American journal of physical medicine & rehabilitation
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Am J Phys Med Rehabil · Mar 1995
Resident versus program director perceptions about PM&R research training.
A survey of all residents and residency program directors in Physical Medicine and Rehabilitation (PM&R) was done to assess perspectives of residents and directors regarding research training, resources, mentorship, and encouragement available to residents. A response rate of 55% was obtained from 1188 resident mailings, and 83% of 77 program directors responded. A number of discrepancies in perceptions of residents v program directors responded. ⋯ Only 19% of residents knew of access to a research coordinator/grant writer, 36% for statistical support, and 67% for library assistance. The corresponding numbers for program directors were 31%, 69%, and 97%. Additional results of the survey are summarized, and suggestions for further study to improve the resident research training experience are given.
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Am J Phys Med Rehabil · Mar 1995
Fellowship training in physical medicine and rehabilitation. Developed by the Association of Academic Physiatrists.
The AAP supports the development of fellowships, especially those that enhance research in areas relevant to PM&R. If possible, research training within fellowship programs should be acknowledged. As accredited fellowships develop, the AAP acknowledges potential risks to residency training and supports accreditation standards that consider the importance of coexisting fellowships and residency programs.
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Substance P is thought to be the principle neurotransmitter of nociceptive impulses in type C sensory neurons. Prolonged repeated applications of capsaicin cream depletes the sensory C-fibers of substance P. In an open-labeled prospective pilot study, 23 patients with chronic neck pain (greater than 3 mo) completed the study. ⋯ Paired t tests failed to show a significant improvement in the McGill Pain Questionnaire. This study demonstrated that topically applied capsaicin cream may decrease subjective neck pain. A double-blind, placebo-controlled trial is needed to confirm this treatment effect.
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Am J Phys Med Rehabil · Jul 1994
Randomized Controlled Trial Clinical TrialLidocaine injection versus dry needling to myofascial trigger point. The importance of the local twitch response.
This study was designed to investigate the effects of injection with a local anesthetic agent or dry needling into a myofascial trigger point (TrP) of the upper trapezius muscle in 58 patients. Trigger point injections with 0.5% lidocaine were given to 26 patients (Group I), and dry needling was performed on TrPs in 15 patients (Group II). Local twitch responses (LTRs) were elicited during multiple needle insertions in both Groups I and II. ⋯ Patients treated with dry needling had postinjection soreness of significantly greater intensity and longer duration than those treated with lidocaine injection. The author concludes that it is essential to elicit LTRs during injection to obtain an immediately desirable effect. TrP injection with 0.5% lidocaine is recommended, because it reduces the intensity and duration of postinjection soreness compared with that produced by dry needling.
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Am J Phys Med Rehabil · Jul 1994
Methods used in the evaluation of clinical competency of physical medicine and rehabilitation residents.
A 17-item questionnaire was designed to determine how physical medicine and rehabilitation (PM&R) training directors assess their residents' clinical competency. A response rate of 83% (62/75) was obtained. Seventy-nine percent (49/62) have a written resident supervision policy, and 73% (45/62) have a written resident probation policy. ⋯ Forty-seven percent (29/62) of the programs have asked at least one resident to leave their program in the past 3 yr. The OSCE is emerging as the state-of-the-art method for assessing clinical skills, although it is expensive. The measurement of clinical competency is important in the certification and recertification process, and our specialty needs better methods to assess these performance skills.