Disability and rehabilitation
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The aim of this study was to assess the clinical course of patients with acute low back pain (LBP) throughout 12 weeks and to identify the prognostic factors for non-recovery in the short term. ⋯ Acute LBP patients with disability generally recover in the first weeks. General health perception (NHP) - pain subgroup score was identified in particular as the best prognostic factor for non-recovery in the short term. Hence, pain should be given particular consideration in baseline assessments of acute LBP patients.
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Phantom limb pain is chronic and intractable. Recently, virtual reality (VR) and motion capture technology has replicated the mirror box device of Ramachandran (Ramachandran et al. Nature 1995, 377, 489-490; Ramachandran and Rogers-Ramachandran Proc R Soc Biol Sci 1996, 263, 377-386) and led to reductions in this pain. We present results from a novel variation on this method which captures motion data directly from a patient's stump (rather than using the opposite remaining limb) and then transforms it into goal directed, virtual action enacted by an avatar in a VR environment. ⋯ This technique, which has shown similar success rates to trials of a virtual mirror box, is relatively cheap and portable, and will allow further trials in a home environment.
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World Health Organisation Disability Assessment Schedule II: contribution to the Italian validation.
The World Health Organisation Disability Assessment Schedule II (WHODAS II) is an instrument developed by the World Health Organisation in order to assess behavioural limitations and restrictions to participation experienced by an individual, independently from a medical diagnosis. The conceptual frame of reference of this instrument is the International Classification of Functioning, Disability and Health: ICF. Specifically, the instrument is designed to evaluate the functioning of the individual in six activity domains: Understanding and communicating, Getting around, Self-care, Getting along with people, Life activities, Participation in society. ⋯ The WHODAS II is a useful instrument for measuring disability and functioning in normal and disabled people. It shows high reliability and a stable factor structure; although an additional psychometric evaluation of a representative sample of Italian disabled should be carried out in order to reach standard scores for each macro-category of disability.
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To alert health professionals on presence and extent of phantom pain and sensation following bilateral upper limb amputation. ⋯ At this time there is no healing for phantom pain; medical and surgical modalities only bring temporary relief, and less than 1% of the respondents achieve permanent relief through different treatment methods.
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To explore the role of Botulinum Toxin type A (BoNT-A) in the management of the spastic hemiplegic shoulder and identify the common achievable goals for treatment. ⋯ BoNT-A injection of the proximal upper limb, with combined therapy, produced a reduction in spasticity, improvement in passive function and pain. Management of upper limb spasticity should include evaluation and, if necessary treatment, of the shoulder girdle and proximal musculature.