Physical Medicine and Rehabilitation Clinics of North America This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Contributors
BLESSEN C. EAPEN, MD (Source: Physical Medicine and Rehabilitation Clinics of North America)
Source: Physical Medicine and Rehabilitation Clinics of North America - October 7, 2023 Category: Rehabilitation Source Type: research

Contents
Blessen C. Eapen (Source: Physical Medicine and Rehabilitation Clinics of North America)
Source: Physical Medicine and Rehabilitation Clinics of North America - October 7, 2023 Category: Rehabilitation Source Type: research

Forthcoming Issues
Disorders of Consciousness (Source: Physical Medicine and Rehabilitation Clinics of North America)
Source: Physical Medicine and Rehabilitation Clinics of North America - October 7, 2023 Category: Rehabilitation Source Type: research

Special Considerations in Behavioral Assessments for Disorders of Consciousness
Behavioral assessment remains the cornerstone of the clinical evaluation of disorders of consciousness (DoC). Because the basic approach to these evaluations has been extensively reviewed elsewhere, this article focuses on special considerations in the behavioral assessment of patients with a DoC. All therapy disciplines (physical therapy/occupational therapy/speech language pathologist) have a significant role to play and other staff and family members should also be encouraged to share their observations. Finally, the assessment with standardized scales should be supplemented by qualitative behavioral observations as wel...
Source: Physical Medicine and Rehabilitation Clinics of North America - September 2, 2023 Category: Rehabilitation Authors: Katherine O ’Brien, Bei Zhang, Elizabeth Anderl, Sunil Kothari Source Type: research

Top-Down and Bottom-Up Mechanisms of Motor Recovery Poststroke
Stroke remains a leading cause of disability. Motor recovery requires the interaction of top-down and bottom-up mechanisms, which reinforce each other. Injury to the brain initiates a biphasic neuroimmune process, which opens a window for spontaneous recovery during which the brain is particularly sensitive to activity. Physical activity during this sensitive period can lead to rapid recovery by potentiating anti-inflammatory and neuroplastic processes. On the other hand, lack of physical activity can lead to early closure of the sensitive period and downstream changes in muscles, such as sarcopenia, muscle stiffness, and ...
Source: Physical Medicine and Rehabilitation Clinics of North America - August 29, 2023 Category: Rehabilitation Authors: Preeti Raghavan Source Type: research

Neurostimulation After Stroke
This article explores its applications in upper and lower limb stroke rehabilitation. The authors review various methods to target the corticomotor system, including transcranial direct current stimulation, repetitive transcranial magnetic stimulation, and vagus nerve stimulation. In addition, the authors review the use of peripheral neuromuscular electrical stimulation for therapeutic and assistive purposes, including transcutaneous electrical nerve stimulation, neuromuscular electrical stimulation, and functional electrical stimulation. For each, the authors examine the potential benefits, limitations, safety considerati...
Source: Physical Medicine and Rehabilitation Clinics of North America - August 21, 2023 Category: Rehabilitation Authors: Hala Osman, Ricardo Siu, Nathan S. Makowski, Jayme S. Knutson, David A. Cunningham Source Type: research

Innovations in Stroke Recovery and Rehabilitation
Pain can be a significant barrier to a stroke survivors ’ functional recovery and can also lead to a decreased quality of life. Common pain conditions after stroke include headache, musculoskeletal pain, spasticity-related pain, complex regional pain syndrome, and central poststroke pain. This review investigates the evidence of diagnostic and manageme nt guidelines for various pain syndromes after stroke and identifies opportunities for future research to advance the field of poststroke pain. (Source: Physical Medicine and Rehabilitation Clinics of North America)
Source: Physical Medicine and Rehabilitation Clinics of North America - August 21, 2023 Category: Rehabilitation Authors: Juliet Zakel, John Chae, Richard D. Wilson Source Type: research

Dysphagia and Enteral Feeding After Stroke in the Rehabilitation Setting
Physiatrists play a vital role in post-stroke dysphagia management not only by providing guidance on the risks, benefits, and efficacy of various treatment options but also as advocates for patients ’ independence and quality of life. While swallow study results are often discussed broadly by acute stroke clinicians as “pass/fail” findings, physiatrists need a more nuanced working knowledge of dysphagia diagnosis and treatment that encompasses swallow pathophysiology, targeted treatment s trategies, and prognosis for recovery. To that end, this review summarizes current clinical practice guidelines on dysphagia, nutr...
Source: Physical Medicine and Rehabilitation Clinics of North America - August 17, 2023 Category: Rehabilitation Authors: Robynne G. Braun, Jodi Arata, Marlis Gonzalez-Fernandez Source Type: research

Technological Modalities in the Assessment and Treatment of Disorders of Consciousness
This article provides a comprehensive review of these modalities including the evidence supporting their potential use in DoC. This review specifically addresses diagnostic, non-invasive therapeutic, and invasive therapeutic technological modalities except for neuroimaging, which is discussed in another article. While technologic advances appear promising for both assessment and treatment of patients with a DoC, high-quality evidence supporting widespread clinical adoption remains limited. (Source: Physical Medicine and Rehabilitation Clinics of North America)
Source: Physical Medicine and Rehabilitation Clinics of North America - August 17, 2023 Category: Rehabilitation Authors: Gang Liu, Bradley Chi Source Type: research

Disorders of Consciousness
We are pleased to present this issue of Physical Medicine and Rehabilitation Clinics of North America on “Disorders of Consciousness” (DoC). There have been dramatic and exciting changes in the field of DoC in just the last several years. The number of publications on DoC, reflecting research as well as clinical experience, has exploded. There has also been much needed growth in the number of progr ams and facilities that provide rehabilitation services for these patients. Finally, several national specialty societies have released guidelines addressing the care of these patients, clinically as well as at an institutio...
Source: Physical Medicine and Rehabilitation Clinics of North America - August 17, 2023 Category: Rehabilitation Authors: Sunil Kothari, Bei Zhang Tags: Preface Source Type: research

Inpatient Rehabilitation Following Burn Injury
Inpatient rehabilitation confers excellent benefit to burn survivors and should be considered as a potential destination during discharge planning. Consulting physiatrists identify and manage complications within the inpatient rehabilitation setting. Interventions can be taken to address medical sequelae of injury, including pain, itch, neuropathy, psychological coping and mood, and nutritional needs. Physiatrists also oversee and direct a rehabilitation program focusing on scar management, contracture prevention, dysphagia treatment, and evaluation and treatment of cognitive impairments. Aerobic and resistive exercise are...
Source: Physical Medicine and Rehabilitation Clinics of North America - August 12, 2023 Category: Rehabilitation Authors: Maria Twichell Source Type: research

Telerehabilitation Following Stroke
Stroke remains a major cause of disability. Intensive rehabilitation therapy can improve outcomes, but most patients receive limited doses. Telehealth methods can overcome obstacles to delivering intensive therapy and thereby address this unmet need. A specific example is reviewed in detail, focused on a telerehabilitation system that targets upper extremity motor deficits after stroke. Strengths of this system include provision of daily therapy associated with very high patient compliance, safety and feasibility in the inpatient or home setting, comparable efficacy to dose-matched therapy provided in-clinic, and a holisti...
Source: Physical Medicine and Rehabilitation Clinics of North America - August 12, 2023 Category: Rehabilitation Authors: Steven C. Cramer, Brittany M. Young, Anne Schwarz, Tracy Y. Chang, Michael Su Source Type: research

Post Stroke Exercise Training
More intense, earlier exercise in rehabilitation results in improved motor outcomes following stroke. Timing and intensity of therapy delivery vary from study to study. For more intensive therapies, there are practical challenges in implementation. However, there are also opportunities for high intensity treatment through innovative approaches and new technologies. Timing of rehabilitation is important. As time post stroke increases, the dosage of therapy required to improve motor recovery outcomes increases. Very early rehabilitation may improve motor outcomes but should be delayed for at least 24  hours post stroke. (So...
Source: Physical Medicine and Rehabilitation Clinics of North America - August 12, 2023 Category: Rehabilitation Authors: Robert Teasell, Jamie L. Fleet, Amber Harnett Source Type: research

Pathophysiology, Assessment, and Management of Post-Stroke Cognitive Impairment, Depression, and Fatigue
We describe patient-reported outcome measures and clinician rating techniques that can be used to assist in screening and comprehensive assessment. We then discuss behavioral and pharmacologic management strategies. Heterogeneity of stroke remains a challenge in management and new research is still needed to optimize and personalize treatments for stroke survivors. (Source: Physical Medicine and Rehabilitation Clinics of North America)
Source: Physical Medicine and Rehabilitation Clinics of North America - August 12, 2023 Category: Rehabilitation Authors: Abhishek Jaywant, Alexandra Keenan Source Type: research

Burn Rehabilitation
The skin is the largest organ in the body and the main protective barrier against external stimuli. The skin is involved with regulation of body temperature, immunologic response, sensation, endocrine and exocrine activity, and other regulatory functions. The skin is the first barrier to the environment and can be susceptible to burn injuries caused by thermal, chemical, electrical, or radiation contact. Burn injuries can vary in severity from mild superficial burns to full-thickness burns. While superficial burns can often be treated in the outpatient setting, there is a subset of partial- or full-thickness burns that may...
Source: Physical Medicine and Rehabilitation Clinics of North America - August 12, 2023 Category: Rehabilitation Authors: Blessen C. Eapen Tags: Foreword Source Type: research