American journal of physical medicine & rehabilitation
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Am J Phys Med Rehabil · Sep 2017
Clinical TrialThe 1-Year Results of Lumbar Transforaminal Epidural Steroid Injection in Patients with Chronic Unilateral Radicular Pain: The Relation to MRI Findings and Clinical Features.
In patients with chronic radicular pain, we aimed to evaluate subgroup differences in 1-yr response to transforaminal epidural steroid injection. ⋯ In patients treated with one or several transforaminal epidural steroid injections due to chronic lumbar radicular pain, clinical findings failed to predict the 1-yr treatment response. Low age, short duration of leg pain, central/subarticular disc herniation, and high-grade subarticular nerve compression predicted a favorable 1-yr response to transforaminal epidural steroid injection.
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Am J Phys Med Rehabil · Aug 2017
Review Meta AnalysisEffectiveness of Extracorporeal Shock Wave Therapy Without Local Anesthesia in Patients With Recalcitrant Plantar Fasciitis: A Meta-Analysis of Randomized Controlled Trials.
The objective of this meta-analysis was to investigate the efficacy of extracorporeal shock wave therapy in the treatment of recalcitrant plantar fasciitis without local anesthesia. ⋯ Advanced ACCREDITATION: 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 activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
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Am J Phys Med Rehabil · Aug 2017
Inflammatory Mediators and Pain in the First Year After Acute Episode of Low-Back Pain in Elderly Women: Longitudinal Data from Back Complaints in the Elders-Brazil.
The aims of this study were to determine the course of plasma levels of inflammatory mediators (interleukin 6 [IL-6], tumor necrosis factor α [TNF-α], soluble TNF receptor 1 [sTNF-R1]) and the severity of low-back pain (LBP) over 6 to 12 months after an acute episode of LBP in elderly women and to establish an association between inflammatory mediators and LBP recovery. ⋯ Our findings showed a relationship between inflammation and LBP by establishing that low IL-6 plasma levels preceded outcome (LBP recovery), supporting the concept that proinflammatory cytokines promote pain.
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Am J Phys Med Rehabil · Aug 2017
Case ReportsParaplegia Following Lumbar Epidural Steroid Injection in a Patient With a Spinal Dural Arteriovenous Fistula.
We report a patient with a previously undiagnosed spinal dural arteriovenous fistula (SDAVF) who became acutely paraplegic following a lumbar epidural steroid injection for lumbar spinal stenosis. Magnetic resonance imaging showed multiple flow voids and serpentine vessels on the cord surface with cord edema extending from T3 through the conus. Spinal angiography confirmed an SDAVF fed by the left lateral sacral artery, which was subsequently endovascularly embolized, and the patient had a partial return of function. Presence of an undiagnosed SDAVF should be considered in patients presenting with lower-extremity weakness without pain and considered a contraindication to lumbar epidural steroid injection.
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Am J Phys Med Rehabil · Aug 2017
Gender and Ethnic Diversity in Academic PM&R Faculty: National Trend Analysis of Two Decades.
Over the years, a number of studies have demonstrated an increase in gender and ethnic diversity among US physicians. Despite substantial progress in eliminating gender and racial inequities in the field of medicine, women and ethnic minorities are still underrepresented among medical faculty at academic institutions. This study aims to describe the trends in gender and ethnic diversity among Physical Medicine and Rehabilitation (PM&R) faculty through statistical analysis of data describing gender and ethnicity of full-time academic faculty gathered from the Association of American Medical Colleges Faculty Roster from 1994 to 2014. ⋯ In contrast, the average yearly percent increase in the proportion of non-Caucasian PM&R faculty in full professor positions (0.19%) was less than those in instructor (0.84%), assistant (0.93%), and associate professor (0.89%) positions. Overall, trends among faculty exhibit a steady increase in gender and ethnic diversity, although promotion disparity continues to exist among specific academic positions for some groups. This study provides a current perspective on recent changes in diversity among faculty in PM&R and may prove useful when defining strategies to improve workforce diversity.