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JBJS Reviews Apr 2022Traumatic brachial plexus injuries are relatively rare but potentially devastating injuries with substantial functional, psychological, and economic consequences.
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Traumatic brachial plexus injuries are relatively rare but potentially devastating injuries with substantial functional, psychological, and economic consequences.
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Prompt referral (ideally within 6 weeks of injury) to a center with a team of experts experienced in the diagnosis and management of these injuries is helpful to achieving optimal outcomes.
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Preoperative and intraoperative decision-making to diagnose and plan reconstructive procedures is complex and must take into account a number of factors, including the time from injury, concomitant injuries, preservation of cervical nerve roots, and the availability of intraplexal and extraplexal donor nerves for nerve transfer.
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A team approach is essential to ensure accurate localization of the pathology before surgery and to maximize rehabilitation after surgery, necessitating close contact between the surgical team, physiatrists, radiologists, and therapists.
Topics: Brachial Plexus; Brachial Plexus Neuropathies; Humans; Nerve Transfer; Plastic Surgery Procedures
PubMed: 35427254
DOI: 10.2106/JBJS.RVW.21.00222 -
American Journal of Physical Medicine &... May 2022As the coronavirus disease 2019 pandemic continues to grow, its clinical manifestations are still emerging and are being widely investigated. However, the pain symptoms,...
OBJECTIVE
As the coronavirus disease 2019 pandemic continues to grow, its clinical manifestations are still emerging and are being widely investigated. However, the pain symptoms, including neurological and musculoskeletal pain symptoms, are still poorly understood.
DESIGN
In this cross-sectional study, we investigated the prevalence of musculoskeletal and neurological pain symptoms among hospitalized coronavirus disease 2019 patients. Furthermore, the association of clinical and demographic factors with the prevalence of pain symptoms was also investigated.
RESULT
We included 182 hospitalized coronavirus disease 2019 patients with a mean age of 48.86 ± 13.98 yrs. Pain symptoms were reported by 61.54% patients (n = 112). Most common symptoms reported were generalized myalgia (n = 60, 32.96%), headache (n = 50, 27.47%), and low back pain (n = 41, 22.53%). Interestingly, neuropathic pain was present in 14 participants (7.69%). Logistic regression analysis revealed an association of pain symptoms with coronavirus disease 2019 severity, male sex, higher body mass index, and a history of addiction.
CONCLUSIONS
Pain symptoms are common manifestation of coronavirus disease 2019. Generalized myalgia, headache, and low back pain are the three most common new-onset pain symptoms in hospitalized coronavirus disease 2019 patients. Further investigation of pain symptoms and their predictive factors are recommended, which may guide healthcare workers and policymakers to plan in this direction.
TO CLAIM CME CREDITS
Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME.
CME OBJECTIVES
Upon completion of this article, the reader should be able to: (1) Understand common musculoskeletal and neurological pain symptoms among hospitalized COVID-19 patients; (2) Understand the basic etiopathogenesis of COVID-19 associated pain; and (3) Identify factors associated with presence of COVID-19 pain symptoms.
LEVEL
Advanced.
ACCREDITATION
The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Topics: Adult; COVID-19; Cross-Sectional Studies; Headache; Humans; Low Back Pain; Male; Middle Aged; Myalgia
PubMed: 35067551
DOI: 10.1097/PHM.0000000000001969 -
The Journal of Surgical Research Dec 2022Poor operative ergonomics can lead to muscle fatigue and injury. However, formal ergonomics education is uncommon in surgical residencies. Our study examines the...
INTRODUCTION
Poor operative ergonomics can lead to muscle fatigue and injury. However, formal ergonomics education is uncommon in surgical residencies. Our study examines the prevalence of musculoskeletal (MSK) symptoms, baseline ergonomics knowledge, and the impact of an ergonomics workshop in general surgery residents.
METHODS
An anonymous voluntary presurvey and postsurvey was distributed to all general surgery residents at a single academic residency, assessing resident characteristics, MSK symptoms, and ergonomic knowledge before and after an ergonomics workshop. The workshop consisted of a lecture and a personalized posture coaching session with a physiatrist.
RESULTS
The presurvey received 33/35 (94%) responses. Of respondents, 100% reported some degree of MSK pain. Prevalence of muscle stiffness and fatigue decreased with increasing height. Females reported higher frequencies of MSK pain (P = 0.01) and more muscle fatigue than males (100% versus 73%, P = 0.03). All residents reported little to no ergonomics knowledge with 68% reporting that ergonomics was rarely discussed in the operating room. The postsurvey received 26/35 (74%) responses. Of respondents, 100% reported the workshop was an effective method of ergonomics education. MSK symptom severity improved in 82% of residents. Reports that ergonomics was rarely discussed in the operating room significantly decreased to 22.8% of residents (P < 0.01).
CONCLUSIONS
Surgical resident ergonomics knowledge is poor and MSK symptoms are common. Resident characteristics are associated with different MSK symptoms. Didactic teaching and personalized posture coaching improve ergonomics knowledge and reduce MSK symptom severity. Surgical residencies should consider implementing similar interventions to improve resident wellbeing.
Topics: Male; Female; Humans; Ergonomics; Internship and Residency; Curriculum; Musculoskeletal Pain; Operating Rooms
PubMed: 35787315
DOI: 10.1016/j.jss.2022.06.014 -
American Journal of Physical Medicine &... Apr 2023Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME. (Review)
Review
TO CLAIM CME CREDITS
Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME.
CME OBJECTIVES
At the conclusion of this educational module, participants will be able to: (1) Describe the possible clinical presentations of Cyclist Palsy based on Ulnar nerve anatomy in the wrist and hand; (2) State the cycling-related risk factors for Cyclist Palsy; and (3) Outline the principles in management for Cyclist Palsy.
LEVEL
Advanced.
ACCREDITATION
The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s) ™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Topics: Humans; Physiatrists; Paralysis
PubMed: 36480362
DOI: 10.1097/PHM.0000000000002163 -
Cureus Dec 2023The article explores the significance of the timely transition of a child living with congenital heart disease (CHD) to adult care and the role played by... (Review)
Review
The article explores the significance of the timely transition of a child living with congenital heart disease (CHD) to adult care and the role played by multidisciplinary care. Due to recent healthcare advances, more children with CHD survive to adulthood without surgical intervention. This survival is mainly due to the lesion being compatible with life and its management being done medically. However, further management requires meeting the child's needs and helping him transition to become a healthy, independent adult with almost equal life expectancy as his counterparts. The article reviews the comprehensive framework of transition through multidisciplinary care. Highlighting the necessity of training physicians to acquire expertise in the management of CHD is a foundational aspect of this review article. Introduction to transition requires assessment of the child's needs through all phases of life and informative counseling of both parents and child. It highlights the approach to educating patients and families with the knowledge to safeguard compliance. Multidisciplinary collaboration from various fields such as cardiology, pediatric physiatrist, nursing, and psychology has been stressed. Patients also need to cultivate skills in self-management and independence and be educated to comprehend their condition, including the potential health issues. This collaborative and multidisciplinary process necessitates the cooperation of patients, families, and the adult congenital heart disease (ACHD) team. Emphasis has been given to individualized counseling for girls to address their sexual health. The article also highlights the possible obstacles and how to tackle them to improve healthcare adherence. Timely transition and follow-up can be measured using various tools or through indices measuring the quality of life and average life expectancy. The global patterns of transition to ACHD care have also been emphasized, as well as the need for research studies to develop reliable indicators for assessing transition success.
PubMed: 38186454
DOI: 10.7759/cureus.50179 -
Neuro-oncology Practice Nov 2020Spinal tumors pose significant treatment challenges for the physicians treating them. Understanding the location of the tumor within the intramedullary, intradural...
Spinal tumors pose significant treatment challenges for the physicians treating them. Understanding the location of the tumor within the intramedullary, intradural extramedullary, or extradural (epidural) space is not only critical in determining a differential diagnosis but may also provide important information about current and future neurologic deficits. Despite significant advances in the treatment of spinal tumors over the past few decades, these patients may still experience significant symptoms related to the tumor or its treatment, such as pain, weakness, impaired sensation, and bowel and bladder dysfunction. Treatment of spinal tumors should involve a multidisciplinary team of neuro-oncologists, spine surgeons, medical and radiation oncologists, physiatrists, and pain specialists to provide comprehensive oncologic management, while optimizing the patient's functional status and quality of life.
PubMed: 33299574
DOI: 10.1093/nop/npaa058 -
Healthcare Management Forum Jan 2020Artificial Intelligence (AI) is poised to revolutionize the way in which medicine is practiced and thereby transform how healthcare is delivered. While in its nascence... (Review)
Review
Artificial Intelligence (AI) is poised to revolutionize the way in which medicine is practiced and thereby transform how healthcare is delivered. While in its nascence in terms of medical applications, it is imperative that the healthcare community plays an active role in helping co-design platforms for the future. This article outlines the Canadian context of AI development by touching on its history and current utility. It also outlines the importance of capital investment, sustainable design, and how Canada has a unique opportunity to be a global leader in AI infrastructure development.
Topics: Artificial Intelligence; Biomedical Technology; Canada; Cultural Diversity; Delivery of Health Care; Healthcare Financing; Humans
PubMed: 31505963
DOI: 10.1177/0840470419874356 -
American Journal of Physical Medicine &... Oct 2021The Association of Academic Physiatrists, the home of academic physiatry, is interested in advancing industry partnerships in research among academic physiatrists. There...
The Association of Academic Physiatrists, the home of academic physiatry, is interested in advancing industry partnerships in research among academic physiatrists. There are limited existing resources that outline opportunities for academic physiatrists in engaging the translational research continuum through industry partnerships and the skill sets that academic physiatrists need to successfully navigate these partnerships. In 2019, then President of the Association of Academic Physiatrists, John Chae, MD, ME, assembled a group of interested physician-scientists in physical medicine and rehabilitation to form the Research and Industry Partnerships Task Force to address this problem. The Task Force implemented a live educational session titled "Collaborating with industry" at Physiatry '19, the Annual Meeting of the Association of Academic Physiatrists held in Puerto Rico. To extend the reach of this valuable information, the Task Force is creating resources that can be easily distributed and accessed by all physiatrists. The goal of this white paper is to provide a roadmap to help academic physiatrists begin to navigate the field of academia-industry relationships with the ultimate goal of accelerating discovery for the benefit of physiatry and rehabilitation patients.
Topics: Advisory Committees; Biomedical Research; Humans; Industry; Physical and Rehabilitation Medicine; Translational Research, Biomedical
PubMed: 33782275
DOI: 10.1097/PHM.0000000000001748 -
Current Physical Medicine and... 2022The aim of this paper is to explore current trends and advancements that lead to improved practitioner knowledge and patient care resulting in better outcomes. It is... (Review)
Review
PURPOSE OF REVIEW
The aim of this paper is to explore current trends and advancements that lead to improved practitioner knowledge and patient care resulting in better outcomes. It is common for the physiatrist to lead the team of interprofessional practitioners in the care of individuals with upper limb absence. The focus of the care is to understand and access prosthetic options, but there are often other health factors and relevant issues to consider.
RECENT FINDINGS
Some of the latest updates offer solutions to pain management, prosthetic control, access to relevant evidence, and outcomes-related data. An interesting finding was the influence of telehealth service delivery on multiple issues faced by this population. These issues include lack of information, pain management, monitoring skin breakdown and peripheral vascular disease, prosthetic training, and access to peers and specialized practitioners.
SUMMARY
The diverse technology advancements in surgical techniques, materials, outcome measures, and data management, as well as telehealth, work together to assist the collaborative interprofessional team to provide contemporary and comprehensive care to this unique population.
PubMed: 35342660
DOI: 10.1007/s40141-022-00342-x -
Health Economics Review Dec 2022Since the enactment of the long-term care insurance (LTCI) act in 2000, the number of LTCI users has increased annually. However, evidence regarding what is being... (Review)
Review
PURPOSE
Since the enactment of the long-term care insurance (LTCI) act in 2000, the number of LTCI users has increased annually. However, evidence regarding what is being carried out as rehabilitation treatment under LTCI is lacking. In this study, a scoping review was performed to bridge this knowledge gap.
METHODS
Articles related to rehabilitation in connection with LTCI published between April 2000 and November 2020 were searched for in PubMed, CINAHL, CENTRAL (Cochrane Central Register of Controlled Trials), Ichushi Web Ver.5, and CiNii and randomized controlled trials (RCTs) of rehabilitation provided under LTCI were examined.
RESULTS
Of the 15,572 publications identified, 15 RCTs, including rehabilitation treatment by physiatrists and therapists, met the eligibility criteria of our review and were included. The rehabilitation trials in the 15 RCTs varied and included balance training, exercise therapy, cognitive tasks, and activities such as singing and dancing. The results allowed us to focus on three categories: fall prevention, dementia, and theory and tools interventions related to occupational therapy practice.
CONCLUSION
The focal points of attention in the rehabilitation treatment of LTCI were identified. However, the physical function, quality of life, and activities of daily living (ADL) of those who "need support" vary from person to person. Therefore, the consolidation of evidence on rehabilitation treatment of LTCI must be continued.
PubMed: 36450881
DOI: 10.1186/s13561-022-00407-6