a Meta-Analysis of 11 Randomized Controlled Trials.
The aim of the study was to examine the effectiveness of noninvasive brain stimulation on neuropathic pain in individuals with spinal cord injury. ⋯ In individuals with spinal cord injury, no significant effects of noninvasive brain stimulation on neuropathic pain and depression were observed. Cranial electrotherapy stimulation may be beneficial for the management of anxiety. These findings do not support the routine use of noninvasive brain stimulation for neuropathic pain in individuals with spinal cord injury.
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Am J Phys Med Rehabil · Sep 2020
Retrospective Analysis of Fractures and Factors Causing Ambulation Loss After Lower Limb Fractures in Duchenne Muscular Dystrophy.
Prevalence and characteristics of fractures and factors related to loss of ambulation after lower limb fractures were investigated. ⋯ The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.