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Total 227 results found since Jan 2013.

Balancing Burdens and Benefits: Ethical Issues of Off-Label Prescription Pharmaceutical Use
I remember when Botox (Allergen, Irvine, CA) was becoming all the rage in rehabilitation in the mid 1990s. As I recall, the only U.S. Food and Drug Administration (FDA) approved uses at the time were for spasmodic torticollis and blepharospasm. In a short period of time, however, Botox was the new treatment du jour for adults and children alike with spasticity from CP, traumatic brain injury (TBI), and stroke. I also remember feeling a bit queasy about it. Perhaps having recently completed a fellowship in clinical medical ethics colored my view. Images of thousands of people with limb deficiencies, the tragic consequence ...
Source: PM and R - October 1, 2013 Category: Rehabilitation Authors: Ford Vox, Alexander M. Capron, Marilyn F. Kraus, G. Caleb Alexander, Kristi L. Kirschner Tags: Ethical Legal Source Type: research

Perceptions of Inpatient Rehabilitation Changes After the Centers for Medicare and Medicaid Service 2010 Regulatory Updates Contrasted With Actual Performance
Conclusion: Comparison with actual data identified that gaps exist between diagnostic category perceptions and actual diagnostic category admission performance. Regulations such as the 75%-60% rule and audit focus on non-neurologic conditions as well as actual inpatient rehabilitation facility program payment reports may have influenced respondents perceptions to change associated with the Medicare Benefit Policy Manual modifications. This disparity between perception and actual data may have implications for programmatic planning, forecasting, and resource allocation.
Source: PM and R - August 26, 2013 Category: Rehabilitation Authors: Richard V. Riggs, Pamela S. Roberts, Margaret A. DiVita, Paulette Niewczyk, Carl V. Granger Tags: Original Research Source Type: research

Risk Factors for Discharge to an Acute Care Hospital From Inpatient Rehabilitation Among Stroke Patients
Conclusion: Based on this research, we identified specific medical and functional health risk factors in the stroke population that affect the rate of discharge to an acute-care hospital. With active medical and functional management, early identification of these critical components may lead to the prevention of stroke patients from being discharged to an acute-care hospital from the inpatient rehabilitation setting.
Source: PM and R - August 26, 2013 Category: Rehabilitation Authors: Pamela S. Roberts, Margaret A. DiVita, Richard V. Riggs, Paulette Niewczyk, Brittany Bergquist, Carl V. Granger Tags: Original Research Source Type: research

Initial Physical Grades and Cognitive Stages After Acute Stroke: Who Receives Comprehensive Rehabilitation Services?
Conclusions: Patients' physical grades and cognitive stages assessed early after stroke are strong determinants of referral for comprehensive rehabilitation.
Source: PM and R - August 26, 2013 Category: Rehabilitation Authors: Margaret G. Stineman, Barbara E. Bates, Jibby E. Kurichi, Pui L. Kwong, Diane Cowper Ripley, W. Bruce Vogel, Dawei Xie Tags: Original Research Source Type: research

Physical Activity in Community-Dwelling Stroke Survivors and a Healthy Population Is Not Explained by Motor Function Only
Objectives: To explore the relationship between self-reporting and physical measures and compare self-reported physical activity (PA) levels in persons who have had a stroke with self-reported PA levels in a control population.Design: Cross-sectional assessment of a convenience sample of survivors of a stroke living in the community and a population-based sample from the same community.Setting: University hospital.Participants: Seventy persons (48 men and 22 women; average age, 60 years) who had a stroke a mean of 6 years earlier and 141 persons (70 men and 71 women; average age, 59 years) who served as control subjects....
Source: PM and R - August 26, 2013 Category: Rehabilitation Authors: Anna Danielsson, Cristiane Meirelles, Carin Willen, Katharina Stibrant Sunnerhagen Tags: Original Research Source Type: research

Diagnosis and Treatment of Abductor Hallucis Focal Dystonia With Botulinum Toxin Injection: A Case Presentation
Orthopedic foot deformities can result from neurologic conditions such as stroke, multiple sclerosis, and cerebral palsy . In such cases, imaging studies of the foot are often not diagnostic of the underlying problem. Although it is not always considered, electrodiagnostic assessment can detect dystonia, spasticity, and neuropathy . The information gained from these electrodiagnostic studies can guide therapy, including medical and surgical management. This case study describes the successful evaluation and treatment of abducted hallux deformity by using electrodiagnostic testing and botulinum injection treatment.
Source: PM and R - August 1, 2013 Category: Rehabilitation Authors: Nathan S. Rosenberg, Ib R. Odderson Tags: Case Presentation Source Type: research

Reliability, Validity, and Sensitivity to Change of the Lower Extremity Functional Scale in Individuals Affected by Stroke
Conclusion: LEFS exhibits good reliability, validity, and sensitivity to change in patients with lower extremity impairments secondary to stroke. Therefore, the LEFS can be a clinically efficient outcome measure in the rehabilitation of patients with subacute stroke. The LAS is shown to be a time-saving and reasonable option to track changes in a patient's functional status.
Source: PM and R - July 22, 2013 Category: Rehabilitation Authors: Joseph L. Verheijde, Fred White, James Tompkins, Peder Dahl, Joseph G. Hentz, Michael T. Lebec, Mark Cornwall Tags: Original Research Source Type: research

Adherence Associated With Oral Medications in the Treatment of Spasticity
Objective: To examine adherence to baclofen, tizanidine, and dantrolene (U.S. Food and Drug Administration–approved oral spasticity medications), and identified determinants of adherence.Design: A retrospective administrative claims data analysis that used medical and pharmacy claims data and enrollment information from a large, national U.S. health plan.Subjects and Methods: The subjects were commercial health plan members who initiated treatment on baclofen, tizanidine, or dantrolene from January 1, 2004, through September 30, 2009, and who had stroke, spinal cord injury, traumatic brain injury, cerebral palsy, or mult...
Source: PM and R - May 6, 2013 Category: Rehabilitation Authors: Rachel Halpern, Patrick Gillard, Glenn D. Graham, Sepideh F. Varon, Richard D. Zorowitz Tags: Original Research Source Type: research

Use of Segmental Coordination Analysis of Nonparetic and Paretic Limbs During Obstacle Clearance in Community-Dwelling Persons After Stroke
Conclusions: The present coordination analysis suggests the preservation of basic control mechanisms in the paretic limb during obstacle clearance after stroke and also reveals its specific motor control compensations. However, a larger study with differing levels of stroke severity must be conducted to understand how the evaluation of intersegmental coordination during walking could guide treatment of specific locomotor control deficits in stroke rehabilitation.
Source: PM and R - February 18, 2013 Category: Rehabilitation Authors: Michael J. MacLellan, Carol L. Richards, Joyce Fung, Bradford J. McFadyen Tags: Commentary Source Type: research

A Comparison of Two Balance Measures to Predict Discharge Performance From Inpatient Stroke Rehabilitation
Objective: To compare the admission Berg Balance Scale (BBS) and Postural Assessment Scale for Stroke (PASS) in predicting outcomes at discharge from an inpatient rehabilitation unit (IRU). We hypothesized that discharge outcomes would be better predicted by (1) the PASS compared with the BBS, and (2) by the PASS changing position subscore compared with the PASS maintain posture subscore. Design: A retrospective study. Setting: An IRU in an academic medical center. Participants: Fifty-five subjects with stroke and mean (standard deviation [SD]) age of 71.5 ± 13.8 years, admission functional independence measures (F...
Source: PM and R - February 18, 2013 Category: Rehabilitation Authors: Michael W. O'Dell, Jessica Au, Eric Schwabe, Holly Batistick, Paul J. Christos Tags: Commentary Source Type: research

Functional Outcomes of Adults with Left Ventricular Assist Devices Receiving Inpatient Rehabilitation
This study included 11 patients with an implanted LVAD who required acute inpatient rehabilitation. All the patients with LVADs were included irrespective of the initial admitting diagnosis. Nine patients were admitted for cardiac diagnoses and underwent LVAD placement before their transfer to the IRU; 2 patients received LVADs before this hospital admission and were admitted for stroke. Methods: Demographic, clinical, and functional data were abstracted. Acute care length of stay (LOS), IRU LOS, and discharge disposition, along with IRU Functional Independence Measure (FIM) scores, were analyzed. Main Outcome Measureme...
Source: PM and R - January 18, 2013 Category: Rehabilitation Authors: Elizabeth Nguyen, Joel Stein Tags: Original Research Source Type: research

The Original Description of Anton Syndrome
We would like to commend Eby et al [] regarding their recent case description in “The Rehabilitation of Anton Syndrome” and would like to share our perspective related to a review of Anton's original description. Many authors have used the eponym “Anton syndrome” to describe cortical blindness with visual anosognosia. Specifically, Eby et al [] state that “Anton syndrome, also referred to as visual anosognosia, is a rare stroke syndrome that involves the bilateral occipital lobes seen most commonly as a result of cerebrovascular disease.” This description is consistent with many recent descriptions of this syndrome.
Source: PM and R - January 1, 2013 Category: Rehabilitation Authors: Bamidele O. Adeyemo, Shanker Nesathurai Tags: Letters to the Editor Source Type: research

A Randomized Comparative Study of Manually Assisted Versus Robotic-Assisted Body Weight Supported Treadmill Training in Persons With a Traumatic Brain Injury
Conclusions: The results of this study demonstrate greater improvement in symmetry of gait (step length) for RATT and no significant differences between RATT and MATT with regard to improvement in gait velocity, endurance, and SIS. Our study provides evidence that participants with a chronic TBI can experience improvements in gait parameters with gait training with either MATT or RATT.
Source: PM and R - November 29, 2012 Category: Rehabilitation Authors: Alberto Esquenazi, Stella Lee, Andrew T. Packel, Leonard Braitman Tags: Original Research Source Type: research

Designing and Implementing a System for Tracking Functional Status After Stroke: A Feasibility Study
Conclusions: This study demonstrates the feasibility of implementing a single functional outcome instrument in clinical and community settings to measure rehabilitation functional outcomes of stroke patients. Integrating the AM-PAC measurement system into clinical workflows and the electronic medical record could provide assistance to clinicians for medical decision making, functional prognostication, and discharge planning.
Source: PM and R - November 16, 2012 Category: Rehabilitation Authors: M. Elizabeth Sandel, Alan M. Jette, Jed Appelman, Joseph Terdiman, Marian TeSelle, Richard L. Delmonico, Hua Wang, Michelle Camicia, Elizabeth K. Rasch, Diane E. Brandt, Leighton Chan Tags: Original Research Source Type: research