ISSN:0894-9115    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The study of electrodiagnosis with respect to recovery of function is in its infancy. There is a need for better understanding of the mechanisms of recovery and for better techniques to monitor recovery. This paper reviews the potential uses and limitations of current electrodiagnostic tests to predict and monitor neuromuscular recovery. It illustrates the use of these techniques in patients with spinal cord injury

ISSN:0894-9115    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Nerve conduction studies of the anterior interosseous nerve were performed on 26 healthy subjects (6 women and 20 men, aged 24 to 63 years). The compound muscle action potential from the pronator quadratus muscle was obtained by using surface electrodes placed over the dorsal aspect of the distal forearm and median nerve stimulation at the elbow. The latency of the evoked potential was determined over distances that ranged from 17.5-28 cm from the elbow to the pronator quadratus muscle; this resulted in latencies of 3.5 ms (±0.4) and 3.6 ms (±0.4) for the left and right extremities, respectively, with a side-to-side difference of 0.1 ms (± 0.1). The amplitude of the potentials recorded was 3.1 mV (± 0.8); a difference in amplitude of 11.4% (± 7.7% between extremities was seen. Although duration measurements were obtained, the frequent presence of biomodal peaks made interpretation difficult. This bimodal pattern was felt to represent either two heads of the pronator quadratus or another muscle innervated by the anterior interosseous nerve. The technique in the present study is easy to perform, allows better assessment of the compound muscle action potentials obtained and provides for side-to-side comparisons of latency and amplitude. This technique aids the electromyographer in evaluation of suspected cases of injury to the anterior interosseous nerve, particularly in unilateral cases

ISSN:0894-9115    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

A thorough comprehension of electrodiagnostic equipment is essential to consistently obtain accurate and reproducible data. Unreliable waveform latencies or morphologies may result from inappropriate filter settings, sensitivity comparisons, sweep speeds, interelectrode separation, cathode/anode reversals and stimulus artifact. A low frequency filter with too high a frequency limit may decrease amplitude, shorten peak latency, decrease the negative spike duration, add a phase and increase total waveform duration. A high frequency filter with too low a cut-off may decrease amplitude and prolong onset and peak latencies. Increasing the amplifier's sensitivity may shorten the onset latency of a response. Sweep speeds that are too slow may omit phases, turns or entire potentials when using digital equipment. If the interelectrode separation is inadequate, waveform morphology and amplitude can be altered. Reversing cathode and anode placement affects latency and velocity determinations. Stimulus artifact may obscure a response and its reduction must be understood. Comparing latencies and amplitudes at different instrument settings is never appropriate and can lead to serious errors and misdiagnoses. A naive approach to instrumentation, therefore, is indefensible

ISSN:0894-9115    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

This paper presents longitudinal charge data on 89 former stroke rehabilitation patients discharged from three Boston area rehabilitation facilities. Medical charges are presented on initial acute and rehabilitation inpatient stays and on care received in the 12 months after discharge. In the sample of 89 stroke patients, charges exceeded four million dollars excluding physician fees and out-of-pocket expenses. Of this total, 23% was for acute hospital care preceding rehabilitation (mean =18 days), 52% for inpatient rehabilitation (mean =55 days), 13% for rehospitalizations in the 12 months after discharge from rehabilitation (mean =22 days) and 12% for a variety of outpatient services

ISSN:0894-9115    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Establishment of rehabilitation goals for spinal cord injury patients generally has been based on the degree of residual motor function. Despite extensive clinical experience with spinal cord injury rehabilitation, there have been no reports of the ability of C5 quadriplegic patients to perform self-care and mobility skills before and after rehabilitation. This study was designed to examine the rehabilitation outcomes of 63 patients with C5 complete quadriplegia, who completed an interdisciplinary inpatient rehabilitation program, using the 100-point modified Barthel Index as a means of rating functional status. There were statistically significant increases in the mean modified Barthel index scores from 7.1 on admission to 28.9 on discharge for the entire group of patients. The self-care subscore increased significantly from 6.5 on admission to 20.0 on discharge and the mobility subscore increased significantly from 0.5 on admission to 8.9 on discharge. Ability to perform self-care and mobility subscore tasks is described. This study documented significant improvements in function during comprehensive rehabilitation among patients with C5 spinal cord injury

ISSN:0894-9115    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Recent changes in health care mandate innovative approaches to teaching. Rehabilitation as part of the continuum of disability motivated the “continuity of care model.” This model permits the presentation of rehabilitation in its global sense: from onset of injury through re-integration into the community. This report describes a curriculum for physical medicine and rehabilitation residents that comprises a three-phase approach to rehabilitation: acute care, inpatient rehabilitation and community re-entry. The curriculum is adaptable for medical students. A secondary benefit of the project for the resident is a better understanding of relevant cost benefit/cost effective concepts in the delivery of quality services. The close interaction of residents with community agencies permits these agencies to gain a better understanding of the medical needs of disabled people

ISSN:0894-9115    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

A hemiplegic patient with severe upper extremity spasticity 2 years after a cerebrovascular accident received a diagnostic median nerve block below the elbow with bupivacaine. He had been placed on Coumadin as prophylaxis for cerebrovascular arteriosclerotic disease, and prothrombin time was kept at twice the control value. Less than 48 hours after the procedure, a compartment syndrome developed in the volar forearm. Compartment syndrome has not previously been reported as a complication resulting from a nerve block procedure. We conclude that (1) compartment syndrome may develop after a peripheral nerve block procedure for spasticity, (2) prophylactic anticoagulation may increase the risk for hemorrhagic events resulting from percutaneous injection and (3) early recognition is essential and appropriate decompressive fasciotomy may be indicated if a compartment syndrome develops after a nerve block procedure

ISSN:0894-9115    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1988

数据来源: OVID