Dizziness and Balance Disorders in a Traumatic Brain Injury Population: Current Clinical Approaches
AbstractPurpose of ReviewBalance deficits are frequently observed in traumatic brain injuries (TBIs). This review seeks to explore the components of the balance system affected by TBIs and current interventions used to address the underlying impairments.Recent FindingsTBIs result in a wide range of impairments often including imbalance and dizziness. The trauma can result in mechanical issues, benign paroxysmal positional vertigo (BPPV), or central processing issues through damage to the vestibular nucleus and pathways. Both issues can be addressed through physical therapy. BPPV treatment involves using a series of positio...
Source: Current Physical Medicine and Rehabilitation Reports - May 4, 2021 Category: Rehabilitation Source Type: research

Resistance Exercise in Prostate Cancer Patients: a Short Review
AbstractPurpose of ReviewThe aim of this paper is to provide an overview of recent findings concerning the utilization of resistance exercise (RE) in prostate cancer (PCa), in particular as pertaining to the management of cancer therapy side effects.Recent FindingsAs of late, studies investigating the effects of RE in PCa patients have found positive effects on muscle strength, body composition, physical functioning, quality of life, and fatigue. The combination of RE and impact training appears to decrease the loss of bone mineral density. RE seems to be well accepted and tolerated, even by patients with bone metastatic d...
Source: Current Physical Medicine and Rehabilitation Reports - January 30, 2021 Category: Rehabilitation Source Type: research

Spinal Cord Stimulation After Spinal Cord Injury: Promising Multisystem Effects
AbstractPurpose of ReviewSpinal cord stimulation (SCS) is an exciting new area of research in the field of spinal cord injury (SCI) medicine. This review aims to provide an overview of recent advances in SCS related to motor control, neurogenic bladder, and cardiovascular effects and discuss future directions.Recent FindingsEpidural spinal stimulation (spES) and transcutaneous stimulation (TSS) have been shown to improve lower and upper-extremity motor control after SCI. Similarly, SCS has shown to impact bladder function and blood pressure control after SCI. Future directions include gaining a better understanding of the ...
Source: Current Physical Medicine and Rehabilitation Reports - January 30, 2021 Category: Rehabilitation Source Type: research

Evidence for Ultrasound-Guided Carpal Tunnel Release
This report is a narrative review of the clinical evidence for ultrasound (US)-guided carpal tunnel release (USGCTR) in patients with carpal tunnel syndrome (CTS).Recent FindingsTo date, there are 23 clinical publications (case reports, prospective and retrospective case series, and randomized comparative studies) on USGCTR, involving 1,072 wrists. Although many different devices have been used to perform USGCTR, current publications report>  98% clinical success rate without any documented neurovascular injuries. Of the publications, 7 were done by orthopedic surgery, 6 by physiatry, 6 by family medicine, and 1 ...
Source: Current Physical Medicine and Rehabilitation Reports - January 4, 2021 Category: Rehabilitation Source Type: research

Focused Extracorporeal Shockwave Therapy in Physical Medicine and Rehabilitation
AbstractPurpose of ReviewFocused extracorporeal shockwave therapy (fESWT) is a physical treatment modality developed over the last 25  years for musculoskeletal indications. It has many indications in the field of physical medicine and rehabilitation (PM&R) and is effective, time-efficient, and cost-efficient. This review focuses on basics and on clinical indications as well as on significant trends in fESWT.Recent FindingsIn PM&R, stimulation of healing processes in tendons, surrounding tissue, and bones via mechanotransduction seems to be a relevant biological effect. The International Society for Medical Sh...
Source: Current Physical Medicine and Rehabilitation Reports - December 18, 2020 Category: Rehabilitation Source Type: research

Acute and Long-Term Complications of Gunshot Wounds to the Head
AbstractPurpose of ReviewTraumatic brain injury (TBI) secondary to gunshot wounds is a common problem in the USA and presents with a unique set of acute and chronic complications.Recent FindingsRecent publications in trauma and critical care literature have sought to better understand incidence, demographics, and acute complications of gunshot wounds to the head. These findings, coupled with literature on rehabilitation of TBI patients secondary to gun violence, may help brain injury physiatrists better understand issues which may arise during rehabilitation. Clinical commonalities among TBI patients with gunshot wounds to...
Source: Current Physical Medicine and Rehabilitation Reports - November 16, 2020 Category: Rehabilitation Source Type: research

Update on Evidence-Based Diagnosis and Treatment of Acetabular Labral Tears
AbstractPurpose of ReviewThis paper aims to assess the pathophysiology, diagnosis, and latest evidence-based treatment of acetabular labral tears.Recent FindingsThe acetabular labrum contributes to the stability of the hip. Labral tears may lead to significant pain and disability, although many are asymptomatic. Imaging and intra-articular injections are often required in addition to standard history and physical examination for accurate diagnosis. Most patients will benefit from initial conservative treatment, but those requiring surgical intervention may have better outcomes with labral repair over debridement. If the la...
Source: Current Physical Medicine and Rehabilitation Reports - November 13, 2020 Category: Rehabilitation Source Type: research

Correction to: Comparison of Female Athlete Triad (Triad) and Relative Energy Deficiency in Sport (RED-S): a Review of Low Energy Availability, Multidisciplinary Awareness, Screening Tools and Education
A Correction to this paper has been published:https://doi.org/10.1007/s40141-020-00303-2 (Source: Current Physical Medicine and Rehabilitation Reports)
Source: Current Physical Medicine and Rehabilitation Reports - November 12, 2020 Category: Rehabilitation Source Type: research

Acute Delirium and Post-Delirium Encephalopathy
AbstractPurpose of ReviewThis paper aims to introduce the reader to the impact, mechanisms, and management of hospital-acquired delirium.Recent FindingsResearchers have found that in addition to increased length of stay and hospital-associated costs, delirium can lead to long-term cognitive dysfunction ( “post-delirium encephalopathy”) and potentially accelerated progression of dementia.SummaryThe best management of delirium is prevention by avoiding deliriogenic medications and through systems-based approaches to pain, sleep, and environmental management. Long-term care of patients who experienced delirium sho...
Source: Current Physical Medicine and Rehabilitation Reports - October 31, 2020 Category: Rehabilitation Source Type: research

Prognostication and Determinants of Outcome in Adults and Children with Moderate-to-Severe Traumatic Brain Injury
AbstractPurpose of ReviewIt has been suggested in the literature that many physicians lack comfort in assessing prognosis following traumatic brain injury (TBI). The purpose of this review is to investigate the most recent work on predicting outcomes after moderate-to-severe TBI.Recent FindingsTBI is one of the leading causes of disability in the USA with an estimated 13.5 million individuals affected by varying severities of TBI. Many clinical variables, including age, admission Glasgow Coma Scale score, duration of posttraumatic amnesia, and duration of coma, have been studied to determine whether they play a role in out...
Source: Current Physical Medicine and Rehabilitation Reports - October 28, 2020 Category: Rehabilitation Source Type: research

Comparison of Female Athlete Triad (Triad) and Relative Energy Deficiency in Sport (RED-S): a Review of Low Energy Availability, Multidisciplinary Awareness, Screening Tools and Education
AbstractPurpose of ReviewThis paper aims to review low energy availability (low EA), compare the Female Athlete Triad (Triad) and Relative Energy Deficiency in Sport (RED-S) screening tools and eating disorder/disordered eating questionnaires, and discuss multidisciplinary awareness, education, and treatment strategies. It provides an overview on the current state of the Triad and RED-S and assists clinicians with an overview of options for screening tools for their practice.Recent FindingsTriad Consensus Panel Screening Questions, Preparticipation Physical Exam (PPE), and Periodic Health Exam (PHE) share overlapping quest...
Source: Current Physical Medicine and Rehabilitation Reports - October 23, 2020 Category: Rehabilitation Source Type: research

Comparison of Female Athlete Triad (Triad) and Relative Energy Deficiency in Syndrome (RED-S): a Review of Low Energy Availability, Multidisciplinary Awareness, Screening Tools and Education
AbstractPurpose of ReviewThis paper aims to review low energy availability (low EA), compare the Female Athlete Triad (Triad) and Relative Energy Deficiency in Sport (RED-S) screening tools and eating disorder/disordered eating questionnaires, and discuss multidisciplinary awareness, education, and treatment strategies. It provides an overview on the current state of the Triad and RED-S and assists clinicians with an overview of options for screening tools for their practice.Recent FindingsTriad Consensus Panel Screening Questions, Preparticipation Physical Exam (PPE), and Periodic Health Exam (PHE) share overlapping quest...
Source: Current Physical Medicine and Rehabilitation Reports - October 23, 2020 Category: Rehabilitation Source Type: research

Autonomic Dysreflexia After Spinal Cord Injury: Beyond the Basics
AbstractPurpose of ReviewThe purpose of this article is to update health care providers on recommended identification and management strategies for autonomic dysreflexia (AD), as well as an in-depth discussion of pharmacological management of AD. In addition, this article will focus on prevention strategies and less commonly recognized causes of AD.Recent FindingClinical practice guidelines are available with effective evaluation and management strategies to treat individuals with spinal cord injury (SCI) presenting to health care professionals with AD. Three common yet easily overlooked causes of AD are distended urinary ...
Source: Current Physical Medicine and Rehabilitation Reports - October 22, 2020 Category: Rehabilitation Source Type: research

Understanding Sleep Dysfunction after Traumatic Brain Injury
AbstractPurpose of ReviewThis paper aims to review the prevalence, pathophysiology, outcomes, evaluation, and management of sleep dysfunction after traumatic brain injury (TBI).Recent FindingsRecent research has focused on the prevalence and effects of sleep disturbance in various age groups after TBI, the correlation of subjective complaints to objective sleep measurement, the use of actigraphy to monitor sleep in those with TBI, updates to our understanding of pathophysiology of sleep dysfunction across the spectrum of severity of TBI, and newly identified associations with sleep and outcomes.SummaryProviders should cont...
Source: Current Physical Medicine and Rehabilitation Reports - October 21, 2020 Category: Rehabilitation Source Type: research

The Fascial System in Musculoskeletal Function and Myofascial Pain
This article aims to discuss the structure and function of fascial systems and the potential role in myofascial pain syndromes.Recent FindingsNew terminology differentiates anatomic structure (fascia) and function (fascial system), improving the conceptual framework and communication. Fascia has been shown to be innervated and biologically active and may have roles in nociception, proprioception, and myofascial force transmission. A number of factors may modify the function of fascial tissues through altering stiffness. A new cell type, “fasciacytes,” produces hyaluronic acid, a molecule critical to fascial lub...
Source: Current Physical Medicine and Rehabilitation Reports - October 19, 2020 Category: Rehabilitation Source Type: research

Musculoskeletal Issues and Care for Pregnant and Postpartum Women
AbstractPurpose of ReviewThis paper seeks to review the important musculoskeletal issues that arise for pregnant and postpartum women. It outlines the background, diagnosis, and management of these musculoskeletal issues; reviews the existing and recent literature; and offers clinical opinions from the perspective of women ’s health PM&R physicians.Recent FindingsExisting and recent literature on pelvic girdle pain, lumbosacral back pain, pubic symphysis separation, transient osteoporosis, rectus diastasis, and postpartum neuropathy offer some new insights on management, which is often context-dependent. Manageme...
Source: Current Physical Medicine and Rehabilitation Reports - October 10, 2020 Category: Rehabilitation Source Type: research

The Role of Interprofessional Teams in the Biopsychosocial Management of Limb Loss
AbstractPurpose of ReviewIndividuals undergoing amputations typically present with comorbid conditions that may adversely impact mortality, mobility, residual limb healing, mood, function, and participation. Understanding how to manage these individuals holistically is essential to optimize function and reduce complications.Recent FindingsA review of recent literature suggests that a biopsychosocial, interprofessional approach remains the recommended approach to limb loss rehabilitation. This can include the following: (1) optimizing health behaviors and fostering self-management skills; (2) assessing cognitive functioning...
Source: Current Physical Medicine and Rehabilitation Reports - October 5, 2020 Category: Rehabilitation Source Type: research

Evidenced-Based Management of Greater Trochanteric Pain Syndrome
AbstractPurpose of ReviewThis paper aims to review the evidenced-based management of greater trochanteric pain syndrome (GTPS).Recent FindingsThere are various studies evaluating greater trochanteric pain syndrome that illustrate the mainstay of treatment is activity modification with the implementation of isometric and isotonic exercise programs. If conservative care fails, short-term benefits can be seen with corticosteroid injections. More refractory cases of GTPS should be referred for diagnostic ultrasound evaluation to illustrate gluteal tendinosis that could benefit from a targeted treatment such as percutaneous ten...
Source: Current Physical Medicine and Rehabilitation Reports - October 5, 2020 Category: Rehabilitation Source Type: research

Role of Exercise Treatment of Low Back Pain in Pregnancy
We describe the biomechanical changes that may lead to sacroiliac dysfunction during pregnancy, pubic symphysis dysfunction, diastasis recti in the peripartum period, and pregnancy-related low back pain. Our focus was to examine the impact of exercise on each condition.Recent FindingsWe consolidated updated guidelines for physical activity throughout pregnancy, explored whether exercise is effective for stabilizing the low back and pelvic girdle in pregnant and postpartum patients as well as reviewed the absolute and relative contraindications to physical activity during pregnancy.SummaryPLBP and PPGP stem from multiple et...
Source: Current Physical Medicine and Rehabilitation Reports - September 28, 2020 Category: Rehabilitation Source Type: research

Musculoskeletal Rehabilitation for the Aging Female
AbstractPurpose of the ReviewDiscuss issues of musculoskeletal rehabilitation unique to the aging female population.Recent FindingsPhysiologic and anatomic changes contribute to functional decline, morbidity, and mortality in aging women. As the lifespan increases, the burden of pain-related disability impacts women more commonly than men. Maintaining physical activity plays an important role in reducing the burden of disability.SummaryPhysical function limitations are potentially modifiable but prevention is preferable. Further research in prevention and management of rehabilitation issues (including sarcopenia, frailty, ...
Source: Current Physical Medicine and Rehabilitation Reports - September 24, 2020 Category: Rehabilitation Source Type: research

Avoiding the Downward Spiral After Stroke: Early Identification and Treatment of Dysphagia
AbstractPurpose of ReviewThis paper reviews recent evidence concerning the epidemiology, evaluation, and treatment of post-stroke dysphagia.Recent FindingsThe large variability in dysphagia severity and outcomes after stroke warrant a comprehensive evaluation and treatment approach. Screening, bedside evaluation, and instrumental assessments should be systematically and consistently used based on clinical presentation and available resources. In addition to traditional methods of diet modification and implementation of strategies and exercises, the use of novel treatments such as biofeedback and noninvasive brain stimulati...
Source: Current Physical Medicine and Rehabilitation Reports - September 22, 2020 Category: Rehabilitation Source Type: research

Team Approach to Prosthetic Prescription Decision-Making
AbstractPurpose of ReviewThis paper aims to review the key concepts in prosthetic limb prescription for adults with limb loss, including the benefits of a multidisciplinary team.Recent FindingsThere is a relative absence of literature directly describing the role of a team-based approach to prosthetic limb prescription. However, comparable literature can be found in other rehabilitation topics and medical disciplines, generally in support of team-based approaches to patient care. While there is a growing body of comparative effectiveness literature for prosthetic componentry, there is generally a lack of coherent prescribi...
Source: Current Physical Medicine and Rehabilitation Reports - September 17, 2020 Category: Rehabilitation Source Type: research

Is Aphasia Treatment Beneficial for the Elderly? A Review of Recent Evidence
AbstractPurpose of ReviewWe review recent literature regarding aphasia therapy in the elderly. Relevant articles from the last 5  years were identified to determine whether or not there is evidence to support that various therapeutic approaches can have a positive effect on post-stroke aphasia in the elderly.Recent FindingsThere were no studies examining the effects of aphasia therapy specifically in the elderly within the timeframe searched. Therefore, we briefly summarize findings from 50 relevant studies that included large proportions of participants with post-stroke aphasia above the age of 65. A variety of behav...
Source: Current Physical Medicine and Rehabilitation Reports - September 17, 2020 Category: Rehabilitation Source Type: research

Stroke and Sarcopenia
AbstractPurpose of ReviewTo evaluate recent scientific research studies related to the changes in skeletal muscle after stroke and the presence of sarcopenia in stroke survivors to establish its incidence and effects on function.Recent FindingsRecently published findings on stroke-related sarcopenia are limited. This might be due to changes in the consensus definition of sarcopenia. Sarcopenia in stroke patients is estimated at 14 to 54%. The presence of sarcopenia at the time of a stroke can lead to worse recovery and functional outcomes.SummaryThe presence of sarcopenia prior to a stroke may be more common than suspected...
Source: Current Physical Medicine and Rehabilitation Reports - September 14, 2020 Category: Rehabilitation Source Type: research

Current Treatments of Insertional Achilles Tendinopathy
AbstractPurpose of ReviewThis paper aims to review the pathophysiology, diagnosis, and treatment of insertional Achilles tendinopathy (IAT).Recent FindingsThere is no current consensus regarding conservative or surgical treatments for IAT. There has recently been an increase of trials demonstrating utility for extracorporeal shock wave in treating IAT. Additionally, a retrospective study of percutaneous ultrasonic tenotomy shows promise.SummaryIAT has historically been recalcitrant to treatment. There are multiple available treatment options, and many that may confer some benefit. Knowing the available conservative treatme...
Source: Current Physical Medicine and Rehabilitation Reports - September 13, 2020 Category: Rehabilitation Source Type: research

Blood Flow Restriction Training in Athletes
AbstractPurpose of ReviewThis paper aims to review the available literature regarding blood flow restriction training (BFRT), summarize its mechanisms of action, address safety concerns, and help direct protocol development and practical implementation, particularly in athletes.Recent FindingsRecent literature, in both athletic and clinical cohorts, has explored the safety and efficacy of BFRT; however, rigorous randomized controlled trials with consistent protocols are lacking.SummaryBFRT is a promising clinical and athletic training tool; however, it should be used in a controlled setting with an individualized approach....
Source: Current Physical Medicine and Rehabilitation Reports - September 13, 2020 Category: Rehabilitation Source Type: research

Post-Stroke Cognitive Impairments and Responsiveness to Motor Rehabilitation: A Review
AbstractPurpose of ReviewThis review discusses the prevalence of cognitive deficits following stroke and their impact on responsiveness to therapeutic intervention within a motor learning context.Recent FindingsClinical and experimental studies have established that post-stroke cognitive and motor deficits may impede ambulation, augment fall risk, and influence the efficacy of interventions. Recent research suggests the presence of cognitive deficits may play a larger role in motor recovery than previously understood.SummaryConsidering that cognitive impairments affect motor relearning, post-stroke motor rehabilitation the...
Source: Current Physical Medicine and Rehabilitation Reports - September 9, 2020 Category: Rehabilitation Source Type: research

The Potential of Corticospinal-Motoneuronal Plasticity for Recovery after Spinal Cord Injury
AbstractPurpose of ReviewThis review focuses on a relatively new neuromodulation method where transcranial magnetic stimulation over the primary motor cortex is paired with transcutaneous electrical stimulation over a peripheral nerve to induce plasticity at corticospinal-motoneuronal synapses.Recent FindingsRecovery of sensorimotor function after spinal cord injury largely depends on transmission in the corticospinal pathway. Significantly damaged corticospinal axons fail to regenerate and participate in functional recovery. Transmission in residual corticospinal axons can be assessed using non-invasive transcranial magne...
Source: Current Physical Medicine and Rehabilitation Reports - August 3, 2020 Category: Rehabilitation Source Type: research

Selecting, Administering, and Interpreting Outcome Measures Among Adults with Lower-Limb Loss: an Update for Clinicians
AbstractPurpose of ReviewTo summarize outcome measurement research among adults with lower-limb loss (LLL) for clinicians.Recent FindingsHoughton Scale, Prosthetic Evaluation Questionnaire-Mobility Subscale (PEQ-m), Prosthetic Limb Users Survey of Mobility (PLUS-M ™), Activities-Specific Balance Confidence Scale (ABC), Amputee Mobility Predictor (AMP), Comprehensive High-Level Activity Mobility Predictor, Four Square Step Test (FSST), Narrowing Beam Walking Test (NBWT), L Test, 10 Meter Walk Test (10MWT), and 6 Minute Walk Test (6MWT) are appropriate for ev aluating individual patient changes post-LLL. Post-LLL, Sock...
Source: Current Physical Medicine and Rehabilitation Reports - August 2, 2020 Category: Rehabilitation Source Type: research

Musculoskeletal Issues and Care Specific to the Female Athlete
AbstractPurpose of ReviewThis chapter aims to provide recent updates in the literature regarding musculoskeletal issues in the female athlete that affects their care. The content will aim to supply specific history, physical exam, diagnostic and treatment pearls for medical providers caring for female athletes.Recent FindingsFemale athletes are more likely to be injured and spend more time away from sport due to their injuries when compared with their male counterparts. The causes of these issues have been found to be multifactorial due to anatomic differences, hormonal influences, and biomechanical patterns that predispos...
Source: Current Physical Medicine and Rehabilitation Reports - July 28, 2020 Category: Rehabilitation Source Type: research

Multidisciplinary Amputation Team Management of Individuals with Limb Loss
AbstractPurpose of the ReviewTo demonstrate the utility of the multidisciplinary team and the role of each member in caring for persons with limb loss, from pre-amputation to lifelong care.Recent FindingsBy ensuring patient-centered care through shared decision-making, persons with limb loss report improved adjustment following amputation. Various medical, physical, and psychosocial factors have been shown to correlate with post-amputation outcomes and should be assessed pre-amputation by the team. Persons with limb loss are at increased risk for re-amputation and secondary disabling conditions that the team should monitor...
Source: Current Physical Medicine and Rehabilitation Reports - July 22, 2020 Category: Rehabilitation Source Type: research

Healthcare Disparities in Dysvascular Lower Extremity Amputations
AbstractPurpose of ReviewOur goal is to provide a current review of health disparities in patients with dysvascular lower extremity amputation, so that we can better identify how disparities persist after an amputation and how to reduce these disparities.Recent FindingsHealth disparities in amputation risk, level, and outcomes exist in the USA based on race/ethnicity, gender, income, insurance, care provider, hospital, neighborhood, and US region.SummaryWhile health disparities exist for patients with dysvascular lower extremity amputation, little is known about differences in function, rehabilitation, and prosthesis presc...
Source: Current Physical Medicine and Rehabilitation Reports - July 15, 2020 Category: Rehabilitation Source Type: research

Spasticity Management After Spinal Cord Injury
This article reviews the current management options and research. (Source: Current Physical Medicine and Rehabilitation Reports)
Source: Current Physical Medicine and Rehabilitation Reports - July 14, 2020 Category: Rehabilitation Source Type: research

Evidence-Based Women ’s Health Physical Therapy Across the Lifespan
AbstractPurpose of ReviewThe aim of this paper is to review the current evidence for physical therapy (PT) in the treatment of pelvic floor disorders (PFDs) in women throughout the female lifespan.Recent FindingsAlthough trials are small and heterogeneous, there is an increase in evidence to support PT as a safe, effective treatment option for women with PFDs at various life stages. Evidence to support PT interventions for pelvic floor conditions including dysmenorrhea, chronic pelvic pain, dyspareunia, urinary incontinence, pelvic organ prolapse, and genitourinary syndrome of menopause are discussed. Clinicians are recomm...
Source: Current Physical Medicine and Rehabilitation Reports - June 23, 2020 Category: Rehabilitation Source Type: research

Acute Intermittent Hypoxia as a Potential Adjuvant to Improve Walking Following Spinal Cord Injury: Evidence, Challenges, and Future Directions
AbstractPurpose of ReviewThe reacquisition and preservation of walking ability are highly valued goals in spinal cord injury (SCI) rehabilitation. Recurrent episodes of breathing low oxygen (i.e., acute intermittent hypoxia, AIH) are a potential therapy to promote walking recovery after incomplete SCI via endogenous mechanisms of neuroplasticity. Here, we report on the progress of AIH, alone or paired with other treatments, on walking recovery in persons with incomplete SCI. We evaluate the evidence of AIH as a therapy ready for clinical and home use and the real and perceived challenges that may interfere with this possib...
Source: Current Physical Medicine and Rehabilitation Reports - June 23, 2020 Category: Rehabilitation Source Type: research

Walking after Spinal Cord Injury: Current Clinical Approaches and Future Directions
AbstractPurpose of ReviewWalking is a major priority after spinal cord injury (SCI). This review aims to inform clinicians of key considerations, available research to assist with prognosis, and current and future rehabilitation strategies to promote walking.Recent FindingsThere are many benefits to walking, although not all aspects may be advantageous. Several models have been developed to assist with prognostication. Gait training and locomotor training (overground or body weight supported treadmill training) are common rehabilitation approaches to promote walking in this population. Walking after SCI is also a significa...
Source: Current Physical Medicine and Rehabilitation Reports - June 21, 2020 Category: Rehabilitation Source Type: research

Physical Activity Interventions After Hip or Knee Joint Replacement: a Systematic Review
This study is aimed at describing and evaluating physical activity interventions in individuals that have undergone hip or knee joint replacement due to osteoarthritis.Recent FindingsA total of 11,873 studies were screened. Seven studies with 627 participants, aged 50 to 85  years, met the review criteria. There are five randomised control trial, one longitudinal quasi-experimental study with a control group, and one pre-/post-test study with control group. Interventions included health coaching, a walking programme, a behavioural change intervention, and an alpine sk iing intervention delivered between 6 and 24 ...
Source: Current Physical Medicine and Rehabilitation Reports - June 17, 2020 Category: Rehabilitation Source Type: research

Novel Approaches to Reduce Symptomatic Neuroma Pain After Limb Amputation
AbstractPurpose of ReviewA considerable number of major limb amputation patients will develop symptomatic neuromas within the residual limb. There has been a paradigm shift in the surgical treatment of symptomatic neuromas from techniques that attempt to interrupt axonal regeneration in favor of techniques that permit reinnervation. In addition, growing evidence suggests that successful treatment of peripheral nerve pain may diminish the development of phantom limb pain. We discuss novel surgical techniques that seek to prevent neuroma formation and in turn reduce phantom limb pain.Recent FindingsTargeted muscle reinnervat...
Source: Current Physical Medicine and Rehabilitation Reports - June 15, 2020 Category: Rehabilitation Source Type: research

PM & amp;R Training in Amputation Rehabilitation: Past, Present and Future
AbstractPurpose of ReviewThis paper aims to review the available literature for amputee rehabilitation training throughout history and current times while giving a preview of future endeavors.Recent FindingsThere is limited literature available regarding specifics of amputee care training in PM&R. There have been some advances with creation of fellowships but most of the literature shows a clear need to increase and improve amputee rehabilitation training and education to ensure the growing population is appropriately cared for.SummaryAmputee care played a huge role in the development of the field of PM&R and is st...
Source: Current Physical Medicine and Rehabilitation Reports - June 14, 2020 Category: Rehabilitation Source Type: research

Bone Loss and the Current Diagnosis of Osteoporosis and Risk of Fragility Fracture in Persons with Spinal Cord Injury
AbstractPurpose of ReviewThe topics to be discussed in this article include bone loss in the regions of the lower extremity that are most prone to fracture, the risk factors for fracture, the diagnosis of osteoporosis in persons with spinal cord (SCI), the determination of the fracture threshold at the knee, and a brief discussion of future directions.Recent FindingsExtensive cross-sectional studies, but a paucity of longitudinal studies, that describe the precipitous bone loss occurs during the acute phase of SCI that likely continues, albeit more gradually, over the lifetime. The distal femur (DF) and proximal tibia (PT)...
Source: Current Physical Medicine and Rehabilitation Reports - June 3, 2020 Category: Rehabilitation Source Type: research

Neurogenic Bowel: Traditional Approaches and Clinical Pearls
AbstractPurpose of ReviewTo describe management options used for neurogenic bowel dysfunction (NBD) in patients with spinal cord injury (SCI).Recent FindingsApproach to treatment for NBD in SCI is primarily derived from traditional approaches and historical guidelines. Large formal randomized control trials and recent high-quality studies on NBD management are sparse. Advances in SCI research are transitioning focus to emerging technologies as well as addressing quality of life (QOL). Recent literature suggests that ongoing challenges remain in NBD management as it pertains to QOL, social activities, and life participation...
Source: Current Physical Medicine and Rehabilitation Reports - May 31, 2020 Category: Rehabilitation Source Type: research

Heterotopic Ossification After Spinal Cord Injury: Current Clinical Approaches
AbstractPurpose of ReviewHeterotopic ossification (HO) is a frequent complication after spinal cord injury (SCI). This review article critically analyzes the scientific literature of HO after SCI and offers expert opinion on how past research translates to clinical practice.Recent FindingsTriple-phase bone scintigraphy has been the gold standard for diagnosing HO; however, recent research suggests diagnostic ultrasound may be more convenient, cost-effective, and safe. Currently, routine pharmaceutical prophylaxis for HO after SCI is not recommended. Range of motion exercises are advised to prevent and treat HO. Etidronate ...
Source: Current Physical Medicine and Rehabilitation Reports - May 29, 2020 Category: Rehabilitation Source Type: research

Transcranial Direct Current Stimulation for Motor Recovery Following Brain Injury
AbstractPurpose of ReviewTo discuss the potential use of transcranial direct current stimulation (tDCS) to improve motor behavior after brain injury.Recent FindingsDespite evidence that tDCS can improve motor function following brain injury, meta-analysis studies have largely failed to find conclusive support for tDCS as a viable treatment. In part, these inconsistencies arise from widespread variability in individuals ’ responsiveness to tDCS because of biological and experimental factors.SummaryProperly designed smart clinical studies are still needed to determine the optimal stimulation parameters and combinations...
Source: Current Physical Medicine and Rehabilitation Reports - May 25, 2020 Category: Rehabilitation Source Type: research

Employment After Spinal Cord Injury
AbstractPurpose of ReviewThis review focuses on employment after spinal cord injury (SCI) and highlights recent evidence-based models of vocational rehabilitation.Recent FindingsEmployment rates among people with SCI remain much lower than the general population. Benefits of employment for persons with SCI include improved quality of life, enhanced independence, reduced depression, improved social integration, greater life satisfaction, better health, and longevity. When striving to work after SCI, there are facilitators to be exploited (e.g., education, transportation, assistive technology) and barriers that need manageme...
Source: Current Physical Medicine and Rehabilitation Reports - May 23, 2020 Category: Rehabilitation Source Type: research

Complementary and Alternative (CAM) Treatment Options for Women with Pelvic Pain
AbstractPurpose of ReviewTo provide an overview of the current complementary and alternative (CAM) treatment options for women with chronic pelvic pain (CPP).Recent FindingsRecent studies on chronic pain at cellular, molecular, and network level and their interaction with the immune system have unfolded several mechanisms for pain making it promising to explore the alternative paradigm to manage the incredibly complex chronic pelvic pain condition where multifactorial etiology often limits successful outcomes.SummaryThe multifactorial nature and complexity in establishing the underlying diagnosis in CPP limit predictable r...
Source: Current Physical Medicine and Rehabilitation Reports - May 22, 2020 Category: Rehabilitation Source Type: research

Women ’s Cancer Rehabilitation: a Review of Functional Impairments and Interventions Among Breast and Gynecologic Cancer Survivors
AbstractPurpose of ReviewThe purpose of this narrative review was to highlight rehabilitation-relevant aspects of cancer treatment and primarily musculoskeletal impairments and rehabilitation interventions among women with breast and gynecologic cancers. For breast cancer, we reviewed post-mastectomy pain syndrome, upper quadrant dysfunction, aromatase inhibitor musculoskeletal syndrome (AIMSS), and lymphedema. For gynecologic cancers, pelvic floor dysfunction, lymphedema, and insufficiency fractures were selected.Recent FindingsThe recent breast cancer rehabilitation literature evaluates the pathophysiology of impairments...
Source: Current Physical Medicine and Rehabilitation Reports - May 22, 2020 Category: Rehabilitation Source Type: research

Female Athlete Triad
AbstractPurpose of ReviewThe Female Athlete Triad (Triad) is a disorder observed in women and girls composed of three related components: low energy availability (EA), menstrual dysfunction, and low bone mineral density (BMD). The purpose of this review is to define the components of the Triad, review risk factors and complications, and review the diagnosis and management of the effects of the Triad.Recent FindingsRecent research has defined guidelines for return to play for athlete with the Triad, which are summarized here. In addition, there has been recent vigorous debate and research in an attempt to define a related d...
Source: Current Physical Medicine and Rehabilitation Reports - May 15, 2020 Category: Rehabilitation Source Type: research

Interventional Treatment Options for Women with Pelvic Pain
AbstractPurpose of ReviewTo provide an overview of current interventional treatment options for women with chronic pelvic pain (CPP).Recent FindingsAccessibility of CT imaging, ultrasound, and fluoroscopy has assisted the development of novel interventional techniques. Similarly, neuromodulation techniques have improved with the development of novel stimulation patterns and device implants.SummaryNumerous small-scale studies report high success rates with injection intervention therapies in CPP, but there are limited well-designed large-scale studies that demonstrate the superiority of treatment. Female pelvic pain is diff...
Source: Current Physical Medicine and Rehabilitation Reports - May 13, 2020 Category: Rehabilitation Source Type: research

New Developments in Non-invasive Brain Stimulation in Chronic Pain
This article reviews the current evidence for the use of transcranial direct current (tDCS) and repetitive transcranial magnetic stimulation (rTMS) to improve outcomes in chronic pain. Finally, we introduce the reader to novel stimulation methods that may improve therapeutic outcomes in chronic pain.Recent FindingsWhile tDCS is approved for treatment of fibromyalgia in Canada and the European Union, no NIBS method is currently approved for chronic pain in the USA. Increasing sample sizes in randomized clinical trials (RCTs) seems the most efficient way to increase confidence in initial promising results. Trends at funding ...
Source: Current Physical Medicine and Rehabilitation Reports - May 10, 2020 Category: Rehabilitation Source Type: research

Chronic Pelvic Pain and the Chronic Overlapping Pain Conditions in Women
AbstractPurpose of ReviewThis paper aims to review chronic pelvic pain (CPP) in the context of the chronic overlapping pain conditions (COPC) in women.Recent findingsEarly literature on CPP focused on individual etiologies of pelvic pain independently and from the limited perspectives of separate medical subspecialties. Recently, there has been increasing recognition of the multifactorial nature of CPP, highlighting numerous overlapping etiologies with common central mechanisms. A link has been established between pelvic and extra-pelvic chronic pain conditions under the emerging construct of COPCs, with the degree of over...
Source: Current Physical Medicine and Rehabilitation Reports - May 7, 2020 Category: Rehabilitation Source Type: research