PM & R : the journal of injury, function, and rehabilitation
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Since October 2001, more than 1.6 million American military service members have deployed to Iraq and Afghanistan in the Global War on Terrorism. It is estimated that between 5% and 35% of them have sustained a concussion, also called mild traumatic brain injury (mTBI), during their deployment. Up to 80% of the concussions experienced in theater are secondary to blast exposures. ⋯ We also are able to offer treatment strategies based on our evaluation of the current literature and experience to help palliate postconcussive symptoms. The purpose of this review is to elucidate common physical, cognitive, emotional, and situational challenges, and possible solutions for this special population of patients who will be transitioning into the civilian sector and interfacing with health professionals. There is a need for further investigation and testing of these strategies.
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To define the prevalence of testosterone deficiency in persons with chronic spinal cord injury (SCI) and to identify factors associated with this deficiency. ⋯ These findings confirm both a substantial population of men with SCI and with testosterone deficiency, and a significant association between testosterone level and severity of SCI. Measuring serum total testosterone levels should be included in standard screenings for patients with SCI, particularly those with motor complete injuries.
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Multicenter Study
Caregiver ratings of long-term executive dysfunction and attention problems after early childhood traumatic brain injury: family functioning is important.
To evaluate the relationship of family and parenting factors to long-term executive dysfunction and attention problems after early childhood traumatic brain injury (TBI). We hypothesized that the magnitude of executive dysfunction and attention problems would be moderated by family and parenting factors. ⋯ Executive function and attention problems persisted on a long-term basis (>24 months) after early childhood TBI, and positive global family functioning and nonpermissive parenting were associated with better outcomes. Better characterization of the optimal family environment for recovery from early childhood TBI could help target future interventions.
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Comparative Study
Combining visual rehabilitative training and noninvasive brain stimulation to enhance visual function in patients with hemianopia: a comparative case study.
To standardize a protocol for promoting visual rehabilitative outcomes in post-stroke hemianopia by combining occipital cortical transcranial direct current stimulation (tDCS) with Vision Restoration Therapy (VRT). ⋯ Results of preliminary case comparisons suggest that occipital cortical tDCS may enhance recovery of visual function associated with concurrent VRT through visual cortical reorganization. Future studies may benefit from incorporating protocol refinements such as those described here, which include global capture of function, control for potential confounds, and investigation of underlying neural substrates of recovery.