American journal of physical medicine & rehabilitation
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Am J Phys Med Rehabil · Mar 1998
Case ReportsTransient osteoporosis of the hip during pregnancy: a case report.
Transient osteoporosis associated with pregnancy is a rare, self-limiting skeletal disorder, the origin of which remains unclear. We report the case of a 36-year-old Japanese woman who developed pain in the left hip, groin, and knee in the seventh month of pregnancy. The pain gradually worsened and prevented weight-bearing. ⋯ First, it is rare for transient osteoporosis associated with pregnancy to involve both hip joints, and it rarely involves the knee. Second, this is the first reported case of pain management of transient osteoporosis associated with pregnancy being successfully treated with an antiresorptive agent. Finally, the use of alendronate in transient osteoporosis associated with pregnancy may help shorten disability by providing pain relief and decreasing the fracture risk associated with this disease.
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Am J Phys Med Rehabil · Jan 1998
Neuromuscular ventilatory insufficiency: effect of home mechanical ventilator use v oxygen therapy on pneumonia and hospitalization rates.
The purpose of this study was to determine rates of pneumonia and hospitalization for patients receiving oxygen therapy, patients having indwelling tracheostomy tubes, and those using tracheostomy or noninvasive methods of home mechanical ventilation. Six hundred eighty-four users of assisted ventilation for 13,751 patient-years or 19.8 years per patient were surveyed by mail and twice by telephone over a span of four years. Pneumonia and hospitalization rates were significantly higher for ventilator users with chronic obstructive pulmonary disease or with neuromuscular ventilatory insufficiency and gastrostomy tubes than for ventilator users with neuromuscular ventilatory insufficiency without gastrostomy tubes. ⋯ The lowest pneumonia and hospitalization rates (P < 0.001) were by full-time, noninvasive intermittent positive pressure ventilation users. We conclude that oxygen therapy is not an effective substitute for assisted ventilation for patients with primarily ventilatory insufficiency. Noninvasive ventilatory aids can be used effectively for up to full-time ventilatory support for patients with neuromuscular conditions whose bulbar muscle function is adequate to avert the need for gastrostomy tube placement.
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Am J Phys Med Rehabil · Nov 1997
Electrophysiologic evaluation of autonomic function in cerebral palsy.
The presence of clinical autonomic dysfunction in patients with neurologic diseases, such as multiple sclerosis, Parkinson's disease, and cerebrovascular accident, has become increasingly recognized in the past decade. Very few autonomic tests have been done on pediatric patients thus far. The purpose of this study was to investigate the autonomic function in patients with cerebral palsy using two noninvasive tests: sympathetic skin response (SSR) and R-R interval variation (RRIV). ⋯ Significant negative correlation between heart rate and age was noted in the control group but was not present in the study group. Also, there was no statistical difference of mean RRIV between the two groups. No objective evidence of autonomic disturbance in patients with cerebral palsy was found in this study.
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Am J Phys Med Rehabil · Nov 1997
Randomized Controlled Trial Comparative Study Clinical TrialThe immediate effectiveness of electrical nerve stimulation and electrical muscle stimulation on myofascial trigger points.
This study is designed to investigate the immediate effectiveness of electrotherapy on myofascial trigger points of upper trapezius muscle. Sixty patients (25 males and 35 females) who had myofascial trigger points in one side of the upper trapezius muscles were studied. The involved upper trapezius muscles were treated with three different methods according to a random assignment: group A muscles (n = 18) were given placebo treatment (control group); group B muscles (n = 20) were treated with electrical nerve stimulation (ENS) therapy; and group C muscles (n = 22) were given electrical muscle stimulation (EMS) therapy. ⋯ It could reduce PI significantly more (P < 0.05) than placebo controls only for the subgroup with mild to moderate pain, but not with severe pain. For pain relief, ENS was significantly better (P < 0.05) than EMS; but for the improvement of ROM, EMS was significantly better (P < 0.05) than ENS. It is concluded that ENS is more effective for immediate relief of myofascial trigger point pain than EMS, and EMS has a better effect on immediate release of muscle tightness than ENS.