Dextromethorphan/Quinidine for Pseudobulbar Affect Following Stroke: Safety and Effectiveness in the PRISM II Trial
Dextromethorphan (DM)/quinidine (Q) was approved for pseudobulbar affect (PBA) treatment based upon efficacy and safety trials in patients with PBA secondary to amyotrophic lateral sclerosis or multiple sclerosis. The PRISM II trial evaluated DM/Q as PBA treatment in patients with stroke, dementia or traumatic brain injury. (Source: PM and R)
Source: PM and R - July 2, 2018 Category: Rehabilitation Authors: Richard D. Zorowitz, David N. Alexander, Andrea E. Formella, Fred Ledon, Charles Davis, Joao Siffert Source Type: research

Botulinum toxin: Techniques within pediatric physiatry
Intramuscular botulinum toxin injections are utilized for treatment of focal spasticity in children, particularly in those with a diagnosis of cerebral palsy. There are a variety of techniques used when performing botulinum toxin injections without clear standards for pediatric providers. (Source: PM and R)
Source: PM and R - July 2, 2018 Category: Rehabilitation Authors: Andrea Paulson, Christina K. Zigler, Amy Houtrow, David Pruitt Source Type: research

Cardiovascular Risk Factors Among Older Adults With Long-Term Spinal Cord Injury
Individuals with spinal cord injury (SCI) now live longer, which increases the risk of cardiovascular disease. Knowledge of cardiovascular risk factors amenable to intervention are therefore needed to support their healthy aging. (Source: PM and R)
Source: PM and R - July 2, 2018 Category: Rehabilitation Authors: Sophie J örgensen, Mattias Hill, Jan Lexell Source Type: research

Predictors of Performance on the American Board of Physical Medicine and Rehabilitation Maintenance of Certification Examination
Maintenance of certification (MOC) in Physical Medicine and Rehabilitation is a process of lifelong learning which begins after successfully completing an Accreditation Council of Graduate Medical Education (ACGME) accredited residency and passing the American Board of Physical Medicine and Rehabilitation (ABPMR) Part I and Part II Examinations. We seek to identify factors predictive of successful MOC Examination performance. (Source: PM and R)
Source: PM and R - July 2, 2018 Category: Rehabilitation Authors: Sherilyn W. Driscoll, Carolyn C. Geis, Mikaela M. Raddatz, Carolyn L. Kinney, Lawrence R. Robinson Source Type: research

Quantifying and reducing retained botulinum toxin post-injection
Retained botulinum toxin solution may be visible in vials and syringe tips after mixing and presumed complete injections, leaving patients without the full prescribed dose. (Source: PM and R)
Source: PM and R - July 2, 2018 Category: Rehabilitation Authors: Ryan Solinsky, Steven C. Kirshblum, Steven C. Kirshblum Source Type: research

Safety Considerations in Prescription of NSAIDs for Musculoskeletal Pain: A Narrative Review
Non-steroidal anti-inflammatory drugs (NSAIDs) are frequently prescribed for the treatment of painful musculoskeletal conditions. When prescribing oral NSAIDs, clinicians must consider coexisting cardiovascular, cerebrovascular, gastrointestinal and renal disease as oral NSAIDs are associated with a broad spectrum of adverse effects on these systems. The varying safety profiles of NSAIDs can be attributed to differences in the extent to which the drug inhibits cyclooxygenase (COX)-1 versus COX-2 and their potential for drug-drug interactions. (Source: PM and R)
Source: PM and R - July 2, 2018 Category: Rehabilitation Authors: Katie M. Hatt, Anita Vijapura, Ian Maitin, Ernesto Cruz Source Type: research

Pregnancy Results in Lasting Changes in Knee Joint Laxity
Altered joint laxity may contribute to joint dysfunction. Knee joint laxity has been shown to increase during pregnancy, but its long-term persistence is unknown. (Source: PM and R)
Source: PM and R - July 2, 2018 Category: Rehabilitation Authors: Stacey R. Chu, Elizabeth H. Boyer, Bruce Beynnon, Neil A. Segal Source Type: research

Can a brief training session prepare physician sonographers of differing experience to measure the ischiofemoral space? A reliability study
The primary aim of this study was to determine the inter-rater and intra-rater reliability of ultrasound (US) measurements of the ischiofemoral space (IFS) following a brief training session. A secondary aim was to determine if reliability correlated with sonographer experience. (Source: PM and R)
Source: PM and R - July 2, 2018 Category: Rehabilitation Authors: Brennan J. Boettcher, John H. Hollman, Jeffrey M. Payne, Adam C. Johnson, Jonathan T. Finnoff Source Type: research

The Suicidal Outpatient: Balancing Autonomy, Trust, and Responsibilities
The intersection where mental health and rehabilitation care converge can raise ethical questions involving boundaries, duties, and perhaps more importantly, our role in recovery, adjustment, and flourishing. The patient with a stroke-related depression is one prototypical example. We know that damage to specific parts of the brain can cause depressive symptomatology as well as the fact that the adjustment process during rehabilitation itself can impact well-being and a sense of self-efficacy. In this column, we explore a case of when a patient becomes severely depressed and suicidal and expresses this ideation during an o...
Source: PM and R - July 1, 2018 Category: Rehabilitation Authors: Elizabeth E. Sita, R. Brett Lloyd, Lynne C. Brady Wagner, Vu Q.C. Nguyen, Eric Swirsky, Debjani Mukherjee Tags: Ethical Legal Feature Source Type: research

Editorial Board
(Source: PM and R)
Source: PM and R - July 1, 2018 Category: Rehabilitation Source Type: research

Table of Contents
(Source: PM and R)
Source: PM and R - July 1, 2018 Category: Rehabilitation Source Type: research

Academy News – July PM & R
As the primary medical society for the specialty of PM&R, your Academy is focused on moving the specialty and you forward. Our mission is to lead the advancement of physiatry ’s impact throughout health care. Your Academy will ensure that: (Source: PM and R)
Source: PM and R - July 1, 2018 Category: Rehabilitation Tags: Departments Source Type: research

Information for Authors
(Source: PM and R)
Source: PM and R - July 1, 2018 Category: Rehabilitation Source Type: research

Copyright Page
(Source: PM and R)
Source: PM and R - July 1, 2018 Category: Rehabilitation Source Type: research

Spanish Translated Abstracts
(Source: PM and R)
Source: PM and R - July 1, 2018 Category: Rehabilitation Tags: Translated Abstracts Source Type: research

ABPMR Certification Exams
On September 9, 2017, the American Board of Physical Medicine and Rehabilitation (ABPMR), in conjunction with the American Board of Anesthesiology (ABA), administered the examination for the subspecialty of pain medicine. The following individuals were certified: (Source: PM and R)
Source: PM and R - July 1, 2018 Category: Rehabilitation Tags: Departments Source Type: research

Correlation of Measurements of the Prearthritic Hip Between Plain Radiography and Computed Tomography
Previous studies have compared radiographic and computed tomography (CT) imaging for the evaluation of prearthritic hip pain. However, the intermodality, interrater, and intrarater consistencies of those parameters have not been investigated. (Source: PM and R)
Source: PM and R - June 19, 2018 Category: Rehabilitation Authors: Mary E. Air, Julian R. Harrison, Joseph T. Nguyen, Bryan T. Kelly, Eric A. Bogner, Peter J. Moley Tags: Original Research Source Type: research

Phenol Neurolysis for the Management of Shoulder Spasticity in Early Recovery From Traumatic Brain Injury —A Case Report
This case describes a 16-year-old boy who suffered a severe traumatic brain injury. The patient gradually recovered but developed debilitating spasticity mainly in left triceps muscle, abnormal positioning of shoulder girdle complex, and shoulder pain. Phenol (6%) was injected to axillary and radial nerves under the guidance of electrical stimulation and ultrasound imaging at 10 weeks after the initial injury. After injection, triceps spasticity and shoulder pain were immediately reduced, and abnormal positions of shoulder girdle complex and elbow joint gradually returned to functional limits over 2 weeks. (Source: PM and R)
Source: PM and R - June 19, 2018 Category: Rehabilitation Authors: Manuel F. Mas, Craig DiTommaso, Sheng Li Tags: Case Presentation Source Type: research

Correlation of Measurements of the Pre-arthritic Hip between Plain Radiography and Computed Tomography
Prior studies have compared radiographic and computed tomography (CT) imaging for evaluation of pre-arthritic hip pain. However, the inter-modality, inter-rater, and intra-rater consistencies of those parameters have not been investigated. (Source: PM and R)
Source: PM and R - June 19, 2018 Category: Rehabilitation Authors: Mary E. Air, Julian R. Harrison, Joseph T. Nguyen, Bryan T. Kelly, Eric A. Bogner, Peter J. Moley Source Type: research

Phenol neurolysis for management of shoulder spasticity in early recovery from traumatic brain injury – a case report
This case describes a 16-year-old boy who suffered a severe traumatic brain injury. The patient gradually recovered but developed debilitating spasticity mainly in left triceps muscle, abnormal positioning of shoulder girdle complex, and shoulder pain. Phenol (6%) was injected to axillary and radial nerves under guidance of electrical stimulation and ultrasound imaging at 10 weeks after initial injury. After injection, triceps spasticity and shoulder pain was immediately reduced and abnormal positions of shoulder girdle complex and elbow joint gradually returned to functional limits over 2 weeks. (Source: PM and R)
Source: PM and R - June 19, 2018 Category: Rehabilitation Authors: Manuel F. Mas, Craig DiTommaso, Sheng Li Source Type: research

The Rehabilitation of Advanced Heart Failure Patients after Left Ventricular Assist Device: A Narrative Review
As an increasing number of patients with advanced heart failure are receiving a Left Ventricular Assist Device (LVAD) as either destination therapy or bridge to transplantation, there is increasing attention on functional outcomes and quality of life after LVAD implantation. Rehabilitation providers in the acute inpatient rehabilitation setting increasingly will treat patients with LVAD and should understand the exercise physiology, medical management, rehabilitation considerations, and outcomes after rehabilitation for patients with LVAD. (Source: PM and R)
Source: PM and R - June 18, 2018 Category: Rehabilitation Authors: Sarah M. Eickmeyer, Kim D. Barker, Anjum Sayyad, Leslie Rydberg Source Type: research

Diminished Kinesthetic and Visual Motor Imagery Ability in Adults With Chronic Low Back Pain: Mental Task and Chronic Low Back Pain
Low back pain (LBP) is the most prevalent musculoskeletal problem among adults. It has been observed that patients with chronic pain have maladaptive neuroplastic changes and difficulty in imagination processes. (Source: PM and R)
Source: PM and R - June 14, 2018 Category: Rehabilitation Authors: Roy La Touche, M ónica Grande-Alonso, Ferran Cuenca-Martínez, Luis Gónzalez-Ferrero, Luis Suso-Martí, Alba Paris-Alemany Tags: Original Research Source Type: research

Diminished kinesthetic and visual motor imagery ability in adults with chronic low back pain
Low back pain (LBP) is the most prevalent musculoskeletal problem among adults. It has been observed that patients with chronic pain have maladaptive neuroplastic changes and difficulty in imagination processes. (Source: PM and R)
Source: PM and R - June 14, 2018 Category: Rehabilitation Authors: Roy La Touche, M ónica Grande-Alonso, Ferran Cuenca-Martínez, Luis Gónzalez-Ferrero, Luis Suso-Martí, Alba Paris-Alemany Source Type: research

Congenital Partial Aplasia of the Atlas Causing Functional Angular Displacement of the Posterior Arch
(Source: PM and R)
Source: PM and R - June 14, 2018 Category: Rehabilitation Authors: Lance M. Mabry, Michael D. Ross, Sonja I. Dardenelle Source Type: research

Sonographically Guided Plantaris Tendon Release: A Cadaveric Validation Study
The plantaris tendon (PT) has been implicated in the pathogenesis of symptoms in a subset of patients with Achilles region pain syndromes and has been traditionally managed via open surgical resection. Although the PT can be visualized on ultrasound, a minimally invasive technique for sonographically guided PT release has not been formally described. (Source: PM and R)
Source: PM and R - June 13, 2018 Category: Rehabilitation Authors: Jay Smith, H åkan Alfredson, Lorenzo Masci, Jacob L. Sellon, Charonn D. Woods Source Type: research

Football Participation and Chronic Traumatic Encephalopathy
A 13-year-old male athlete presents to the clinic with his parents for a preparticipation physical examination. The athlete has participated in soccer, baseball, and track in the past but is very interested in joining the football team this year. His parents are hesitant for him to participate in football because they have heard about a brain injury in football players called chronic traumatic encephalopathy (CTE). They would like your advice regarding whether their child should avoid football due to the risk of developing CTE. (Source: PM and R)
Source: PM and R - June 1, 2018 Category: Rehabilitation Authors: Scott R. Laker, Christine Greiss, Jonathan T. Finnoff, Jaspal R. Singh Tags: Point/Counterpoint Source Type: research

Editorial Board
(Source: PM and R)
Source: PM and R - June 1, 2018 Category: Rehabilitation Source Type: research

Table of Contents
(Source: PM and R)
Source: PM and R - June 1, 2018 Category: Rehabilitation Source Type: research

Academy News – June PM & R
As the primary medical society for the specialty of PM&R, your Academy is focused on moving the specialty and you forward. Our mission is to lead the advancement of physiatry ’s impact throughout health care. Your Academy will ensure that: (Source: PM and R)
Source: PM and R - June 1, 2018 Category: Rehabilitation Tags: Departments Source Type: research

Information for Authors
(Source: PM and R)
Source: PM and R - June 1, 2018 Category: Rehabilitation Source Type: research

Copyright Page
(Source: PM and R)
Source: PM and R - June 1, 2018 Category: Rehabilitation Source Type: research

Spanish Translated Abstracts
(Source: PM and R)
Source: PM and R - June 1, 2018 Category: Rehabilitation Tags: Translated Abstracts Source Type: research

Validity, Reliability, and Responsiveness of the Spanish Version of the OPTIMAL Instrument
The Outpatient Physical Therapy Improvement in Movement Assessment Log (OPTIMAL) is a self-report instrument developed to measure the ability to perform mobility actions. (Source: PM and R)
Source: PM and R - May 31, 2018 Category: Rehabilitation Authors: Arrate Pinto-Carral, Tania Fern ández-Villa, Andrew A. Guccione, Federico Montero Cuadrado, José M Cancela, Antonio José Molina Tags: Original Research Source Type: research

Aphonogelia After Recovery From Severe Traumatic Brain Injury: A Case Report
During rehabilitation from a severe traumatic brain injury, a 16-year-old girl became aware that she had lost the ability to laugh out loud. This rare phenomenon previously has been described as “aphonogelia.” A discussion of therapeutic avenues that were explored with this patient is presented and is the first case, to our knowledge, of aphonogelia after a traumatic brain injury. (Source: PM and R)
Source: PM and R - May 31, 2018 Category: Rehabilitation Authors: Scott A. McLeod, Alva Lam, Adam Spencer, Xing-Chang Wei, Vithya Gnanakumar Tags: Case Presentation Source Type: research

A Case Report of Aphonogelia following Recovery from Severe Traumatic Brain Injury
During rehabilitation from a severe traumatic brain injury, a 16-year-old woman became aware that she had lost the ability to laugh out loud. This rare phenomenon has previously been described as “aphonogelia.” A discussion of therapeutic avenues which were explored with this patient is the first case, to our knowledge, of aphonogelia following a traumatic brain injury is presented. (Source: PM and R)
Source: PM and R - May 31, 2018 Category: Rehabilitation Authors: Scott A. McLeod, Alva Lam, Adam Spencer, Xing-Chang Wei, Vithya Gnanakumar Source Type: research

Septic Sacroiliitis in a 53-year-old Adult: A Case Report
A 53-year-old female with no significant past medical history presented with 10/10 right buttock pain that radiated to the right groin. With no reported recent injury, the absence of fever, and no identifiable risk factors, an infectious etiology including septic sacroiliitis is at the end spectrum of the differential. Septic sacroiliitis (SSI) is a rare condition with nonspecific findings that can lead to major complications, including death. To our knowledge, there are only four recent major literature reviews on SSI, with most cases reported to have at least one risk factor or clinical sign indicating the possibility of...
Source: PM and R - May 31, 2018 Category: Rehabilitation Authors: Jesse Lou, Eric B. Smith, Michael J. Mehnert, Jeremy I. Simon Source Type: research

Validity, reliability and responsiveness of the Spanish version of the OPTIMAL instrument
The Outpatient Physical Therapy Improvement in Movement Assessment Log (OPTIMAL) is a self-report instrument developed to measure the ability to perform mobility actions. (Source: PM and R)
Source: PM and R - May 31, 2018 Category: Rehabilitation Authors: Arrate Pinto-Carral., Tania Fern ández-Villa., Andrew A. Guccione., Federico Montero Cuadrado., José M Cancela, Antonio José Molina. Source Type: research

Cytotoxic Effects of Nonionic Iodinated Contrast Agent on Human Adipose-derived Mesenchymal Stem Cells
Transplantation of mesenchymal stem cells (MSCs) is a promising therapy for degenerative spine conditions. However, cell therapy for painful spine degeneration presently requires use of contrast agents during fluoroscopy-guided injections and the effects of these agents on MSCs represents a gap in knowledge. (Source: PM and R)
Source: PM and R - May 31, 2018 Category: Rehabilitation Authors: Tao Wu, Hai Nie, Allan B. Dietz, David R. Salek, Jay Smith, Andre J. van Wijnen, Wenchun Qu Source Type: research

Early Clinical Outcomes of Intra-Articular Injections of Bone Marrow Aspirate Concentrate for the Treatment of Early Osteoarthritis of the Hip, and Knee: A Cohort Study
Bone marrow aspirate concentrate (BMC) is one of the few cell-based therapies available as a possible biological treatment for early osteoarthritis (OA). Its efficacy, safety, and benefit compared with other treatments are still to be determined. (Source: PM and R)
Source: PM and R - May 29, 2018 Category: Rehabilitation Authors: Francisco Rodriguez-Fontan, Nicolas S. Piuzzi, Matthew J. Kraeutler, Cecilia Pascual-Garrido Tags: Original Research Source Type: research

Postneedling soreness and tenderness after different dosages of dry needling of an active myofascial trigger point in patients with neck pain: a randomised controlled trial
Previous studies in asymptomatic subjects have demonstrated that myofascial trigger point (MTrP) dry needling is frequently associated with postneedling soreness. However, to the author ’s knowledge, there is not any study that performs a detailed description of postneedling soreness characteristics in patients with myofascial pain. This information could help clinicians to make evidence-informed decisions considering the benefits and negative effects of different dry needling do sages. (Source: PM and R)
Source: PM and R - May 29, 2018 Category: Rehabilitation Authors: Aitor Mart ín-Pintado-Zugasti, Josué Fernández-Carnero, Jose Vicente León-Hernández, Cesar Calvo Lobo, Hector Beltrán Alacreu, Isabel Alguacil-Diego, Tomás Gallego-Izquierdo, Daniel Pecos-Martin Source Type: research

Early Clinical Outcomes of Intraarticular Injections of Bone Marrow Aspirate Concentrate for the Treatment of Early Osteoarthritis of the Hip and Knee: A Cohort Study
Bone marrow aspirate concentrate (BMC) is one of the few cell-based therapies available as a possible biological treatment for early osteoarthritis (OA). Its efficacy, safety, and benefit compared with other treatments are still to be determined. (Source: PM and R)
Source: PM and R - May 29, 2018 Category: Rehabilitation Authors: Francisco Rodriguez-Fontan, Nicolas S. Piuzzi, Matthew J. Kraeutler, Cecilia Pascual-Garrido Source Type: research

Risk Factors for Thirty-Day Readmissions After Lower Extremity Amputation in Patients With Vascular Disease
Understanding risk factors associated with readmission after lower extremity amputation may indicate targets for reducing readmission. (Source: PM and R)
Source: PM and R - May 28, 2018 Category: Rehabilitation Authors: Todd R. Vogel, Jamie B. Smith, Robin L. Kruse Tags: Original Research Source Type: research

Evaluation of the Combined Application of Neuromuscular Electrical Stimulation and Volitional Contractions on Thigh Muscle Strength, Knee Pain and Physical Performance in Women at Risk for Knee Osteoarthritis: A Randomized Controlled Trial
Knee osteoarthritis (OA) is a leading cause of disability that is associated with quadriceps weakness. However, strengthening in people with or with risk factors for knee OA can be poorly tolerated. (Source: PM and R)
Source: PM and R - May 28, 2018 Category: Rehabilitation Authors: Kaitlin G. Rabe, Hiroo Matsuse, Anthony Jackson, Neil A. Segal Source Type: research

Risk Factors for Thirty-Day Readmissions Following Lower-Extremity Amputation in Patients with Vascular Disease
Understanding risk factors associated with readmission after lower extremity amputation may indicate targets for reducing readmission. (Source: PM and R)
Source: PM and R - May 28, 2018 Category: Rehabilitation Authors: Todd R. Vogel, Jamie B. Smith, Robin L. Kruse Source Type: research

The Feasibility of Blood Flow Restriction Exercise in Patients With Incomplete Spinal Cord Injury
Blood flow restriction (BFR) exercise, which already has shown promise in the able-bodied population, may be a novel method for improving muscle function in the incomplete spinal cord injury (iSCI) population. However, the feasibility and tolerance for BFR exercise in this population is unknown. (Source: PM and R)
Source: PM and R - May 23, 2018 Category: Rehabilitation Authors: Jon Stavres, Tyler J. Singer, Amber Brochetti, Martin Kilbane, Steven Brose, John McDaniel Tags: Original Research Source Type: research

The Feasibility of Blood Flow Restriction Exercise in Incomplete Spinal Cord Injured Patients
Blood flow restriction (BFR) exercise, which has already shown promise in the able-bodied population, may be a novel method for improving muscle function in the incomplete spinal cord injury (iSCI) population. However, the feasibility and tolerance for BFR exercise in this population is unknown. (Source: PM and R)
Source: PM and R - May 23, 2018 Category: Rehabilitation Authors: Jon Stavres, Tyler J. Singer, Amber Brochetti, Martin Kilbane, Steven Brose, John McDaniel Source Type: research

Motor Retraining (MoRe) for Functional Movement Disorders: Outcomes From a 1-Week Multidisciplinary Rehabilitation Program
This study reports patient outcomes from a multidisciplinary FMD treatment program using motor retraining (MoRe) strategies. (Source: PM and R)
Source: PM and R - May 18, 2018 Category: Rehabilitation Authors: Alexandra Jacob, Darryl Kaelin, Abbey Roach, Craig Ziegler, Kathrin LaFaver Tags: Original Research Source Type: research

Percent Differences: Another Look
This article discusses 3 common measures of comparison (absolute difference, ratio, and percent difference [PD]), explores the advantages and disadvantages of each, introduces a less-common measure called symmetrized percent change, and explains how it overcomes some of the disadvantages of the other measures. (Source: PM and R)
Source: PM and R - May 18, 2018 Category: Rehabilitation Authors: Regina Nuzzo Tags: Statistically Speaking Source Type: research

Safe Needle Approach for Examination of the Rhomboid Major
Safe and accurate needle access to the rhomboid major (RM) during electromyography is challenging due to the overlying trapezius muscle and the risk of pneumothorax. (Source: PM and R)
Source: PM and R - May 18, 2018 Category: Rehabilitation Authors: Ki Hoon Kim, Goo Young Kim, Seong Gyu Lim, Byung Kyu Park, Dong Hwee Kim Source Type: research

Participation in Daily Life: Influence on Quality of Life in Ambulatory Children with Cerebral Palsy
Cerebral palsy is a chronic condition which affects children and has an impact on social and physical activity, as well as participation in daily life. Participation and quality of life are two important measures of successful rehabilitation that have not been well studied in children with cerebral palsy. (Source: PM and R)
Source: PM and R - May 18, 2018 Category: Rehabilitation Authors: Jaclyn Omura, Molly Fuentes, Kristie Bjornson Source Type: research