Spine Disorders and Regenerative Rehabilitation
AbstractPurpose of ReviewThe purpose of this review is to evaluate recent advancements in regenerative medicine modalities in the treatment of the most common spinal disorders.Recent FindingsImmunomodulatory and trophic effects of the mesenchymal stem cells (MSCs), platelet-rich plasma (PRP), and growth factors have been studied in the treatment of symptomatic degenerative spine disorders including degenerative disc disease and facet joint arthropathy. Gene therapy and exosomes are investigated as a future generation of biologics with gene therapy most advanced in the treatment of osteoarthritis.SummaryWhile current studie...
Source: Current Physical Medicine and Rehabilitation Reports - January 21, 2020 Category: Rehabilitation Source Type: research

Percutaneous and Implanted Peripheral Nerve Stimulation for the Management of Pain: Current Evidence and Future Directions
This article provides an overview of commercially available devices, the evidence supporting their use, and novel treatments being considered for the future.Recent FindingsThere are four peripheral nerve stimulators commercially available in multiple countries around the world. The stimulation may be used temporarily, with percutaneous placement of leads, or indefinitely with permanent implantation of the leads. Two stimulation paradigms are described in the literature for treatment of pain —stimulation of motor (efferent) nerve fibers to create muscle contraction and stimulation of sensory (afferent) nerve fibers to...
Source: Current Physical Medicine and Rehabilitation Reports - January 13, 2020 Category: Rehabilitation Source Type: research

Muscular Dystrophy and Rehabilitation Interventions with Regenerative Treatment
AbstractPurpose of ReviewThis paper reviews the enhanced therapeutic effects of rehabilitation and regenerative medicine toward Duchenne muscular dystrophy.Recent FindingsDuchenne muscular dystrophy (DMD) is one of the most severe forms of muscle disorders. Muscle in DMD patients is extremely fragile and can be damaged even during normal daily activity. There is little in the way of treatment for the disease and no cure. Some investigators have been developing cell therapies for DMD by generating muscle stem cells from human-induced pluripotent stem (iPS) cells and other progenitor/stem cells. Although reports have shown d...
Source: Current Physical Medicine and Rehabilitation Reports - January 11, 2020 Category: Rehabilitation Source Type: research

Regenerative Rehabilitative Medicine for Joints and Muscles
AbstractPurpose of ReviewThe purpose of this paper was to review regenerative medicine treatments for joints and muscles.Recent FindingsThere is level 1 evidence supporting the use of platelet-rich plasma (PRP) injections for the treatment of osteoarthritis (OA). Few studies have investigated the efficacy and safety of bone marrow aspirate concentrate (BMAC), microfragmented fat (MF), and placental and amniotic product (PAP) injections for OA. Preliminary studies have not found a benefit of PRP injections for acute muscle injury. No studies have been performed evaluating the therapeutic effect of BMAC, MF, or PAP injection...
Source: Current Physical Medicine and Rehabilitation Reports - January 11, 2020 Category: Rehabilitation Source Type: research

Correction to: The Accuracy of SPECT/CT for Diagnosing Lumbar Zygapophyseal Joint Pain: a Systematic Review
The original version of this article unfortunately contained a mistake in the authorgroup section. Author Byron Schneider ’s family name was incorrectly presented as “Schnieder”. (Source: Current Physical Medicine and Rehabilitation Reports)
Source: Current Physical Medicine and Rehabilitation Reports - December 23, 2019 Category: Rehabilitation Source Type: research

Correction to: The Effectiveness and Safety of Percutaneous Platelet-Rich Plasma and Bone Marrow Aspirate Concentrate for the Treatment of Suspected Discogenic Low Back Pain: a Comprehensive Review
The original version of this article unfortunately contained a mistake in the authorgroup section. Author Byron Schneider ’s family name was incorrectly presented as “Schnieder”. (Source: Current Physical Medicine and Rehabilitation Reports)
Source: Current Physical Medicine and Rehabilitation Reports - December 20, 2019 Category: Rehabilitation Source Type: research

Systemic Effects of Steroids Following Epidural Steroid Injections
AbstractPurpose of ReviewSystemic absorption of corticosteroids occurs following epidural administration. Central steroid response, including sleeplessness, flushing, and non-positional headache, insomnia, hiccups, flushing, and increased radicular pain, represents some of the most common immediate or delayed adverse event related to epidural steroid injections (ESI).Recent FindingsThe systemic effects of corticosteroids themselves likely represent the most commonly encountered complications that result from ESI. These include hyperglycemia, hypothalamic-pituitary-adrenal axis suppression, decreased bone mineral density, a...
Source: Current Physical Medicine and Rehabilitation Reports - November 27, 2019 Category: Rehabilitation Source Type: research

Exercise Benefits in Patients Recovering from Traumatic Brain Injury
AbstractPurpose of ReviewThis paper aims to understand in what aspects exercise benefits traumatic brain injury patients. It examines the molecular basis of how exercise may facilitate cognitive recovery, discuss the clinical evidence of the benefits of exercise on cognition and mood impairments in patients, and identify potential barriers for patients recovering from traumatic brain injury from engaging in physical exercise.Recent FindingsThere are extensive reviews exploring the effect of exercise on patients recovering from traumatic brain injury. Exercise appears to have benefit in global cognition and mood. Exercise i...
Source: Current Physical Medicine and Rehabilitation Reports - November 27, 2019 Category: Rehabilitation Source Type: research

Cervical Ultrasound Utilization in Selective Cervical Nerve Root Injection for the Treatment of Cervical Radicular Pain: a Review
AbstractPurpose of ReviewThis paper aims to review the available literature addressing the safety, accuracy, and efficacy of ultrasound-guided injections for cervical radicular pain.Recent FindingsUltrasound-guided injections remain a “partially blind technique” due to the inability to visualize relevant structures and the distribution of injectate. There remains a need for adequately powered studies evaluating the safety, accuracy, and effectiveness of ultrasound-guided steroid injections in the cervical spine. Fluoroscopy r emains the best evidence-based image-guidance modality for injections into the cervica...
Source: Current Physical Medicine and Rehabilitation Reports - November 15, 2019 Category: Rehabilitation Source Type: research

The Effectiveness and Safety of Percutaneous Platelet-Rich Plasma and Bone Marrow Aspirate Concentrate for the Treatment of Suspected Discogenic Low Back Pain: a Comprehensive Review
AbstractPurpose of ReviewComprehensively review the effectiveness and safety of percutaneous, fluoroscopically guided, intradiscal injection of platelet-rich plasma (PRP) and bone marrow aspirate concentrate (BMAC) for the treatment of suspected discogenic low back pain.Recent FindingsPublications in PubMed up to February 2019 were independently assessed. The literature search yielded three intradiscal PRP studies: one randomized controlled trial and two prospective cohort studies. Five intradiscal BMAC studies were identified. Four of the five prospective cohort studies were completed by the same primary author and result...
Source: Current Physical Medicine and Rehabilitation Reports - October 28, 2019 Category: Rehabilitation Source Type: research

Neurologic, Cognitive, and Behavioral Consequences of Opioid Overdose: a Review
AbstractPurpose of ReviewTo review the literature regarding neurologic, cognitive, and behavioral disorders resulting from non-fatal opioid overdose.Recent FindingsAlthough there is extensive literature regarding hypoxic-ischemic brain injury resulting from cardiac arrest, studies specifically examining opioid-induced brain injury are limited, derived mainly from patient case reports or animal models. Medical management of this population requires careful consideration of acute and long-term complications, as well as careful treatment planning in coordination with neurology, neuropsychology, psychiatry, and addiction medic...
Source: Current Physical Medicine and Rehabilitation Reports - October 21, 2019 Category: Rehabilitation Source Type: research

The Effectiveness and Safety of Genicular Nerve Radiofrequency Ablation for the Treatment of Recalcitrant Knee Pain Due to Osteoarthritis: a Comprehensive Literature Review
AbstractPurpose of ReviewReview the effectiveness and safety of current treatment protocols for fluoroscopically guided genicular nerve radiofrequency ablation (RFA) used for recalcitrant knee pain secondary to osteoarthritis (OA).Recent FindingsRandomized controlled trials and cohort studies of fluoroscopically guided RFA of the genicular nerves demonstrate variability in responder rates from 59% at 3  months to as high as 74% at 6 month follow-up. Studies that investigated the prognostic value of genicular nerve blocks to select patients for RFA demonstrate no difference in outcomes with current treatment proto...
Source: Current Physical Medicine and Rehabilitation Reports - September 14, 2019 Category: Rehabilitation Source Type: research

Safe Injectate Choice, Visualization, and Delivery for Lumbar Transforaminal Epidural Steroid Injections: Evolving Literature and Considerations
This article summarizes the recent literature regarding considerations relevant to safe performance of TFESIs.Recent FindingsWe collated recent case report reporting of permanent neurologic injury after TFESI, which has been theorized to occur as a result of disrupted radiculomedullary arterial blood flow to the spinal cord. We also review how injectate selection, visualization methods, and delivery techniques may impact the safety considerations of these injections.SummaryWhile TFESIs are safe, there is continued need to optimize injectate selection, visualization methods, and delivery techniques to minimize the possibili...
Source: Current Physical Medicine and Rehabilitation Reports - September 7, 2019 Category: Rehabilitation Source Type: research

Neuroplasticity in Brain Injury: Maximizing Recovery
AbstractPurpose of ReviewThe ability to promote greater neuroplasticity through external influencers is an emerging field of study with potentially significant consequences on the treatment of neurologic injury. Several of these methods are reviewed in this paper.Recent FindingsThrough advances in neuroscience, a clearer understanding of the complexity of the brain ’s interconnectedness and its ability to adapt to the environment is leading to neurorehabilitation treatments that augment the brain’s capacity towards neuroplastic change.SummaryAn increased appreciation and recognition of neuroplasticity has led t...
Source: Current Physical Medicine and Rehabilitation Reports - August 31, 2019 Category: Rehabilitation Source Type: research

Management of Traumatic Brain Injury: Special Considerations for Older Adults
AbstractPurpose of ReviewThis review focuses on the unique challenges facing older adults with traumatic brain injury (TBI) and provides considerations for appropriate medical treatment.Recent FindingsOlder adults are the fastest growing population to suffer TBI, typically due to falls. Despite less severe injuries based on the Glasgow Coma Scale, older adults more frequently have abnormal head CT findings, are more likely to be admitted to the hospital, and suffer higher mortality than younger adults. Older adults have higher degree of medical comorbidities that require careful management in the acute hospital and rehabil...
Source: Current Physical Medicine and Rehabilitation Reports - August 8, 2019 Category: Rehabilitation Source Type: research

Biological Sex/Gender and Biopsychosocial Determinants of Traumatic Brain Injury Recovery Trajectories
AbstractPurpose of ReviewThe goals of the report are to integrate recent and key foundational gender- and sex-related, post-traumatic brain injury (TBI) literature across several research domains, to highlight need for increased cross-field communication using an integrative biopsychosocial research model, and to provide recommendations for further research approaches and foci.Recent FindingsRecent findings of TBI studies addressing gender and/or biological sex provide evidence of women ’s unique risks for injury, significant differences in severity, type, and number of post-TBI symptoms reported by women vs. men, an...
Source: Current Physical Medicine and Rehabilitation Reports - August 8, 2019 Category: Rehabilitation Source Type: research

Mobile Health Interventions for Traumatic Brain Injuries
AbstractPurpose of ReviewMobile health (mHealth) interventions may be useful for individuals with traumatic brain injury (TBI), but there is minimal knowledge regarding how mHealth technology is currently being used for TBI treatment or rehabilitation. The purpose of this review is to examine the extant literature on the use of mHealth for intervention delivery in order to identify considerations for using mHealth with the TBI population, and to provide recommendations for further study.Recent FindingsConsistent with recent literature in other disability populations, mHealth shows promise for people with TBI as a compensat...
Source: Current Physical Medicine and Rehabilitation Reports - August 1, 2019 Category: Rehabilitation Source Type: research

Military Blast-Related Traumatic Brain Injury
AbstractPurpose of ReviewThis paper aims to review and discuss the epidemiological, neuropathologic, and mechanistic characteristics of blast traumatic brain injury (bTBI) specific to the military population.Recent FindingsMilitary service members have sustained over 383,000 reported incidents of TBI since 2000. In combat, mild bTBI due to explosive attacks comprise the most common type. Identification, treatment, and reporting of bTBI are compounded by the operational demands of combat as well as frequent co-presentation with PTSD and associated injuries. Following primary injury, a secondary metabolic and inflammatory ca...
Source: Current Physical Medicine and Rehabilitation Reports - August 1, 2019 Category: Rehabilitation Source Type: research

The Accuracy of SPECT/CT for Diagnosing Lumbar Zygapophyseal Joint Pain: a Systematic Review
AbstractPurposeTo determine the accuracy of Tc-99m methylenediphosphonate single photon emission computed tomography (SPECT/CT) for the diagnosis of lumbar zygapophyseal joint-related pain with dual medial branch block (>  70% threshold) as the reference standard.Recent FindingsTo date, the accuracy of SPECT/CT for the diagnosis of lumbar zygapophyseal joint pain has not been systematically reviewed.SummaryOne study met inclusion criteria. A prospective cohort study of 35 patients reported a prevalence of 24% (95% CI 9.0 –40.0%) using dual medial branch blocks (MBBs) as the means of diagnosis and found that...
Source: Current Physical Medicine and Rehabilitation Reports - July 29, 2019 Category: Rehabilitation Source Type: research

Sarcopenia: a Muscle Disease with Decreased Functional Capacity and an Increased Risk of Adverse Health Outcomes
AbstractPurpose of ReviewThis paper aims to provide an overview of sarcopenia, an enigmatic skeletal muscle disease where age, disuse, injury, and chronic disease can all contribute to the accelerated loss of mass and strength beyond normal variation, and that can negatively affect a person ’s physical function and quality of life.Recent FindingsA rapid and pervasive “graying” of societies worldwide is expected to continue in the coming decades. Due to this projected increase in the number of older adults, sarcopenia and its associated costs will be a significant public health concern. New international g...
Source: Current Physical Medicine and Rehabilitation Reports - July 25, 2019 Category: Rehabilitation Source Type: research

Ultramarathon Comprehensive Injury Prevention
AbstractPurpose of ReviewThis paper aims to review injury prevention for ultramarathon runners during training, race day, and recovery.Recent FindingsInjury prevention starts with a training plan that emphasizes a gradual increase in distance interspersed with speed work, long runs, strength training, and active recovery. Pre-race training environment that mirrors race day terrain and climate is preferred. Customized nutrition and hydration strategies are recommended. Further research is needed regarding various carbohydrate/fat nutrition strategies.SummaryThere are numerous reviews of ultramarathon running-related injurie...
Source: Current Physical Medicine and Rehabilitation Reports - July 4, 2019 Category: Rehabilitation Source Type: research

Knee Osteoarthritis and Meniscal Injuries in the Runner
AbstractPurpose of ReviewThis paper aims to review new evidence regarding the epidemiology, pathophysiology, and treatment of knee osteoarthritis and meniscal injuries in the recreational and professional running population.Recent FindingsThough conservative measures remain the mainstay of treatment, increasing evidence shows a role for platelet-rich plasma as a conservative management option for osteoarthritis and meniscal injury, though further studies need to be performed. Cell-based therapy, such as mesenchymal stem cells, remains a controversial topic without clear evidence of their efficacy. Newer surgical options, s...
Source: Current Physical Medicine and Rehabilitation Reports - July 1, 2019 Category: Rehabilitation Source Type: research

Sex Differences in the Spine
AbstractPurpose of ReviewThis paper aims to review anatomic and pathology-specific sex differences of the spine.Recent FindingsWhile cadaveric and imaging analyses have shown differences in planar orientation of vertebral anatomy and alignment, the data is less conclusive for clinically correlating these differences. Reports show that predilection to injury in athletes is influenced by both gender and the nature of the sport, which makes it difficult to determine the exact contribution of sex differences to injury rates. Multiple articles report an increased incidence of spondylolysis, disc degeneration, and ankylosing spo...
Source: Current Physical Medicine and Rehabilitation Reports - June 27, 2019 Category: Rehabilitation Source Type: research

Review of Musculoskeletal Injury Prevention in Female Soccer Athletes
AbstractPurpose of ReviewThis paper aims to review the recent literature regarding the prevention of musculoskeletal injuries in female soccer athletes.Recent FindingsFemale soccer players are at risk for many musculoskeletal injuries, mostly involving the lower extremities, due to anatomic, hormonal, and biomechanical factors. Various programs are available that target overall injury prevention, as well as specifically the prevention of anterior cruciate ligament (ACL), ankle, and overuse injuries. The F édération Internationale de Football Association (FIFA) 11+ is the most well-studied program for overall ...
Source: Current Physical Medicine and Rehabilitation Reports - June 11, 2019 Category: Rehabilitation Source Type: research

Patellar Tendinopathy in Athletes
AbstractPurpose of ReviewThis review discusses the current practice of evaluation and treatment of patellar tendinopathy with emphasis on rehabilitation.Recent FindingsThe latest studies revolve primarily around implementation of isometric and heavy slow resistance (HSR) exercises in the rehabilitation of patellar tendinopathy rather than the traditional rehabilitation method of eccentric exercise.SummaryPatellar tendinopathy is a common injury of the inferior anterior knee seen in athletes but predominantly in jumping athletes. Onset is insidious and frequently noted in a loaded position with knee flexion. Physical exam f...
Source: Current Physical Medicine and Rehabilitation Reports - June 8, 2019 Category: Rehabilitation Source Type: research

A Review of Hip-Spine Syndrome
AbstractPurpose of ReviewThis review is aimed at summarizing our current understanding of hip-spine syndrome. In particular, the review discusses the clinical assessment and diagnosis of commonly implicated conditions to help a practitioner realize an efficient and organized approach to the evaluation and management of pain in the setting of hip-spine syndrome.Recent FindingsWhile initially described as the concurrent presence of hip osteoarthritis and lumbar spinal stenosis, the catalog of diagnoses associated with hip-spine syndrome has expanded and includes femoroacetabular impingement, acetabular dysplasia, hip osteoar...
Source: Current Physical Medicine and Rehabilitation Reports - June 3, 2019 Category: Rehabilitation Source Type: research

Extracorporeal Shockwave Therapy in Lower Limb Sports Injuries
AbstractPurpose of ReviewTo outline current evidence on the use of ESWT for the treatment of lower limb sports injuries.Recent FindingsThere is growing evidence to support the use of extracorporeal shockwave therapy (ESWT) for a variety of musculoskeletal conditions in the general population. However, research focused on the use of ESWT specifically for lower extremity injuries in the athletic population is more limited. Athletes represent a subgroup of patients that may benefit from ESWT. Compared with injections or surgical interventions, athletes undergoing ESWT often are able to continue sports participation with fewer...
Source: Current Physical Medicine and Rehabilitation Reports - June 3, 2019 Category: Rehabilitation Source Type: research

Management of Pressure Ulcers and Pressure-Related Injury
We examined which studies of available support surfaces, new and currently utilized wound dressings or any other treatment modalities have provided ev idence of any greater effectiveness than standard of care in the prevention of pressure injury and in promotion of pressure ulcer healing. Our objective is to provide healthcare providers with an assessment of the relative efficacy of the various interventions available to facilitate their decision- making in the healing of their patient’s pressure ulcers. Goals for pressure injury prevention or treatment, especially in the geriatric population, address repositioning f...
Source: Current Physical Medicine and Rehabilitation Reports - June 1, 2019 Category: Rehabilitation Source Type: research

Musculoskeletal Injuries in Climbers
This article aims to review the epidemiology of musculoskeletal injuries in climbers, risk factors leading to those injuries, and treatment and prevention strategies specific to climbers.Recent FindingsMost chronic climbing injuries occur in the upper extremities, especially the hands, and are due to overuse. Outdoor climbing is associated with a higher rate of injury than indoor climbing, and among indoor climbing sub-disciplines, bouldering has the highest injury rate. Further research is needed to identify specific techniques or training regimens that may lead to injury, and furthermore, if changing technique during tra...
Source: Current Physical Medicine and Rehabilitation Reports - May 31, 2019 Category: Rehabilitation Source Type: research

Evidence Analysis of Sympathetic Blocks for Visceral Pain
AbstractPurpose of ReviewThis paper aims to review common sympathetic nerve blocks to treat visceral pain.Recent FindingsExtensive reviews exist exploring the approach to care for those with visceral pain due to malignancy. These often include interventional pain procedures. Research demonstrates these procedures may reduce opioid use. Research is ongoing to assess the efficacy when treating non-malignant source of visceral pain. Recently, several case reports and small-scale studies demonstrate benefits for non-painful entities, such as improved cardiac function after such procedures.SummaryThe management of visceral alge...
Source: Current Physical Medicine and Rehabilitation Reports - May 31, 2019 Category: Rehabilitation Source Type: research

Outcome Measures of Free-Living Activity in Spinal Cord Injury Rehabilitation
AbstractPurpose of ReviewThe purpose of this article was to describe the utilization of body-worn activity monitors in the spinal cord injury (SCI) population and discuss the challenges of using body-worn sensors in rehabilitation research.Recent FindingsMany activity monitor-based measures have been used and validated in the SCI population including stroke number, push frequency, upper limb activity counts, and wheelchair propulsion distance measured from a sensor attached to the wheelchair.SummaryThe ability to accurately measure physical activity in the free-living environment using body-worn sensors has the potential t...
Source: Current Physical Medicine and Rehabilitation Reports - May 28, 2019 Category: Rehabilitation Source Type: research

Rehabilitation Considerations in Pediatric Brain Tumors
AbstractPurpose of ReviewThe goal of this paper is to provide an evidence-based update for rehabilitation providers to guide rehabilitation treatment plans during the care of children with brain tumors across the lifespan.Recent FindingsBrain tumors are the most common solid tumors in children, and overall the second most common cancer type in children. In 2016, the World Health Organization (WHO) revised classification of these tumors to incorporate molecular parameters. Rehabilitation providers have a role throughout the continuum of care in this population, providing preventative, restorative, supportive, and palliative...
Source: Current Physical Medicine and Rehabilitation Reports - May 22, 2019 Category: Rehabilitation Source Type: research

Polypharmacy and Rational Prescribing: Changing the Culture of Medicine One Patient at a Time
AbstractPurpose of ReviewPolypharmacy and the associated concept of potentially inappropriate prescribing (PIP) have well-documented deleterious effects on older adults and other vulnerable groups commonly treated by physiatrists. Addressing the issues of polypharmacy and PIP presents an opportunity to improve health and rehabilitation outcomes. In this article, we review medications commonly initiated and managed by physiatrists such as anticoagulants, antidepressants, neuro-stimulants, and pain medications based on current evidence. We also offer strategies to minimize polypharmacy and PIP by exploring alternative and be...
Source: Current Physical Medicine and Rehabilitation Reports - May 20, 2019 Category: Rehabilitation Source Type: research

Management of Urinary Incontinence in Older Adults in Rehabilitation Care Settings
AbstractPurpose of ReviewThis review focuses on updates in the management of urinary incontinence occurring in older adult populations living with conditions frequently managed by physical medicine and rehabilitation specialists.Recent FindingsUrinary incontinence is common among older adults who live with neurologic diseases, such as stroke, Parkinson ’s disease, multiple sclerosis, and traumatic brain injury, and may be cared for in outpatient and acute rehabilitation facilities. While the evidence is growing regarding treatment strategies specific to patients with neurogenic bladder, behavioral treatment approache...
Source: Current Physical Medicine and Rehabilitation Reports - May 18, 2019 Category: Rehabilitation Source Type: research

Delirium: Evaluation and Management
AbstractPurpose of ReviewDelirium is associated with high morbidity, mortality and healthcare costs, and longer inpatient hospital length of stays. The purpose of this review is to summarize the most recent evidence pertaining to the recognition, prevention, and management of delirium to help guide clinicians to make evidence-based decisions in patient care.Recent FindingsDelirium is best managed with a multicomponent strategy using standardized tools for early recognition, such as the Confusion Assessment Method (CAM), non-pharmacologic interventions including restoration of the natural sleep-wake cycle with environmental...
Source: Current Physical Medicine and Rehabilitation Reports - May 14, 2019 Category: Rehabilitation Source Type: research

Strengthening Quadriceps Muscles with Neuromuscular Electrical Stimulation Following Total Hip Replacement: a Review
AbstractPurpose of ReviewFunctional recovery from total hip replacement can be suboptimal and deficits in quadriceps muscle strength may hinder the return to activities of daily living. Neuromuscular electrical stimulation (NMES) devices have long been used to preserve and restore skeletal muscle mass and function following periods of muscle atrophy due to immobilisation. Here, we evaluate the potential role of NMES for strengthening the quadriceps muscles following hip replacement.Recent FindingsTwo studies have investigated the effects of NMES on quadriceps strength following hip replacement. NMES in addition to exercise...
Source: Current Physical Medicine and Rehabilitation Reports - May 9, 2019 Category: Rehabilitation Source Type: research

Pediatric Cardiac Rehabilitation: a Review
AbstractPurpose of ReviewIn addition to concerns with physical health and activity levels, children with cardiac conditions can be at risk of neurodevelopmental and socioemotional maladjustment. Children with congenital heart defects requiring surgery early in life are at risk of developmental delays and cognitive impairments, and both children with congenital heart defects and those with cardiomyopathies are at risk of socioemotional concerns. As a result, there is an increasing focus on rehabilitation efforts for these patients, in order to improve both their physical well-being and their adjustment outcomes. However, th...
Source: Current Physical Medicine and Rehabilitation Reports - May 7, 2019 Category: Rehabilitation Source Type: research

Injury Prevention Considerations in Adolescent Overhead-Throwing Athletes
AbstractPurpose of ReviewThe purpose of this manuscript is to summarize concepts to consider when implementing ways to prevent injuries in adolescent overhead-throwing athletes. The goal of this review is to provide an updated and novel overview for the practitioner who cares for this specific patient population.Recent FindingsThis manuscript will review all factors related to the prevention of overhead-throwing injury risk in adolescents. The latest studies as well as well-cited literature are cited to provide up-to-date and accurate data backing up our conclusions.SummaryThere are many overhead-throwing injuries in adole...
Source: Current Physical Medicine and Rehabilitation Reports - May 6, 2019 Category: Rehabilitation Source Type: research

Clinical Considerations and Resources for Youth Athletes with Intellectual Disability: a Review with a Focus on Special Olympics International
This article summarizes recent SOI efforts in both sports competition and health initiatives. Data collected from SOI ’s Healthy Athletes Initiative revealed obesity in 31.5% of youth with ID. Data also demonstrated concerns with flexibility in 71.3% of athletes and concerns with muscle strength in 56.5% of athletes. Results from medical coverage of the 2009 Special Olympics Great Britain Summer Games revealed mu sculoskeletal and skin concerns as the primary reasons for on-site sports coverage medical consultation.SummaryClinicians caring for youth with ID should be aware of the sport opportunities for this populati...
Source: Current Physical Medicine and Rehabilitation Reports - May 4, 2019 Category: Rehabilitation Source Type: research

Post-Acute Care Determination for Hospitalized Older Adults
AbstractPurpose of ReviewA significant percentage of hospitalized older adults are discharged to a post-acute care (PAC) setting. This review will discuss the characteristics of the main PAC options in the USA and the key evaluation criterion to be utilized in determining the most appropriate PAC setting for an older hospitalized patient.Recent FindingsThere is limited literature regarding PAC determination in the USA. However, this is a growing area of interest due to PAC costs and the growing older adult population. A standardized method of assessment for older adult patients nearing hospital discharge is presented inclu...
Source: Current Physical Medicine and Rehabilitation Reports - May 4, 2019 Category: Rehabilitation Source Type: research

Utilizing Functional Electrical Stimulation and Exoskeletons in Pediatrics: a Closer Look at Their Roles in Gait and Functional Changes in Cerebral Palsy
AbstractPurpose of ReviewA primary focus for many children with cerebral palsy (CP) is functional independence. However, due to neurologic insults that occur early in life, typical gait pattern development is impaired. Research has shown the importance of task-oriented movements in reorganizing the central nervous system in a functionally meaningful way. Advancements in technology, when used in conjunction with conventional strategies, have made it possible for therapists to utilize devices that provide repetitive patterning and feedback for gait retraining. This enables patients the opportunity to develop normal gait patt...
Source: Current Physical Medicine and Rehabilitation Reports - April 29, 2019 Category: Rehabilitation Source Type: research

Community Participation and Transition Outcomes in Youth with Spina Bifida and Other Chronic Health Conditions in an Urban Children ’s Hospital Outpatient Clinic
AbstractPurpose of ReviewCommunity participation and emerging adult transition outcomes are important to consider as they appear to have implications upon health outcomes and an individual ’s ability to take on adult roles within society. To our knowledge, the relationship between community participation of CYSHCN (Children and Youth with Special Health Care Needs) in relation to transition outcomes, particularly in the spina bifida population, is not well described.Recent FindingsParticipation in community activities is lower in transitioning youth with spina bifida compared to transitioning youth with other chronic...
Source: Current Physical Medicine and Rehabilitation Reports - April 25, 2019 Category: Rehabilitation Source Type: research

Youth Para and Adaptive Sports Medicine
AbstractPurpose of ReviewThis review aims to provide an overview of sports medicine principles pertaining to youth Para athletes.Recent FindingsWhile little research on youth Para athletics exists, recent elite Paralympic Games data confirms a higher rate of upper extremity injuries in wheelchair athletes and lower extremity injuries in ambulatory athletes, while showing a higher rate of acute injuries in the Winter Games and skin/soft-tissue injuries in Summer Games. These summer sport findings are consistent with historic youth Para sport data.SummaryClinicians caring for youth Para athletes should be aware of medical co...
Source: Current Physical Medicine and Rehabilitation Reports - March 27, 2019 Category: Rehabilitation Source Type: research

Rehabilitation in Children with Disorder of Consciousness
AbstractPurpose of ReviewConsciousness is a state of wakefulness with awareness of self and the environment. Disorder of consciousness (DOC) can result from any type of acquired brain injury (ABI). While children with ABI and DOC are commonly encountered in pediatric rehabilitation settings, research in this population is lacking, necessitating extrapolation from adult literature.Recent FindingsAdults and children with DOC who participate in specialized inpatient rehabilitation programs show functional gains during and following the inpatient admission. Here, we present a model for an interdisciplinary rehabilitation progr...
Source: Current Physical Medicine and Rehabilitation Reports - March 9, 2019 Category: Rehabilitation Source Type: research

Indirect Care Utilization Among Children with Medical Complexity
We describe the value of ICT for CMC in a mature, consultative, subspecialty complex care program.Recent FindingsNine hundred five CMC in our Comprehensive Care Program over a 2-year period received an average of 1283  h of ICT and 640 h of direct visit time per year. Provider costs/year were $93,977 for ICT and $62,848 for direct care provision. The odds of incurring hospital costs increased by 43% among CMC who used ICT.SummaryCMC utilize substantial, costly, and unreimbursed amounts of ICT, yet ICT is associated with increased hospital costs. Perhaps ICT might be a proxy indicator of rising clinical acuity and...
Source: Current Physical Medicine and Rehabilitation Reports - March 4, 2019 Category: Rehabilitation Source Type: research

Addressing Over-Medicalization in Children with Medical Complexity
AbstractPurpose of ReviewChildren with medical complexity (CMC) are at risk for over-medicalization and medical child abuse. Their multiple diagnoses, medical complexities, and functional limitations require providers to partner with parents in their care. Even in the context of shared decision-making, over-medicalization and medical child abuse can occur.Recent FindingsWe define over-medicalization and medical child abuse as related to the care of CMC, present strategies to prevent, identify, and address shared provider-parent decision-making, and review ethical principles that can guide care decisions.SummaryComplex pedi...
Source: Current Physical Medicine and Rehabilitation Reports - February 8, 2019 Category: Rehabilitation Source Type: research

Exercise in Children with Disabilities
AbstractPurpose of ReviewThe goal of this paper is to review the role and importance of exercise in the overall health and fitness of children with disabilities and to identify unique considerations in specific populations.Recent FindingsExercise and activity are known to be of critical importance to the health and well-being of typically developing children and adolescents. Children with disabling conditions are not immune to the obesity epidemic and even less likely to participate in structured or recreational activities than their typically developing peers. Although barriers to participation exist, studies largely supp...
Source: Current Physical Medicine and Rehabilitation Reports - February 1, 2019 Category: Rehabilitation Source Type: research

Active Rehabilitation After Childhood and Adolescent Mild Traumatic Brain Injury: a Narrative Review and Clinical Practice Implications
AbstractPurpose of ReviewDevelopment of rehabilitation strategies for youth after mTBI can be challenging for the rehabilitation professional. The purpose of this narrative review is to highlight current evidence for the use of active rehabilitation to manage common impairments after concussion/mild traumatic brain injury (mTBI).Recent FindingsExertional intolerance, vestibular deficiency, visual problems, and cervical dysfunction are common after mTBI. Active rehabilitation strategies targeting these problems are likely effective at reducing these impairments, leading to improved functioning.SummaryActive rehabilitation r...
Source: Current Physical Medicine and Rehabilitation Reports - January 28, 2019 Category: Rehabilitation Source Type: research

Chronic Pediatric Pain Management: a Review of Multidisciplinary Care and Emerging Topics
AbstractPurpose of ReviewChronic pain is a prevalent, disabling, and expensive pediatric condition. Specific treatment options have limited evidence and are often extrapolated from adult care. This review evaluates pain outcome measures, psychological treatment, pharmacologic management, multidisciplinary treatment models, and emerging topics in pediatric pain medicine.Recent FindingsMultimodal cognitive behavioral therapy and intensive interdisciplinary pain treatment have the strongest evidence for improving pain and function while decreasing healthcare utilization. There is emerging evidence that parental involvement in...
Source: Current Physical Medicine and Rehabilitation Reports - January 25, 2019 Category: Rehabilitation Source Type: research

Health-Related Quality of Life and Family Functioning of Parents of Children with Medical Complexity
We describe the HRQOL of parents of CMC.Recent FindingsOne hundred seventy parents of CMC (mean age =3.4  years; 57% male) in a Comprehensive Care Program at a tertiary care center completed the PedsQL Family Impact Module (PedsQL FIM™). Scores were low across all sections, with a total average of 52 (SD + 17.7). Parental HRQOL was not associated with the child’s medically complexity, level of parental education, parental medical training, number of children, number of CMC in the home, or advance directive status.SummaryParents of CMC report low HRQOL. Strategies to better support parents of CMC ...
Source: Current Physical Medicine and Rehabilitation Reports - January 25, 2019 Category: Rehabilitation Source Type: research