Autonomic dysreflexia as a potential adverse effect of duloxetine and amitriptyline combination therapy: A case report
We present a 31 year-old woman with T3 AIS A spinal cord injury who developed recurrent AD while receiving duloxetine and amitriptyline combination therapy for neuropathic pain. After excluding other AD generators, duloxetine was discontinued and the AD episodes resolved. While secondary hypertension is a known side effect of amitriptyline and duloxetine, neither drug has been previously associated with AD. One potential mechanism for inhibition of duloxetine metabolism is discussed. (Source: PM and R)
Source: PM and R - July 20, 2018 Category: Rehabilitation Authors: Sara C. Parke, Maria R. Reyes Source Type: research

Walking Stability During Normal Walking And Its Association With Slip Intensity Among Individuals With Incomplete Spinal Cord Injury
Ambulatory individuals with incomplete spinal cord injury (iSCI) experience frequent falls suggesting impairments in their balance control. Individuals with iSCI are more stable during normal walking as compared to able-bodied individuals; however, it is not known whether this increased stability helps prevent hazardous slips. (Source: PM and R)
Source: PM and R - July 20, 2018 Category: Rehabilitation Authors: Tarun Arora, Kristin E. Musselman, Joel Lanovaz, Gary Linassi, Catherine Arnold, Stephan Milosavljevic, Alison Oates Source Type: research

Regenerative Sports Medicine: Past, Present, and Future  (Adapted From the PASSOR Legacy Award Presentation; AAPMR; October 2016)
In 2008, the American Academy of Physical Medicine and Rehabilitation (AAPMR) fully integrated the Physiatric Association of Spine, Sports, and Occupational Rehabilitation (PASSOR) and established the PASSOR legacy award. AAPMR now takes the lead in education for its membership in musculoskeletal ultrasound and regenerative medicine. During the past decade, there has been an unprecedented increase in educational offerings, hands-on training, workshops, standalone courses, and most recently a 1-year ultrasound training curriculum and certificate that is available through the AAPMR. (Source: PM and R)
Source: PM and R - July 19, 2018 Category: Rehabilitation Authors: Joanne Borg-Stein, Hector Osoria, Todd Hayano Tags: Perspectives Source Type: research

Female office workers with moderate neck pain have increased anterior positioning of the cervical spine and stiffness of upper trapezius myofascial tissue in sitting posture
Work related neck disorders (WRNDs) are among the most common dysfunctions in office workers. Understanding cervical myofascial mechanical characteristics that differentiate symptomatic and asymptomatic office workers is crucial for the understanding of musculoskeletal dysfunctions in workers with neck pain. (Source: PM and R)
Source: PM and R - July 19, 2018 Category: Rehabilitation Authors: Piotr Kocur, Maciej Wilski, Jacek Lewandowski, Dawid Lochynski Source Type: research

Regenerative Sports Medicine: Past, Present and Future
(Source: PM and R)
Source: PM and R - July 19, 2018 Category: Rehabilitation Authors: Joanne Borg –Stein, Hector Osoria, Todd Hayano Source Type: research

Test-retest reliability of dynamic balance performance-based measures among adults with a unilateral lower-limb amputation
There is large variation in administration of performance-based, dynamic balance measures among adults with lower-limb amputation (LLA). Further, there has been limited exploration of test-retest reliability of these measures in adults with lower-limb loss, including whether there is a difference in reliability if one records ‘best’ versus ‘average’ performance across trials. (Source: PM and R)
Source: PM and R - July 19, 2018 Category: Rehabilitation Authors: Jefferson R. Cardoso, Emma H. Beisheim, John R. Horne, J. Megan Sions Source Type: research

Lumbar Stability in Healthy Individuals and Low Back Pain Patients Quantified by Wall Plank-and-Roll Test
Low back pain has been linked to the degree of lumbar stability, but evaluating lumbar stability has remained a challenge. A previous research has shown that inertial sensors could be used to quantify motor patterns during the wall plank-and-roll (WPR) test, and that low back pain may cause deviations in movement from the general motor patterns observed in healthy subjects. (Source: PM and R)
Source: PM and R - July 19, 2018 Category: Rehabilitation Authors: Joonnyong Lee, Chiyul Yoon, Keewon Kim, Minkyung Cho, Hee Chan Kim, Sun Gun Chung Source Type: research

Bone Marrow –Derived and Adipose-Derived Mesenchymal Stem Cell Therapy in Primary Knee Osteoarthritis: A Narrative Review
This article provides an overview of MSC-derived therapy and offers a comprehensive review of adipose- and bone marrow –derived MSC therapy in primary knee osteoarthritis OA. (Source: PM and R)
Source: PM and R - July 15, 2018 Category: Rehabilitation Authors: Prathap Jayaram, Uzoh Ikpeama, Joshua B. Rothenberg, Gerard A. Malanga Tags: Narrative Review Source Type: research

Proximal Iliotibial Band Syndrome in a Runner: A Case Report
We report a case of a 38-year-old female recreational runner with progressive lateral hip pain and magnetic resonance imaging findings of edema along the gluteal aponeurotic fascia and origin of the tensor fascia lata muscle consistent with the diagnosis of enthesopathy of the proximal iliotibial band. (Source: PM and R)
Source: PM and R - July 15, 2018 Category: Rehabilitation Authors: Gregory Decker, Devyani Hunt Tags: Case Presentation Source Type: research

Frequency and Characteristics of Recommendations from  Interdisciplinary Outpatient Cancer Rehabilitation Monthly Team Meetings
Ambulatory cancer rehabilitation programs vary widely in the types of services offered, and there is a lack of consistency with respect to the coordination of rehabilitation with oncologic treatment plans. There are no guidelines for outpatient interdisciplinary rehabilitation team meetings, and the types and characteristics of recommendations that a physiatrist can provide during these meetings have not been reported. (Source: PM and R)
Source: PM and R - July 15, 2018 Category: Rehabilitation Authors: Jegy M. Tennison, An Ngo-Huang, Jack B. Fu, Anissa E. Hill, Seyedeh S. Dibaj, Eduardo Bruera Tags: Original Research Source Type: research

Frequency and Characteristics of Recommendations from Interdisciplinary Outpatient Cancer Rehabilitation Monthly Team Meetings
Ambulatory cancer rehabilitation programs vary widely in the types of services offered, and there is a lack of consistency with respect to the coordination of rehabilitation with oncologic treatment plans. There are no guidelines for outpatient interdisciplinary rehabilitation team meetings, and the types and characteristics of recommendations that a physiatrist can provide during these meetings have not been reported. (Source: PM and R)
Source: PM and R - July 15, 2018 Category: Rehabilitation Authors: Jegy M. Tennison, An Ngo-Huang, Jack B. Fu, Anissa E. Hill, Seyedeh S. Dibaj, Eduardo Bruera Source Type: research

Proximal Iliotibial Band Enthesopathy in a Runner: A Case Report
We report a case of a 38 year-old female recreational runner with progressive lateral hip pain and MRI findings of edema along the gluteal aponeurotic fascia and origin of the tensor fascia lata muscle consistent with the diagnosis of enthesopathy of the proximal iliotibial band. (Source: PM and R)
Source: PM and R - July 15, 2018 Category: Rehabilitation Authors: Gregory Decker, Devyani Hunt Source Type: research

Interdisciplinary Pain Management Improves Pain and Function in Pediatric Patients with Chronic Pain Associated with Joint Hypermobility Syndrome
The relationship between chronic musculoskeletal pain and joint hypermobility in a small percentage of the pediatric population is well described. However, literature discussing the treatment of chronic pain associated with joint hypermobility in pediatrics is limited. The present study examines the impact of interdisciplinary treatment on chronic pain in pediatrics with joint hypermobility syndrome (JHS). (Source: PM and R)
Source: PM and R - July 15, 2018 Category: Rehabilitation Authors: Gadi Revivo, Diane K. Amstutz, Christine M. Gagnon, Zachary L. McCormick Source Type: research

Bone Marrow Derived and Adipose Derived Mesenchymal Stem Cell Therapy in Primary Knee Osteoarthritis: A Narrative Review
This article provides an overview of MSC derived therapy and offers a comprehensive review of Adipose and Bone Marrow derived MSC therapy in primary knee osteoarthritis OA. (Source: PM and R)
Source: PM and R - July 15, 2018 Category: Rehabilitation Authors: Prathap Jayaram, Uzoh Ikepeama, Joshua B. Rothenberg, Gerard A. Malanga Source Type: research

Quantifying and Reducing Retained Botulinum Toxin Postinjection
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 Tags: Original Research Source Type: research

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