American journal of physical medicine & rehabilitation
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Am J Phys Med Rehabil · Sep 2002
Case ReportsCentral post-stroke pain syndrome: yet another use for gabapentin?
Although gabapentin was originally developed for treating partial seizures, it has been used mainly to treat various peripheral neuropathic pain conditions; however, there is very limited experience with gabapentin for the treatment of pain conditions of the central nervous system like central post-stroke pain syndrome. We report the case of a 45-yr old man with central post-stroke pain syndrome who failed to respond to a variety of oral analgesics, but within 2 wk of the inception of gabapentin therapy, his average pain was significantly reduced and his level of function improved. We conclude that gabapentin may be an effective medication for the treatment of central post-stroke pain syndrome.
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Am J Phys Med Rehabil · Aug 2002
Mechanical insufflation-exsufflation: pressure, volume, and flow relationships and the adequacy of the manufacturer's guidelines.
Pulmonary complications of neuromuscular disease can be averted by increasing peak cough flows with the use of a forced exsufflation device. The purpose of this study was to examine the pressure, volume, and flow relationships for a range of settings generated by this device, and compare them with clinically efficacious values and the manufacturer's guidelines. ⋯ In-exsufflator performance was very consistent. Its clinical effectiveness can be explained by its generation of exsufflation flows >2.7 l/sec. Increasing insufflation times more than exsufflation times is more important for optimal function. Current manufacturer use guidelines may not yield optimal exsufflation flows.
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Am J Phys Med Rehabil · Aug 2002
Comparative StudyLack of utility of Semmes-Weinstein monofilament testing in suspected carpal tunnel syndrome.
To investigate the value of Semmes-Weinstein monofilament (SWM) testing in patients with electrodiagnostically confirmed carpal tunnel syndrome in a group of patients with symptoms compatible with carpal tunnel syndrome. ⋯ Semmes-Weinstein monofilament testing was not shown to have utility in diagnosing electrodiagnostically confirmed carpal tunnel syndrome in our population of predominantly male veterans.
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Am J Phys Med Rehabil · Jul 2002
Effect of botulinum toxin on endplate noise in myofascial trigger spots of rabbit skeletal muscle.
To assess the effect of botulinum toxin type A (BTX-A) on the endplate noise prevalence in rabbit myofascial trigger spots to confirm the role of excessive acetylcholine release on the pathogenesis of myofascial trigger points and to develop an objective indicator of the effectiveness of BTX-A in the treatment of myofascial trigger points. ⋯ This study demonstrated the suppressive effect of BTX-A on endplate noise prevalence in a myofascial trigger spot region. The prevalence of endplate noise in the myofascial trigger point region may be a useful objective indicator for evaluating the therapeutic effectiveness of BTX-A injection to treat myofascial trigger points.
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Am J Phys Med Rehabil · Jul 2002
Peak flow and peak cough flow in the evaluation of expiratory muscle weakness and bulbar impairment in patients with neuromuscular disease.
To study the expiratory muscle force and the ability to cough estimated by the peak expiratory flow and peak cough flow in patients with Duchenne muscular dystrophy and amyotrophic lateral sclerosis. ⋯ These results suggest that peak cough flow-peak expiratory flow is useful to monitor expiratory muscle weakness and bulbar involvement and to assess its evolution in these patients.