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.

Integrating Cardiac Rehabilitation in Stroke Recovery
Stroke remains a top contributor to long-term disability in the United States and substantially limits a person ’s physical activity. Decreased cardiovascular capacity is a major contributing factor to activity limitations and is a significant health concern. Addressing the cardiovascular capacity of stroke survivors as part of poststroke management results in significant improvements in their endurance, fu nctional recovery, and medical outcomes such as all-cause rehospitalization and mortality. Incorporation of a structured approach similar to the cardiac rehabilitation program, including aerobic exercise and risk fact...
Source: Physical Medicine and Rehabilitation Clinics of North America - August 11, 2023 Category: Rehabilitation Authors: Sara J. Cuccurullo, Talya K. Fleming, Hayk Petrosyan Source Type: research

Spasticity Treatment Beyond Botulinum Toxins
Botulinum toxin (BonT) is the mainstream treatment option for post-stroke spasticity. BoNT therapy may not be adequate in those with severe spasticity. There are a number of emerging treatment options for spasticity management. In this paper, we focus on innovative and revived treatment options that can be alternative or complementary to BoNT therapy, including phenol neurolysis, cryoneurolysis, and extracorporeal shock wave therapy. (Source: Physical Medicine and Rehabilitation Clinics of North America)
Source: Physical Medicine and Rehabilitation Clinics of North America - August 11, 2023 Category: Rehabilitation Authors: Sheng Li, Paul Winston, Manuel F. Mas Source Type: research

Emergence from Disorders of Consciousness
This article will provide an overview of language and communication deficits that can significantly confound the accuracy of diagnostic assessment in these patients. Authors will also discuss interventions to promote early communication using assistive technology and augmentative communication rehabilitation strategies. Finally, this article will discuss the importance of family education as well as ethical considerations connected to the recovery of communication and adaptive strategies to support patient autonomy and enhance self-agency. (Source: Physical Medicine and Rehabilitation Clinics of North America)
Source: Physical Medicine and Rehabilitation Clinics of North America - August 11, 2023 Category: Rehabilitation Authors: Brooke Murtaugh, Susan Fager, Tabatha Sorenson Source Type: research

Evaluation and Management of Disorders of Consciousness in the Acute Care Setting
Acute disorders of consciousness (DOC) are impairments in arousal and awareness that occur within 28  days of an initial injury and can result from a variety of insults. These states range from coma, unresponsive wakefulness, covert consciousness, minimal consciousness, to confusional state. It is important to perform thorough, serial examinations with particular emphasis on the level of conscious ness, brainstem reflexes, and motor responses. Evaluation of acute DOC includes laboratory tests, imaging, and electrophysiology testing. Prognostication in the acute phase of DOC must be done cautiously, using open, frequent co...
Source: Physical Medicine and Rehabilitation Clinics of North America - August 8, 2023 Category: Rehabilitation Authors: Ruth Tangonan, Christos Lazaridis Source Type: research

Health Care Disparities in Stroke Rehabilitation
This article conducted a literature review of original research articles published between 2008 and 2022. The article also expands on research that highlights stroke disparities in risk factors, rehabilitative stroke care, language barriers, outcomes for stroke survivors, and interventions focused on rehabilitative stroke disparities. (Source: Physical Medicine and Rehabilitation Clinics of North America)
Source: Physical Medicine and Rehabilitation Clinics of North America - August 2, 2023 Category: Rehabilitation Authors: Audrie A. Chavez, Kent P. Simmonds, Aardhra M. Venkatachalam, Nneka L. Ifejika Source Type: research

Innovations in Stroke Recovery and Rehabilitation
Despite improvements in acute stroke management, many stroke survivors remain with substantial disability. Efforts to more effectively harness the brain ’s plasticity and capacity for recovery have been gradually providing a more robust array of evidence to help guide practitioners. At the same time, new treatments, such as cryoneurolysis, are being incorporated into the management of long-term sequelae of stroke. In this special issue focusing on stroke rehabilitation, contributors review our current understanding of mechanisms involved in motor recovery and motor learning following stroke. (Source: Physical Medicine an...
Source: Physical Medicine and Rehabilitation Clinics of North America - August 2, 2023 Category: Rehabilitation Authors: Joan Stilling, Joel Stein Tags: Preface Source Type: research

Pharmacology in Treatment of Patients with Disorders of Consciousness
Pharmacologic treatment of disorders of consciousness remains a critical but challenging task for clinicians. Amantadine has been shown to promote the rate of neurologic recovery for patients with traumatic disorders of consciousness when administered between 4 and 16  weeks, as demonstrated by a well-designed randomized control trial. While there are no large, randomized controlled trials to support the use of other dopaminergic medicines (bromocriptine, levodopa, apomorphine), there is a large body of literature implicating their role in improving alertness an d responsiveness in disorders of consciousness. Zolpidem can...
Source: Physical Medicine and Rehabilitation Clinics of North America - August 1, 2023 Category: Rehabilitation Authors: Michael H. Marino Source Type: research

Factors Associated with the Rehabilitation of the Older Adult Burn Patient
The number of older people is increasing and as a result so will the number of older adult patients who present with a burn injury. There are distinct differences between older and younger burn patients, particularly with respect to skin anatomy and physiology and frailty. These are 2 important factors that influence the rehabilitation efforts with respect to older adult burn patients. There has been minimal work done studying the specific rehabilitation of older adult burn patients. More work is needed to fully understand the rehabilitation needs of older adult burn patients. (Source: Physical Medicine and Rehabilitation ...
Source: Physical Medicine and Rehabilitation Clinics of North America - August 1, 2023 Category: Rehabilitation Authors: Kathleen S. Romanowski Source Type: research

Burn Injury Complications Impacting Rehabilitation
This article reviews a range of potential challenges including burn scar contracture, amputation, peripheral nerve injury, heterotopic ossification, dysphagia, altered skin physiology, pain, and pruritis. The overall focus is to serve as a guide for post-injury therapy and rehabilitation spanning the phases of care and considering evidence-based approaches, prevention, and treatment with an ultimate goal of aiding in the functional recovery and long-term quality of life for burn survivors. (Source: Physical Medicine and Rehabilitation Clinics of North America)
Source: Physical Medicine and Rehabilitation Clinics of North America - July 28, 2023 Category: Rehabilitation Authors: Matthew Godleski, Miranda Yelvington, Stephanie Jean Source Type: research

Disorders of Consciousness
In this article, we discuss the taxonomy associated with the four major disorders of consciousness (DoC): coma, vegetative state or unresponsive wakefulness syndrome, minimally conscious state, and post-traumatic confusional state. We briefly review the history of each disorder and then provide operational definitions and diagnostic criteria for each one. We rely heavily on recently released practice guidelines and, where appropriate, identify knowledge gaps and discuss future directions to advance DoC research and practice. (Source: Physical Medicine and Rehabilitation Clinics of North America)
Source: Physical Medicine and Rehabilitation Clinics of North America - July 27, 2023 Category: Rehabilitation Authors: Katherine Golden, Yelena G. Bodien, Joseph T. Giacino Source Type: research

Assessment and Management of Acute Burn Injuries
Burn injuries can affect patients from all walks of life and represent a significant healthcare problem globally. The skin is the largest organ of the body and consequences of injury range of minor pain to severe end-organ dysfunction and even death. The acute assessment and management of burn-injured patients is a critical part of their short-term and long-term outcomes and often benefit from specialty, multidisciplinary care. Local wound care and appropriate excision and grafting are important parts of managing the functional, cosmetic, and physiologic derangements caused by burn injuries. Large burns also require judici...
Source: Physical Medicine and Rehabilitation Clinics of North America - July 27, 2023 Category: Rehabilitation Authors: Alison Haruta, Samuel P. Mandell Source Type: research

Conceptualizing Consciousness: a Change in Perspective
Providers of patients with disorders of consciousness (DoC) face clinical and ethical challenges that could be lessened by becoming acquainted with the subjective and objective aspects of consciousness. A first step to improving DoC taxonomies, management, and outcomes might be to recognize the shortcomings of the medical concept of consciousness and to improve the terminology used for the clinical parameters assessed. The authors critically review the medical perspective of consciousness represented by three sub-concepts that do not necessarily correlate with one another and discuss how none of them reflects fully the per...
Source: Physical Medicine and Rehabilitation Clinics of North America - July 27, 2023 Category: Rehabilitation Authors: Mariel Kalkach Aparicio, Christos Lazaridis Source Type: research

Medical, Neurologic, and Neuromusculoskeletal Complications
For patients with disorders of consciousness (DoC), treating the medical, neurologic, and neuromuscular complications not only stabilizes their medical disturbances, but minimizes confounding factors that may obscure the ability to accurately identify the level of consciousness and increase the chance of patients ’ neurologic and functional recovery. Lack of reliable communication and low-level function of patients with DoC make it challenging to diagnose some of the complications. Skilled clinical observation will be imperative to appropriately care for the patients. (Source: Physical Medicine and Rehabilitation Clinics of North America)
Source: Physical Medicine and Rehabilitation Clinics of North America - July 27, 2023 Category: Rehabilitation Authors: Jean E. Woo, Abana Azariah, Eboni A. Reed, Nicholas Gut Source Type: research

Technological Advances in Stroke Rehabilitation
Robotic technology and virtual reality (VR) have been widely studied technologies in stroke rehabilitation over the last few decades. Both technologies have typically been considered as ways to enhance recovery through promoting intensive, repetitive, and engaging therapies. In this review, we present the current evidence from interventional clinical trials that employ either robotics, VR, or a combination of both modalities to facilitate post-stroke recovery. Broadly speaking, both technologies have demonstrated some success in improving post-stroke outcomes and complementing conventional therapy. However, more high-quali...
Source: Physical Medicine and Rehabilitation Clinics of North America - July 27, 2023 Category: Rehabilitation Authors: Deepthi Rajashekar, Alexa Boyer, Kelly A. Larkin-Kaiser, Sean P. Dukelow Source Type: research

Early Mobilization, Early Ambulation, and Burn Therapy in the Acute Hospital Setting
Rehabilitation therapies in the burn acute care environment continue to evolve. Immediate access to therapy is considered standard, and therapy is a key component of the transprofessional care team. Early positioning, edema management, and therapy care in the intensive care unit (ICU) environment can limit later complications; mobility in the ICU can be engaged safely using a systems-based approach in the absence of nondirectable agitation. Later in the course of acute care, early ambulation is an appropriate intervention that can improve outcomes. (Source: Physical Medicine and Rehabilitation Clinics of North America)
Source: Physical Medicine and Rehabilitation Clinics of North America - July 27, 2023 Category: Rehabilitation Authors: Audrey O ’Neil, Danika Hines, Emily Wirdzek, Cody Thornburg, Derek Murray, John Porter Source Type: research