American journal of physical medicine & rehabilitation
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Am J Phys Med Rehabil · Jul 2004
Clinical Trial Controlled Clinical TrialEvaluation of rocker sole by pressure-time curves in insensate forefoot during gait.
The rocker sole reduces plantar pressure in the insensate forefoot during gait, but the reasons have remained unclear. This study aimed to derive new variables descriptive of the effects of the rocker sole. ⋯ To evaluate the effectiveness of a rocker sole, physiatrists may regress sigmoid pressure-time curves as cubic functions of time in the insensate forefoot, check simultaneous inflections of the curves in areas rotated by the rocker sole, and compare their concavity and regression parameters in areas rotated at different distances from the axis of rotation. By doing so, physiatrists may be better able to improve the design of rocker sole and other forms of forefoot orthoses.
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Am J Phys Med Rehabil · Jul 2004
Case ReportsVentilator weaning by lung expansion and decannulation.
This case series of ventilator-dependent patients with neuromuscular disease who had no ventilator-free breathing ability demonstrates that decannulation and switching to continuous noninvasive intermittent positive-pressure ventilation combined with regular lung expansion therapy can result in improvements in pulmonary function and at least partial ventilator weaning. These six patients were also managed using mechanical insufflation-exsufflation for regular lung expansion and cough assistance. Thus, some ventilator users with neuromuscular disease can benefit from tracheostomy tube decannulation and transition to noninvasive intermittent positive-pressure ventilation and assisted coughing for ventilator weaning to predominantly nocturnal-only use.
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Am J Phys Med Rehabil · Jun 2004
Randomized Controlled Trial Clinical TrialEffects of methylphenidate on attention deficits after traumatic brain injury: a multidimensional, randomized, controlled trial.
To evaluate the effects of methylphenidate on a variety of aspects of attention, ranging from laboratory-based impairment measures to caregiver ratings and work productivity, in individuals after traumatic brain injury. ⋯ Methylphenidate, at 0.3 mg/kg/dose, given twice a day to individuals with attentional complaints after traumatic brain injury, seems to have clinically significant positive effects on speed of processing, caregiver ratings of attention, and some aspects of on-task behavior in naturalistic tasks. Further research is needed to identify the optimal dose and to extend these findings to less carefully selected individuals.
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Am J Phys Med Rehabil · Jun 2004
Therapeutic selective nerve root block in the nonsurgical treatment of traumatically induced cervical spondylotic radicular pain.
To investigate the outcomes resulting from the use of fluoroscopically guided therapeutic selective nerve root block in the nonsurgical treatment of traumatically induced cervical spondylotic radicular pain. ⋯ These initial and preliminary findings do not support the use of therapeutic selective nerve root block in the treatment of this challenging patient population with traumatically induced spondylotic radicular pain.
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Am J Phys Med Rehabil · May 2004
Clinical Trial Controlled Clinical TrialBilateral activation of motor unit potentials with unilateral needle stimulation of active myofascial trigger points.
The objective of this study was to determine if there are electromyographic differences between active and latent myofascial trigger points (MTrPs) during trigger point needling. ⋯ We demonstrated bilateral or mirror-image electromyographic activity associated with unilateral needle stimulation of active MTrPs. We have found no previous mention of this phenomenon in the literature. Our study supports the concept that the perpetuation of pain and muscle dysfunction in active MTrPs may be related to abnormal central nervous system processing of sensory input at the level of the spinal cord.