American journal of physical medicine & rehabilitation
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Am J Phys Med Rehabil · Mar 2005
Postacute care services use for dysvascular amputees: a population-based study of Massachusetts.
Rehabilitation and other postacute care services utilization for persons with a lower limb amputations due to dysvascular disease is important information for physiatrists, therapists, patients, and health-policy planners. The purpose of this study was to examine rates of inpatient rehabilitation services use in a statewide population. ⋯ Sixteen percent of dysvascular amputees received inpatient rehabilitation services. This was higher than the 1997 rate for Maryland (12%) and suggests geographic differences in services utilization. Prospective studies are necessary to examine outcomes for persons receiving rehabilitation services in different care settings to define the optimal rehabilitation venue for functional restoration. Development of more specific International Classification of Diseases, Ninth Revision-Clinical Modification codes for dysvascular amputations would further research and public policy efforts.
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Am J Phys Med Rehabil · Feb 2005
Randomized Controlled Trial Comparative Study Clinical TrialEvaluation of iontophoresis and local corticosteroid injection in the treatment of carpal tunnel syndrome.
The aim of this study was to compare the efficacy of local corticosteroid injection with iontophoresis of corticosteroids in the treatment of carpal tunnel syndrome. ⋯ Our study comparing a standardized treatment protocol for incorporating local corticosteroid injection and iontophoresis of dexamethasone sodium phosphate in carpal tunnel syndrome revealed success of both iontophoresis of dexamethasone sodium phosphate and injection of corticosteroids, but symptom relief was greater at 2 and 8 wks with injection of corticosteroids.
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Am J Phys Med Rehabil · Feb 2005
Comparative StudyMechanical insufflation-exsufflation improves outcomes for neuromuscular disease patients with respiratory tract infections.
The efficacy of mechanical insufflation-exsufflation, in addition to standard chest physical treatments, was investigated as a first-line intervention for patients with neuromuscular diseases with respiratory tract infections and airway mucous encumbrance. ⋯ Provision of mechanical insufflation-exsufflation in combination with standard chest physical treatments may improve the management of airway mucous encumbrance in neuromyopathic patients; its use should be included in the noninvasive approach to treatment of respiratory tract infections with impaired mucous clearance.
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Am J Phys Med Rehabil · Jan 2005
Case ReportsTransforaminal cervical blood patch for the treatment of post-dural puncture headache.
A 40-yr-old woman received a series of three interlaminar epidural steroid injections for the treatment of axial neck pain secondary to degenerative disc disease. Immediately after her third injection, she experienced symptoms of a dural puncture-induced headache. ⋯ The headache was immediately relieved and remained alleviated through the follow-up interval of 1 yr. In this patient, a fluoroscopically guided transforaminal epidural blood patch proved to be more effective than the classic blind interlaminar approach in the treatment of post-dural puncture headache.
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Am J Phys Med Rehabil · Dec 2004
Case ReportsEpidural steroid injections in the treatment of symptomatic lumbar spinal stenosis associated with epidural lipomatosis.
Epidural lipomatosis has been implicated as a cause or contributor of symptomatic lumbar spinal stenosis. Although epidural steroid injections have been very successful for symptomatic treatment of spinal stenosis; their role in treatment of symptomatic stenosis secondary to epidural lipomatosis is unclear. A review literature (MEDLINE, PubMed) found no reports justifying the use of steroids. ⋯ They were treated with a single transforaminal epidural steroid injection at the symptomatic level. Both had 80-85% pain relief. These reports suggest a beneficial role of epidural steroid injections for patients with symptomatic lumbar spinal stenosis caused by or contributing to epidural lipomatosis.