American journal of physical medicine & rehabilitation
-
Am J Phys Med Rehabil · Apr 2015
Case ReportsDo not rush to return to sports after trigger finger injection.
Trigger finger, or digital stenosing tenosynovitis, is a common hand problem. A widely accepted treatment is steroid injection into the flexor tendon sheath. This can cause rupture of the flexor tendon. ⋯ Clinicians who perform local steroid injections for tendinopathy treatment should be aware of the possible dangers of tendon rupture and should confirm that steroids are not administrated into the tendon. Patients should also be warned about returning to sports prematurely and should be encouraged to gradually resume sports after the injection to prevent further damage. Herein, we report an unusual case of flexor digitorum profundus rupture after a single corticosteroid injection in a 57-yr-old male golfer and we also present a review of the literature.
-
Am J Phys Med Rehabil · Mar 2015
Review Meta AnalysisSystematic literature review of abobotulinumtoxinA in clinical trials for adult upper limb spasticity.
The aim of this study was to elucidate clinical trial efficacy, safety, and dosing practices of abobotulinumtoxinA (ABO) treatment in adult patients with upper limb spasticity (ULS). ⋯ On the basis of data extracted from 12 randomized clinical studies, a strong evidence base (9/12 studies) exists for the use of ABO to reduce ULS caused by stroke.
-
Am J Phys Med Rehabil · Mar 2015
Case ReportsRecovery of injured lower portion of the ascending reticular activating system in a patient with traumatic brain injury.
The authors report on a patient with traumatic brain injury who showed recovery of an injured lower portion of the ascending reticular activating system (ARAS) between the pontine reticular formation and the thalamus. A 57-yr-old male patient experienced head trauma. After 4 mos from onset, he exhibited impaired alertness, with a score of 7 on the Glasgow Coma Scale. ⋯ By contrast, on 40-mo diffusion tensor tractography, the fractional anisotropy and the tract volume values of the lower portion of the right ARAS were within 2 SDs of those of the control subjects. The increment fractional anisotropy and the FV value of the lower portion of the right ARAS on 40-mo diffusion tensor tractography indicated recovery of the injured lower ARAS. As a result, recovery of an injured lower portion of the ARAS in a patient with traumatic brain injury was demonstrated.
-
Am J Phys Med Rehabil · Mar 2015
Mobility, continence, and life expectancy in persons with Asia Impairment Scale Grade D spinal cord injuries.
Previous research on the life expectancy of persons with American Spinal Injury Association (ASIA) Impairment Scale Grade D spinal cord injury has considered them as a large homogenous group, making no functional or medical distinctions. This study sought to (1) determine how survival in this group depends on ambulatory function and the extent of bowel or bladder dysfunction, (2) compute life expectancies for various subgroups, and (3) examine whether survival has improved over time. ⋯ Life expectancy of persons with ASIA Impairment Scale D spinal cord injury depends strongly on the ability to walk and the need for catheterization.