American journal of physical medicine & rehabilitation
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Am J Phys Med Rehabil · Jul 2014
Duchenne muscular dystrophy: life prolongation by noninvasive ventilatory support.
American, Japanese, and Canadian centers have demonstrated that noninvasive intermittent positive pressure ventilatory support (NVS) can be used continuously and in the long-term by people with Duchenne muscular dystrophy as a definitive alternative to tracheostomy mechanical ventilation. The aim of this study was to report this for the first time in Europe. ⋯ Noninvasive respiratory management can prolong survival without resorting to tracheotomy and without hospitalization.
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Am J Phys Med Rehabil · Jul 2014
New challenges for the graduate medical educator: implementing the milestones.
Physical medicine and rehabilitation residency programs will face new challenges as they implement the Milestones and establish a Clinical Competency Committee, new requirements in the Accreditation Council of Graduate Medical Education's Next Accreditation System. The milestones require programs to measure the capabilities of individual residents, and programs will be expected to show how residents progress to successively higher levels of behavior during the course of the residency. Program directors will be assisted by a committee of faculty whose role is to assess each individual resident's attainment of milestones and assist in the early identification of residents not making the expected progress. ⋯ Because the milestones are based on observable behaviors, a key component of this system will be direct observation by faculty of residents during patient care. However, many faculty are not trained in this skill. Faculty development in observational skills, workplace-based assessment skills, and providing formative feedback will be a very important aspect if the milestones are to be successfully used to help residents make developmental progress in their clinical competence.
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Am J Phys Med Rehabil · May 2014
Randomized Controlled Trial Comparative StudyEfficacy of therapeutic ultrasound for the management of knee osteoarthritis: a randomized, controlled, and double-blind study.
The aim of this study was to compare whether the effectiveness of continuous ultrasound (US) was superior against pulsed US and against sham US in knee osteoarthritis. ⋯ The present study demonstrated that all assessment parameters significantly improved in all groups without a significant difference. This result suggested that therapeutic US provided no additional benefit in improving pain and functions in addition to exercise training.
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Am J Phys Med Rehabil · May 2014
Review Case ReportsA rare presentation of subacute progressive ascending myelopathy secondary to cement leakage in percutaneous vertebroplasty.
Percutaneous vertebroplasty is used to manage osteoporotic vertebral body compression fractures. Although it is relatively safe, complications after vertebroplasty ranging from minor to devastatingly major ones have been described. Cement leakage into the spinal canal is one such complication. ⋯ A few weeks later, the neurologic level ascended to higher cervical level (C3). To date, no case of subacute progressive ascending myelopathy secondary to cement leakage after percutaneous vertebroplasty has been reported. Literature is reviewed regarding subacute progressive ascending myelopathy, and the rehabilitation challenges in the management of this patient are discussed.