American journal of physical medicine & rehabilitation
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Am J Phys Med Rehabil · Sep 2001
Isokinetic measurement of trunk muscle strength in women with chronic low-back pain.
To investigate the relationships among chronic low-back pain and obesity, total spinal range of motion, and trunk muscle strength. The short-term impact of trunk muscle strengthening exercises on this condition was also examined. ⋯ Obesity and decrease in trunk muscle strength are important factors in chronic low-back pain, and a trunk muscle strengthening program will be helpful in reducing the pain.
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Am J Phys Med Rehabil · Aug 2001
Use and satisfaction with prosthetic devices among persons with trauma-related amputations: a long-term outcome study.
To document and examine the use, satisfaction, and problems with prosthetic devices among persons who suffered a trauma-related lower limb amputation. ⋯ Although almost all persons living with trauma-related amputations use prosthetic devices, the majority are not satisfied with prosthetic comfort. Phantom pain and residual limb skin problems are also common afflictions in this population.
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Am J Phys Med Rehabil · Aug 2001
Case ReportsPersistent hiccup associated with thoracic epidural injection.
Epidural steroid injections are commonly used to treat lumbosacral radicular and discogenic pain. When used in this manner, these agents can cause minor, transient systemic side effects and rarely result in any serious complications. Because adverse reactions are uncommon and transient, epidural injections are considered a safe therapeutic intervention. We describe the first case of persistent hiccups as a consequence of a thoracic epidural steroid injection in a patient with thoracic discogenic pain.
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Strokes in children related to sports injuries are rare, but pediatric trampoline injuries are dramatically increasing. Minor trauma to the vulnerable extracranial vertebral arteries as they travel superficially through the dorsum of the neck can begin a cascade of events that results in arterial dissection, thrombus formation, and embolization with cerebral infarction. We present the case of an 11-yr-old boy who developed left vertebral artery dissection subsequent to a trampoline injury.
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Am J Phys Med Rehabil · Jul 2001
ReviewConducting clinical trials to establish drug efficacy in chronic pain.
Design of clinical trials to establish drug efficacy in chronic pain is a complicated issue, and numerous factors must be considered in identifying an optimal study design. Investigators should begin by identifying a focused and testable research question, with the outcome variables operationalized in a way that allows appropriate quantitative analysis. The prospective, randomized, placebo-controlled, doubled-blind study using validated quantitative measures is considered the optimal clinical trial design. ⋯ Sample selection issues must be considered during study design, including the sample size required (based on statistical power analysis), appropriate inclusion and exclusion criteria, and likely availability of qualifying patients. There are numerous statistical options for analyzing data that must be selected based on whether data are parametric or nonparametric, whether within-subject (crossover) or between-subject comparisons are used, and whether baseline values of outcome measures affect the degree of change in these measures over the course of the study. Involvement of a biostatistical consultant is recommended during all phases of clinical trials.