ISSN:0894-9115    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Numerous authorities have emphasized the need for expanding the quantity and quality of physical medicine and rehabilitation (PM&R) research and academic productivity. Thus far, however, attempts to evaluate academic productivity have involved the manual sampling of relevant specialty journals. This approach greatly underestimates productivity. By conducting a computer-facilitated search for PM&R-related publications and then contacting the most academically prolific PM&R departments to verify the computer-generated data, it was found that computer search strategies more accurately estimate PM&R academic productivity. PM&R publication activity increased by 15% in the United States and 46% internationally over the period 1988 to 1990. At least 76% of the United States residency programs in PM&R had scientific publications over this period. With ever increasing emphasis placed on academic productivity, the trend of increasing productivity can only be expected to continue in the future.

ISSN:0894-9115    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

A survey was conducted to determine the level of training in geriatrics in physical medicine and rehabilitation (PM&R) residency training programs. Questionnaires were sent to 76 accredited programs in 1989 with a 63% (48/76) response rate. Results show that 49% of patients cared for by PM&R residents in inpatient settings are 65 years of age or older, and 42% of patients cared for in ambulatory settings are in the same age group. Of PM&R programs, 30% have physician faculty who are geriatric “specialists.” PM&R residents have a significant exposure to elderly patients in the consultation role. Less exposure to elderly patients occurs in distinct geriatric rehabilitation and geriatric medicine programs or units. Among 10 medical specialties, PM&R programs compare well in terms of teaching about the topics and the personnel that are important in geriatrics. This is due in part to an obvious overlap between the content of rehabilitation medicine and that of geriatrics. Furthermore, there is moderate interest in PM&R in developing fellowship training in geriatric rehabilitation. The need for more academic faculty who are geriatric “specialists,” as well as the need for increasing PM&R exposure to distinctly geriatric settings as a part of training, is apparent.

ISSN:0894-9115    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Although segmental and dermatomal somatosensory evoked potentials have been used in the diagnosis of lumbosacral radiculopathy, the unilateral or bilateral normal intertrial variation of these responses has not been investigated. Furthermore, there exists little consensus on how many sequential trials for a single nerve or dermatome are optimal and how to use the data generated from these trials. Without investigation of these basic parameters, determination of what constitutes a normal somatosensory-evoked potential (SEP) is difficult. In 29 normal subjects, the ipsilateral intertrial variations, arithmetic mean side-to-side differences and maximum potential side-to-side differences with stimulation of the superficial peroneal sensory nerve, sural nerve and L5 and S1 dermatomes with respect to P1 and N1 latencies and peak-to-peak amplitudes were investigated. Considerable ipsilateral intertrial variation was observed and side-to-side comparisons revealed a further increase in this inherent variation regarding the above measured parameters. The maximum potential side-to-side differences were even more remarkable than the mean side-to-side differences. For these results and others presented, a method of evaluating SEP parameters whereby the arithmetic mean of two sequential trials for both latency and amplitude is presented that attempts to minimize the normal, inherent variation. We also suggest an additional parameter with which to evaluate SEPs: the maximum sideto- side latency difference. Only through the use of a consistent methodology can segmental or dermatomal SEPs be utilized in a reliable diagnostic manner.

ISSN:0894-9115    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

The functional independence measure (FIM) is used to determine the degree of disability that patients experience and the progress that they make through programs of medical rehabilitation. Rasch analysis is a statistical technique for constructing interval measures from ordinal data that was applied to derive FIM measures. The major factors that are taken into account to produce FIM measures are the relative difficulty in performance of FIM items and the ability of the persons tested.Our analyses showed the relative difficulties that patients experienced in performing items in the FIM. There were two dominant patterns of difficulty, one for motor FIM items and the other for cognitive FIM items. The patterns were consistent across impairment groups, although not identical. Of the motor items, eating and grooming were easiest whereas stair climbing, tub/shower transfers and locomotion were most difficult. Of the cognitive items, expression and comprehension were easiest and problem solving was the most difficult. The patterns of difficulty in performing FIM items are illustrated by analysis of the following impairment groups: for motor items, orthopedic conditions, stroke with left hemiparesis and spinal cord dysfunction; for cognitive items, orthopedic conditions, brain dysfunction, stroke with right hemiparesis and spinal cord dysfunction.By understanding patterns of difficulty in performing FIM items according to types of impairment and levels of function, clinicians may more precisely design treatment programs, use services and predict outcomes of medical rehabilitation.

ISSN:0894-9115    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

This retrospective study outlines interventions taken as a result of rehabilitation medicine consultation in persons hospitalized with human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS). The medical records of 30 persons with HIV infection consecutively referred for rehabilitation medicine consultation over a one-year period were reviewed. The sample was composed primarily of white, homosexual males with a mean age of 38.5 (SD, 8.5) years and a mean length of AIDS diagnosis of 14.6 (SD, 14.1) months. Rehabilitation medicine evaluation resulted in additional diagnoses in four cases (13.3%), prescriptions for new medications in 8 (26.7%), physical modalities/devices in 9 (30.0%) and referrals to occupational, physical and speech therapies in 26 (86.7%), 24 (80.0%) and 3 (10.0%) patients, respectively. Interventions were often directed toward deconditioning, painful peripheral neuropathy and fatigue. Mean survival after rehabilitation consultation was approximately 23 weeks. No intervention was novel or unusual suggesting that current knowledge is sufficient to manage much of the disability associated with HIV infection. This study concludes that rehabilitation medicine can contribute to the management of persons hospitalized with AIDS. Further research should address efficacy of intervention, fatigue as a source of disability and the value of early rehabilitation intervention.

ISSN:0894-9115    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Prochlorperazine, a piperazine phenothiazine, is a commonly used anti-emetic that blocks dopamine receptors in the central nervous system. Prochlorperazine causes various extrapyramidal syndromes, with the incidence in the inpatient population estimated to be 0.5 to 0.8%. These side effects are typically manifested by motor dysfunction and easily observed on physical examination. We report the case of an 18-year-old male with C4 complete quadriplegia who developed an acute dystonic reaction isolated to the tongue during short-term treatment with prochlorperazine. This case demonstrates the importance of maintaining a high level of suspicion in the spinal cord population, considering that many key physical findings may be absent below the level of function.

ISSN:0894-9115    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

The allocation of resources to rehabilitation is beset with many difficulties. Among them are the general crisis in the American health care system and the problem of how to make a case for the role of rehabilitation. Rehabilitation must be prepared to show how and why it is a good medical and social investment in relation to other needs. Rehabilitation has played a secondary role in the American health care system because of overemphasis on curative and life-extending medicine. Rehabilitation must work to show that money invested in caring is as well spent as money aiming at the extension of life. It must also establish a fresh new vision of health care in general as well as illustrate where rehabilitation stands in a more integrated and coherent health care system. Improved quality of life, which rehabilitation can provide, is as important as saving and extending life.

ISSN:0894-9115    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0894-9115    

出版商:OVID    

年代:1993

数据来源: OVID