Severe Leg Pain Following Spinal Cord Stimulator Implantation – A Case Report
We present a case of immediate, severe, post-operative leg pain secondary to a lower extremity deep vein thrombosis (DVT) and subsequent pulmonary embolism (PE) after percutaneous SCS implantation for failed back syndrome. The risk factors of DVT after spine surgery and perioperative prophylaxis will be further discussed with a brief literature review. (Source: PM and R)
Source: PM and R - September 11, 2018 Category: Rehabilitation Authors: Weibin Shi, Shannon Schultz, David R. Gater Source Type: research
Popliteal Artery Entrapment Syndrome – Return to Sport Considerations: A Case Report
This is a case of a 19-year-old female collegiate field hockey player with left leg pain, numbness and tingling. A comprehensive workup including dynamic ultrasound, Magnetic Resonance Imaging (MRI) and Magnetic Resonance Angiogram (MRA) revealed a type VI functional popliteal artery entrapment syndrome (PAES). There are many options for treatment of functional PAES including activity modification, botulinum toxin injection, and surgery. To the authors knowledge there is no published return to sport recommendation for post-surgical functional PAES . (Source: PM and R)
Source: PM and R - September 11, 2018 Category: Rehabilitation Authors: Todd Hayano, Joan Borg-Stein, David J. Cormier, Niki Rybko Source Type: research
Treatment of Knee Meniscus Pathology: Rehabilitation, Surgery, and Orthobiologics
The meniscal tear treatment paradigm traditionally begins with conservative measures such as physical therapy with referral for operative management for persistent or mechanical symptoms. As a result, the partial meniscectomy is performed more than any other orthopedic procedure in the United States. This treatment paradigm has shifted as recent literature supports the attempt to preserve or repair the meniscus whenever possible given its importance for the structural integrity of the knee joint and the risk of early osteoarthritis associated after meniscus excision. (Source: PM and R)
Source: PM and R - September 6, 2018 Category: Rehabilitation Authors: Paul S. Chirichella, Steven Jow, Stephen Iacono, Hannah E. Wey, Gerard A. Malanga Source Type: research
Frequency and circumstances of falls reported by ambulatory unilateral lower limb prosthesis users: a secondary analysis
More than 50% of lower limb prosthesis (LLP) users report falling at least once a year, placing them at high risk for adverse health outcomes like reduced mobility and diminished quality-of-life. Efforts to reduce falls among LLP users have traditionally focused on developing clinical tests to assess fall risk, designing prosthetic components to improve patient safety, and identifying risk factors to recognize potential fallers. Little attention has been directed towards recording, reporting, and characterizing the circumstances of falls among LLP users. (Source: PM and R)
Source: PM and R - September 6, 2018 Category: Rehabilitation Authors: Janis Kim, Matthew J. Major, Brian Hafner, Andrew Sawers Source Type: research
A Descriptive Study of Self-Reported Injury in Non-elite Adaptive Athletes
Adaptive sports programs are increasing across the country and there is a paucity of research investigating the epidemiology and sports injury risk factors in non-elite athletes. (Source: PM and R)
Source: PM and R - September 6, 2018 Category: Rehabilitation Authors: Jennifer A. SooHoo, Erek Latzka, Mark A. Harrast Source Type: research
Bone Mineral Density among Individuals with Residual Lower Limb Weakness after Polio
Literature indicates that individuals with long-term residual lower extremity (LE) weakness after polio have decreased bone mineral density (BMD) deficiencies related to muscle weakness. Where weakness is asymmetrical, bone densitometry (BDt) measured only on the stronger LE may misclassify BMD. (Source: PM and R)
Source: PM and R - September 6, 2018 Category: Rehabilitation Authors: Beth Grill, Pamela Levangie, Maria Cole, Darren Rosenberg, Leah Jensen Source Type: research
Ankle joint and rearfoot biomechanics during toe-in and toe-out walking in people with medial compartment knee osteoarthritis
Toe-in and toe-out walking are two strategies which have been shown to be effective in reducing the knee adduction moment in people with knee osteoarthritis. However, despite a positive biomechanical impact on the knee, altering foot rotation may impart unintended forces or joint positions on the ankle that could impact joint health. The kinematic and kinetic changes at the ankle during toe-in or toe-out walking have yet to be examined. (Source: PM and R)
Source: PM and R - September 6, 2018 Category: Rehabilitation Authors: Jesse M. Charlton, Gillian L. Hatfield, Jordan A. Guenette, Michael A. Hunt Source Type: research
Is Technology for Orthostatic Hypotension Ready for Primetime?
Spinal cord injury (SCI) often results in the devastating loss of motor, sensory, and autonomic function. After SCI, the interruption of descending sympathoexcitatory pathways disrupts supraspinal control of blood pressure (BP). A common clinical consequence of cardiovascular dysfunction after SCI is orthostatic hypotension (OH), a debilitating condition characterized by rapid profound decreases in BP when assuming an upright posture. OH can result in a diverse array of insidious and pernicious health consequences. (Source: PM and R)
Source: PM and R - September 1, 2018 Category: Rehabilitation Authors: Zoe K. Sarafis, Aaron K. Monga, Aaron A. Phillips, Andrei V. Krassioukov Tags: Innovations Influencing Physical Medicine and Rehabilitation Source Type: research
Transcranial Direct Current Stimulation for Poststroke Motor Recovery: Challenges and Opportunities
There has been a renewed research interest in transcranial direct current stimulation (tDCS) as an adjunctive tool for poststroke motor recovery as it has a neuro-modulatory effect on the human cortex. However, there are barriers towards its successful application in motor recovery as several scientific issues remain unresolved, including device-related issues (ie, dose-response relationship, safety and tolerability concerns, interhemispheric imbalance model, and choice of montage) and clinical trial-related issues (ie, patient selection, timing of study, and choice of outcomes). (Source: PM and R)
Source: PM and R - September 1, 2018 Category: Rehabilitation Authors: Wuwei Feng, Steven A. Kautz, Gottfried Schlaug, Caitlyn Meinzer, Mark S. George, Pratik Y. Chhatbar Tags: Innovations Influencing Physical Medicine and Rehabilitation Source Type: research
Ethical Issues Surrounding a New Generation of Neuroprostheses for Patients With Spinal Cord Injuries
Traumatic spinal cord injury (SCI) is a significant life event, one that often defines a fixed time point: life before SCI and life after it. However, the rise of new neuroprostheses may introduce a new point to this timeline, one that could be as precise as the injury itself: the restoration of volitional movement and perhaps even sensation. Neuroprostheses offer possibilities that may forever change physical and psychological experiences after SCI. Yet it is important to balance excitement about these possibilities with consideration of the ethical dimensions of the study and use of these technologies. (Source: PM and R)
Source: PM and R - September 1, 2018 Category: Rehabilitation Authors: Ryan Solinsky, Laura Specker Sullivan Tags: Innovations Influencing Physical Medicine and Rehabilitation Source Type: research
Adaptation, Artificial Intelligence, and Physical Medicine and Rehabilitation
Adaptation, cooperation, and trust are at the center of rehabilitation. Artificial intelligence and robots enhance adaptation with guidance for movement, cues for sensation, control of environment, and improved situational awareness. That said, how do we decide to trust complex technologies that might seek personal information or control dangerous equipment? (Source: PM and R)
Source: PM and R - September 1, 2018 Category: Rehabilitation Authors: Daniel T. Barry Tags: Innovations Influencing Physical Medicine and Rehabilitation Source Type: research
Brain Computer Interfaces in Rehabilitation Medicine
One innovation currently influencing physical medicine and rehabilitation is brain –computer interface (BCI) technology. BCI systems used for motor control record neural activity associated with thoughts, perceptions, and motor intent; decode brain signals into commands for output devices; and perform the user’s intended action through an output device. BCI systems used for se nsory augmentation transduce environmental stimuli into neural signals interpretable by the central nervous system. Both types of systems have potential for reducing disability by facilitating a user’s interaction with the environment. (Source: PM and R)
Source: PM and R - September 1, 2018 Category: Rehabilitation Authors: Marcia A. Bockbrader, Gerard Francisco, Ray Lee, Jared Olson, Ryan Solinsky, Michael L. Boninger Tags: Innovations Influencing Physical Medicine and Rehabilitation Source Type: research
Exoskeleton and End-Effector Robots for Upper and Lower Limbs Rehabilitation: Narrative Review
Recovery of upper and lower limbs function is essential to reach independence in daily activities in patients with upper motor neuron syndrome (UMNS). Rehabilitation can provide a guide for motor recovery influencing the neurobiology of neuronal plasticity providing controlled, repetitive, and variable patterns. Increasing therapy dosage, intensity, number of repetition, execution of task-oriented exercises, and combining top-do wn and bottom-up approaches can promote plasticity and functional recovery. (Source: PM and R)
Source: PM and R - September 1, 2018 Category: Rehabilitation Authors: Franco Molteni, Giulio Gasperini, Giovanni Cannaviello, Eleonora Guanziroli Tags: Innovations Influencing Physical Medicine and Rehabilitation Source Type: research
Getting the Best Out of Advanced Rehabilitation Technology for the Lower Limbs: Minding Motor Learning Principles
Advanced technology, including gait-training devices, is increasingly being integrated into neurorehabilitation. However, to use gait-training devices to their optimal potential, it is important that they are applied in accordance with motor learning and locomotor training principles. In this article, we outline the most important principles and explain how advanced gait-training devices are best used to improve therapy outcome. (Source: PM and R)
Source: PM and R - September 1, 2018 Category: Rehabilitation Authors: Martina Rebekka Spiess, Frans Steenbrink, Alberto Esquenazi Tags: Innovations Influencing Physical Medicine and Rehabilitation Source Type: research
Wearable Movement Sensors for Rehabilitation: A Focused Review of Technological and Clinical Advances
Recent technologic advancements have enabled the creation of portable, low-cost, and unobtrusive sensors with tremendous potential to alter the clinical practice of rehabilitation. The application of wearable sensors to track movement has emerged as a promising paradigm to enhance the care provided to patients with neurologic or musculoskeletal conditions. These sensors enable quantification of motor behavior across disparate patient populations and emerging research shows their potential for identifying motor biomarkers, differentiating between restitution and compensation motor recovery mechanisms, remote monitoring, tel...
Source: PM and R - September 1, 2018 Category: Rehabilitation Authors: Franchino Porciuncula, Anna Virginia Roto, Deepak Kumar, Irene Davis, Serge Roy, Conor J. Walsh, Louis N. Awad Tags: Innovations Influencing Physical Medicine and Rehabilitation Source Type: research
