American journal of physical medicine & rehabilitation
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Am J Phys Med Rehabil · Dec 2012
Case ReportsChylothorax complicating inpatient rehabilitation after thoracic spinal cord injury: a review of risk factors and anatomy for the physiatrist.
After malignancy, traumatic and surgical injuries to the upper abdomen and chest are the leading causes of chylothorax. Thoracic spine extension injury, blunt or penetrating chest trauma, anterior thoracic spine surgery, and increased intra-abdominal pressure have all been implicated in the development of chylothorax. ⋯ We present the case of a patient with traumatic spinal cord injury from a high-speed motor vehicle accident who was diagnosed with a left-sided chylothorax while wearing a thoracolumbosacral orthosis 4 wks into her inpatient rehabilitation stay. Knowledge of the anatomy of the thoracic duct can be useful for diagnosing chylothorax in patients with thoracic spine fractures, upper abdomen/chest injury, or thoracic surgery, as the trajectory of the duct often determines the location of pleural effusion.
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Am J Phys Med Rehabil · Dec 2012
Randomized Controlled Trial Multicenter StudyDoes botulinum toxin type A decrease pain and lessen disability in hemiplegic survivors of stroke with shoulder pain and spasticity?: a randomized, double-blind, placebo-controlled trial.
The aim of this study was to assess the efficacy of botulinum toxin type A injections in reducing pain, impairment, and disability in patients who have had a stroke with shoulder pain and spasticity. ⋯ Although botulinum toxin type A shoulder muscle injections in patients who have had a stroke with spasticity and shoulder pain resulted in improvement in selected disability measures, the observed pain reduction was not greater than that found for placebo.
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This focused review summarizes and critically evaluates clinical trial evidence for the effectiveness of Tai Chi as a supportive therapy for stroke rehabilitation. All prospective, controlled clinical trials published in English or Chinese and involving the use of Tai Chi by survivors of stroke were searched in eight electronic databases. Information from the included studies was extracted and synthesized. ⋯ Improvements in quality-of-life and mental health were reported in three trials. This focused review suggests that Tai Chi exercise might be beneficial with respect to balance, quality-of-life, and mental health in survivors of stroke. More rigorous randomized controlled trials are required to determine whether Tai Chi is effective in stroke rehabilitation.
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Am J Phys Med Rehabil · Dec 2012
Randomized Controlled Trial Comparative StudyKambin triangle versus the supraneural approach for the treatment of lumbar radicular pain.
The aim of this study was to conduct a randomized, blinded, prospective outcome study on the short-term benefits of the Kambin triangle vs. the supraneural approach for the treatment of lumbar radicular pain. ⋯ The Kambin triangle approach can be used instead of the supraneural approach in cases where it is difficult to place the needle at the anterior epidural space.
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Am J Phys Med Rehabil · Dec 2012
Randomized Controlled TrialEfficacy of early treatment with carbamazepine in prevention of neuropathic pain in patients with spinal cord injury.
The aim of this study was to evaluate whether early treatment with carbamazepine decreases the incidence of neuropathic pain (NP) or its intensity in patients with spinal cord injury. ⋯ Early intervention with carbamazepine decreased NP incidence at the 1-month but not at the 3- and 6-month follow-ups in the group of patients with acquired spinal cord injury.