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Muscle & Nerve Oct 2019Neuromuscular ultrasound has become an essential tool in the diagnostic evaluation of various neuromuscular disorders, and, as such, there is growing interest in...
Neuromuscular ultrasound has become an essential tool in the diagnostic evaluation of various neuromuscular disorders, and, as such, there is growing interest in neuromuscular ultrasound training. Effective training is critical in mastering this modality. Our aim was to develop consensus-based guidelines for neuromuscular ultrasound training courses. A total of 18 experts participated. Expert opinion was sought through the Delphi method using 4 consecutive electronic surveys. A high degree of consensus was achieved with regard to the general structure of neuromuscular ultrasound training; the categorization of training into basic, intermediate, and advanced levels; the learning objectives; and the curriculum for each level. In this study, a group of neuromuscular ultrasound experts established consensus-based guidelines for neuromuscular ultrasound training. These guidelines can be used in the development of the specialty and the standardization of neuromuscular ultrasound training courses and workshops.
Topics: Clinical Competence; Curriculum; Delphi Technique; Guidelines as Topic; Humans; Neurologists; Neuromuscular Diseases; Physiatrists; Radiologists; Rheumatologists; Ultrasonography
PubMed: 31335971
DOI: 10.1002/mus.26642 -
Physical Medicine and Rehabilitation... May 2021With the rapid shift to telemedicine brought on by the COVID-19 pandemic, physiatrists must get accustomed to the new technology and learn how to optimize their... (Review)
Review
With the rapid shift to telemedicine brought on by the COVID-19 pandemic, physiatrists must get accustomed to the new technology and learn how to optimize their evaluations. For those practitioners managing patients with acquired brain injuries, which include stroke and traumatic brain injury, this can seem a daunting task given potential physical and cognitive barriers. However, as the authors discuss techniques to optimize visits, the aim is to illustrate how telehealth appointments can not only be comparable to in-person examinations but also may help increase outreach, compliance, and even satisfaction among this unique population.
Topics: Brain Injuries; COVID-19; Health Services Accessibility; Humans; Pandemics; Patient Compliance; Patient Satisfaction; Physical Examination; SARS-CoV-2; Telemedicine
PubMed: 33814054
DOI: 10.1016/j.pmr.2021.01.001 -
Journal of Pediatric Rehabilitation... 2022Cerebral palsy (CP) encompasses a group of disorders pertaining to abnormalities in movement, tone, and/or posture due to a nonprogressive lesion to an immature brain.... (Review)
Review
Cerebral palsy (CP) encompasses a group of disorders pertaining to abnormalities in movement, tone, and/or posture due to a nonprogressive lesion to an immature brain. Hip dysplasia is the second most common orthopedic deformity seen in CP, and its severity can range from a hip at risk for subluxation to full hip dislocation with degenerative changes. The purpose of this article is to review the hip pathologies that occur in CP focusing on their pathogenesis, physical exam findings, impact on function, and conservative treatment. Through a review of the medical literature, it is demonstrated that early, aggressive, and comprehensive care led by a pediatric physiatrist is essential to mitigate progression to complete hip dislocation and preserve range of motion, prevent contracture, and promote maximum functional ability in all children with CP.
Topics: Cerebral Palsy; Child; Hip Dislocation; Humans; Physiatrists; Posture
PubMed: 35311727
DOI: 10.3233/PRM-220007 -
Expert Review of Neurotherapeutics Oct 2020Degenerative cervical myelopathy (DCM) is a prevalent condition causing significant impairment spanning several domains of health. A multidisciplinary approach to the... (Review)
Review
INTRODUCTION
Degenerative cervical myelopathy (DCM) is a prevalent condition causing significant impairment spanning several domains of health. A multidisciplinary approach to the care of DCM would be ideal in utilizing complex treatments from different disciplines to address broad patient needs.
AREAS COVERED
In this article the authors will discuss the importance of multidisciplinary care and establish a general framework for its use. The authors will then highlight the potential role of a multidisciplinary team in each aspect of DCM care including assessment, diagnosis, decision-making, surgical intervention, non-operative therapy, monitoring, and postoperative care.
EXPERT OPINION
In order to provide comprehensive personalized care to DCM patients, it is necessary to have a multidisciplinary team composed by a combination of the patient, surgeon, primary care practitioner, neurologist, anesthesiologist, radiologist, physiatrist, nurses, physiotherapist, occupational therapist, pain specialist, and social workers all functioning independently and communicating to achieve a common goal.
Topics: Cervical Cord; Cervical Vertebrae; Humans; Neurodegenerative Diseases; Spinal Cord Diseases
PubMed: 32683993
DOI: 10.1080/14737175.2020.1798231 -
Techniques in Hand & Upper Extremity... Jun 2022Nerve transfer surgery is an important new addition to the treatment paradigm following nerve trauma. The following rehabilitation plan has been developed over the past...
Nerve transfer surgery is an important new addition to the treatment paradigm following nerve trauma. The following rehabilitation plan has been developed over the past 15 years, in an interdisciplinary, tertiary peripheral nerve program at the "Roth|McFarlane Hand and Upper Limb Centre." This center evaluates more than 400 patients with complex nerve injuries annually and has been routinely using nerve transfers since 2005. The described rehabilitation program includes input from patients, therapists, physiatrists, and surgeons and has evolved based on experience and updated science. The plan is comprised of phases which are practical, reproducible and will serve as a framework to allow other peripheral nerve programs to adapt and improve the "Roth|McFarlane Hand and Upper Limb Centre" paradigm to enhance patient outcomes.
Topics: Hand; Humans; Nerve Transfer; Peripheral Nerve Injuries; Upper Extremity
PubMed: 34619740
DOI: 10.1097/BTH.0000000000000359 -
Physical Medicine and Rehabilitation... Aug 2019Medicolegal expert opinions can be the source of long and senseless acrimonious debates when they lack the necessary qualities to be considered good evidence. In... (Review)
Review
Medicolegal expert opinions can be the source of long and senseless acrimonious debates when they lack the necessary qualities to be considered good evidence. In contrast, quality medicolegal expert reports contribute significantly to the proper and prompt resolution of personal injury claims in civil litigation. To this end, expert physiatrists must develop the medicolegal mindset necessary to survive and thrive in the civil litigation arena. Medicolegal core competencies needed for this endeavor are identified and addressed for what is a lifelong learning project.
Topics: Expert Testimony; Humans; Logic; Physical and Rehabilitation Medicine; Professional Role; Professionalism; Terminology as Topic; United States
PubMed: 31227138
DOI: 10.1016/j.pmr.2019.03.010 -
Physical Medicine and Rehabilitation... Feb 2020Adaptive sports and recreation have an important role in the lifestyle of individuals with cerebral palsy (CP). This article discusses the history of adaptive sports and... (Review)
Review
Adaptive sports and recreation have an important role in the lifestyle of individuals with cerebral palsy (CP). This article discusses the history of adaptive sports and the benefits of adaptive sports and recreation. Barriers and medical challenges are also thoroughly discussed, including common musculoskeletal issues, methods to prevent musculoskeletal injury, pain, fatigue, maximal exertion, and other medical comorbidities and illness. The role of health care providers such as physiatrists is emphasized to provide support to individuals with CP who either are interested in starting exercise or a sport or are already an athlete.
Topics: Art; Cerebral Palsy; History, 19th Century; History, 20th Century; History, 21st Century; Humans; Recreation; Sports for Persons with Disabilities
PubMed: 31760987
DOI: 10.1016/j.pmr.2019.09.003 -
American Journal of Physical Medicine &... Apr 2022Pilot and feasibility studies are conducted early in the clinical research pathway to evaluate whether a future, definitive study can or should be done and, if so, how.... (Review)
Review
Pilot and feasibility studies are conducted early in the clinical research pathway to evaluate whether a future, definitive study can or should be done and, if so, how. Poor planning and reporting of pilot and feasibility studies can compromise subsequent research efforts. Inappropriate labeling of studies as pilots also compromises education. In this review, first, a systematic survey of the current state of pilot and feasibility studies in rehabilitation research was performed, and second, recommendations were made for improvements to their design and reporting. In a random sample of 100 studies, half (49.5%) were randomized trials. Thirty (30.0%) and three (3.0%) studies used "pilot" and "feasibility" in the study title, respectively. Only one third (34.0%) of studies provided a primary objective related to feasibility. Most studies (92.0%) stated an intent for hypothesis testing. Although many studies (70.0%) mentioned outcomes related to feasibility in the methods, a third (30.0%) reported additional outcomes in the results and discussion only or commented on feasibility anecdotally. The reporting of progression plans to a main study (21.0%) and progression criteria (4.0%) was infrequent. Based on these findings, it is recommended that researchers correctly label studies as a pilot or feasibility design based on accepted definitions, explicitly state feasibility objectives, outcomes, and criteria for determining success of feasibility, justify the sample size, and appropriately interpret and report the implications of feasibility findings for the main future study.
Topics: Feasibility Studies; Humans; Physiatrists; Pilot Projects; Rehabilitation Research; Research Design; Research Report
PubMed: 34091466
DOI: 10.1097/PHM.0000000000001797 -
Seminars in Radiation Oncology Apr 2023Individuals with cancer experience a host of symptoms, especially when the malignancy is advanced. Pain occurs from the cancer itself or related treatments. Undertreated... (Review)
Review
Individuals with cancer experience a host of symptoms, especially when the malignancy is advanced. Pain occurs from the cancer itself or related treatments. Undertreated pain contributes to patient suffering and lack of engagement in cancer-directed therapies. Adequate pain management includes thorough assessment; treatment by radiotherapists or anesthesia pain specialists; anti-inflammatory medications, oral or intravenous opioid analgesics, and topical agents; and attention to the emotional and functional effects of pain, which may involve social workers, psychologists, speech therapists, nutritionists, physiatrists and palliative medicine providers. This review discusses typical pain syndromes arising in cancer patients undergoing radiotherapy and provides concrete recommendations for pain assessment and pharmacologic treatment.
Topics: Humans; Radiation Oncologists; Pain; Pain Management; Neoplasms; Analgesics, Opioid
PubMed: 36990640
DOI: 10.1016/j.semradonc.2023.01.002