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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 of ...
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

Neuromodulation in Childhood Onset Dystonia: Evolving Role of Deep Brain Stimulation
AbstractPurpose of ReviewThis review will provide an update on the current status of deep brain stimulation in pediatric onset dystonias.Recent FindingsDystonia is a complex movement disorder that may occur in isolation or in combination with other abnormalities of tone and posture. The dystonias represent a heterogeneous group of movement disorders that can be progressive, painful, and severely disabling. Genetic and extrinsic factors may influence the treatment response. Pharmacologic treatment often has limited effectiveness and unacceptable, unwanted effects. Neuromodulation by deep brain stimulation (DBS) is a targete...
Source: Current Physical Medicine and Rehabilitation Reports - April 21, 2020 Category: Rehabilitation Source Type: research

Pelvic Floor Dysfunction in Women
AbstractPurpose of ReviewThe purpose of this review is to give an overview of pelvic floor muscle (PFM) dysfunction in women including evaluation, diagnosis, and treatment.Recent FindingsThe prevalence of PFM dysfunction is thought to be higher in women and may contribute to urinary, defecatory, and sexual dysfunction, as well as chronic pelvic pain.SummaryPFM dysfunction is more prevalent amongst athletes, women who have given birth, and postmenopausal women than the general population. Stress and urge incontinence, urinary frequency and urgency, functional constipation, and fecal incontinence are all symptoms that may re...
Source: Current Physical Medicine and Rehabilitation Reports - April 15, 2020 Category: Rehabilitation Source Type: research

Neuromodulation in Post-stroke Aphasia Treatment
AbstractPurpose of ReviewThis paper aims to review non-invasive brain stimulation (NIBS) methods to augment speech and language therapy (SLT) for patients with post-stroke aphasia.Recent FindingsIn the past 5  years, there have been more than 30 published studies assessing the effect of transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS) for improving aphasia in people who have had a stroke. Different approaches to NIBS treatment have been used in post-stroke aphas ia treatment including different stimulation locations, stimulation intensity, number of treatment sessions, outcome mea...
Source: Current Physical Medicine and Rehabilitation Reports - February 21, 2020 Category: Rehabilitation Source Type: research

Cerebellar Neuromodulation for Stroke
AbstractPurpose of ReviewThis paper reviews the current preclinical and clinical evidence for cerebellar deep brain stimulation for stroke rehabilitation.Recent FindingsWe have demonstrated the effectiveness of cerebellar stimulation for stroke rehabilitation in rodent models, which has been reproduced by other groups. Synaptogenesis, neurogenesis, and vicariation of function in the perilesional cortex likely contribute to the mechanistic underpinnings of the effectiveness of this therapy. A Phase I clinical trial investigating dentate nucleus stimulation for improvement of hemiparesis due to stroke is currently underway, ...
Source: Current Physical Medicine and Rehabilitation Reports - February 19, 2020 Category: Rehabilitation Source Type: research

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 20, 2020 Category: Rehabilitation Source Type: research