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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 -
European Journal of Physical and... Apr 2016Musculoskeletal sonography use in point-of-care physical medicine and rehabilitation is rapidly expanding, not only by physiatrists, but also by non-physician... (Review)
Review
BACKGROUND
Musculoskeletal sonography use in point-of-care physical medicine and rehabilitation is rapidly expanding, not only by physiatrists, but also by non-physician rehabilitation providers.
AIM
The aim of the present review was to evaluate the current range, extent and nature of the related literature and to identify emerging areas of evidence for the use of musculoskeletal sonography involving non-physician rehabilitation providers to guide research and clinical practice.
DESIGN
Scoping review.
SETTING
Inpatient, outpatient, other.
POPULATION
Musculoskeletal conditions.
METHODS
Five databases were searched and 578 unique abstracts were identified and screened for eligibility. Three raters independently read 68 full texts, and 36 articles that reported on applied uses of sonography by non-physician rehabilitation providers were included.
RESULTS
Eighteen studies described direct clinical use, primarily for outcomes measurement (N.=12) or as a biofeedback intervention (N.=10). Twelve laboratory studies were included that related morphology to patient reports or validated clinical interventions. Six additional studies, although not involving non-physician providers, were included as they presented potential valuable uses that were not noted in the other included studies, such as monitoring bone healing, tendon repair, and evaluation of idiopathic symptom reports or non-specific primary diagnoses.
CONCLUSIONS
This review indicates that non-physician rehabilitation providers use sonography for outcomes measurement and biofeedback interventions. Research is needed to evaluate effects of these uses on patient outcomes and to explore additional potential uses for clinical reasoning, treatment planning, and monitoring of tissue healing related to intervention.
CLINICAL REHABILITATION IMPACT
Implementation of musculoskeletal sonography by non-physician rehabilitation providers has the potential to be a critically advantageous addition to improve care.
Topics: Humans; Musculoskeletal Diseases; Point-of-Care Systems; Ultrasonography
PubMed: 26201705
DOI: No ID Found -
Frontiers in Neurology 2021Pompe disease, also denoted as acid maltase or acid α-glucosidase deficiency or glycogen storage disease type II, is a rare, autosomal recessive lysosomal storage... (Review)
Review
Pompe disease, also denoted as acid maltase or acid α-glucosidase deficiency or glycogen storage disease type II, is a rare, autosomal recessive lysosomal storage disorder. Several reports have previously described Pompe disease in Iran and considering increased awareness of related subspecialties and physicians, the disease's diagnosis is growing. This guideline's main objective was to develop a national guideline for Pompe disease based on national and international evidence adapting with national necessities. A group of expert clinicians with particular interests and experience in diagnosing and managing Pompe disease participated in developing this guideline. This group included adult neurologists, pediatric neurologists, pulmonologists, endocrinologists, cardiologists, pathologists, and physiatrists. After developing search terms, four authors performed an extensive literature review, including Embase, PubMed, and Google Scholar, from 1932 to current publications before the main meeting. Before the main consensus session, each panel member prepared an initial draft according to pertinent data in diagnosis and management and was presented in the panel discussion. Primary algorithms for the diagnosis and management of patients were prepared in the panel discussion. The prepared consensus was finalized after agreement and concordance between the panel members. Herein, we attempted to develop a consensus based on Iran's local requirements. The authors hope that disseminating these consensuses will help healthcare professionals in Iran achieve the diagnosis, suitable treatment, and better follow-up of patients with infantile-onset Pompe disease and late-onset Pompe disease.
PubMed: 34621239
DOI: 10.3389/fneur.2021.739931 -
Future Science OA Oct 2021Knee osteoarthritis is a common disabling disorder, with no curative treatment. This study aims to assess autologous conditioned serum effectiveness in its treatment. (Review)
Review
AIM
Knee osteoarthritis is a common disabling disorder, with no curative treatment. This study aims to assess autologous conditioned serum effectiveness in its treatment.
MATERIALS & METHODS
Following a systematic search (2000-2020) on major databases and screening and filtering processes, eight articles were included in the final analyses. The pooled effect of visual analog scale (VAS) and the Western Ontario and McMaster Universities (WOMAC) variables was evaluated before and after the intervention.
RESULTS
The combined standardized mean difference for the global WOMAC score was -2.44 and the combined weighted mean difference was -22.92. The combined standardized mean difference for the VAS score was -3.77 and the combined weighted mean difference was -32.37 (p < 0.000).
CONCLUSION
This meta-analysis reported that the autologous conditioned serum can reduce pain and improve function (VAS and WOMAC outcome measures) in patients with knee osteoarthritis.
PubMed: 34737891
DOI: 10.2144/fsoa-2021-0069 -
Clinical excellence in physical medicine and rehabilitation: Examples from the published literature.Journal of Rehabilitation Medicine Mar 2016Advancements in medical knowledge and technology are enabling people to live longer with chronic medical conditions, and creating a need for physiatrists to help... (Review)
Review
OBJECTIVE
Advancements in medical knowledge and technology are enabling people to live longer with chronic medical conditions, and creating a need for physiatrists to help maintain and restore function. Clinical excellence in physical medicine and rehabilitation (PM&R) is not well documented in the literature. The aim of this paper is to provide examples of clinical excellence in PM&R as they relate to the definition formulated by the Miller-Coulson Academy of Clinical Excellence (MCACE).
METHODS AND RESULTS
A review of the literature revealed 1,686 published articles that were evaluated to determine their relevance to the definition of clinical excellence in PM&R. From these articles, exemplary case reports and research studies were identified for each of the domains of excellence.
CONCLUSION
The application of the definition of clinical excellence to PM&R is more than just an intellectual exercise, as it can help to establish the model to which physicians and trainees may want to aspire.
Topics: Clinical Competence; Humans; Physical and Rehabilitation Medicine; Quality of Health Care; Terminology as Topic
PubMed: 26867132
DOI: 10.2340/16501977-2058 -
Journal of Clinical Medicine Mar 2023To review the available data on non-surgical management for neurogenic lower urinary tract dysfunction (NLUTD) in patients with chronic spinal cord injury (SCI) and... (Review)
Review
To review the available data on non-surgical management for neurogenic lower urinary tract dysfunction (NLUTD) in patients with chronic spinal cord injury (SCI) and provide the most updated knowledge for readers. We categorized the bladder management approaches into storage and voiding dysfunction separately; both are minimally invasive, safe, and efficacious procedures. The main goals for NLUTD management are to achieve urinary continence; improve quality of life; prevent urinary tract infections and, last but not least, preserve upper urinary tract function. Annual renal sonography workups and regular video urodynamics examinations are crucial for early detection and further urological management. Despite the extensive data on NLUTD, there are still relatively few novel publications and there is a lack of high-quality evidence. There is a paucity of new minimally invasive and prolonged efficacy treatments for NLUTD, and a partnership between urologists, nephrologists and physiatrists is required to promote and ensure the health of SCI patients in the future.
PubMed: 36902808
DOI: 10.3390/jcm12052021 -
Musculoskeletal Surgery Dec 2022The exact nature of sex and gender differences in knee osteoarthritis (OA) among patient candidates for total knee arthroplasty (TKA) remains unclear and requires better...
PURPOSE
The exact nature of sex and gender differences in knee osteoarthritis (OA) among patient candidates for total knee arthroplasty (TKA) remains unclear and requires better elucidation to guide clinical practice. The purpose of this investigation was to survey physician practices and perceptions about the influence of sex and gender on knee OA presentation, care, and outcomes after TKA.
METHODS
The survey questions were elaborated by a multidisciplinary scientific board composed of 1 pain specialist, 4 orthopedic specialists, 2 physiatrists, and 1 expert in gender medicine. The survey included 5 demographic questions and 20 topic questions. Eligible physician respondents were those who treat patients during all phases of care (pain specialists, orthopedic specialists, and physiatrists). All survey responses were anonymized and handled via remote dispersed geographic participation.
RESULTS
Fifty-six physicians (71% male) accepted the invitation to complete the survey. In general, healthcare professionals expressed that women presented worse symptomology, higher pain intensity, and lower pain tolerance and necessitated a different pharmacological approach compared to men. Pain and orthopedic specialists were more likely to indicate sex and gender differences in knee OA than physiatrists. Physicians expressed that the absence of sex and gender-specific instruments and indications is an important limitation on available studies.
CONCLUSIONS
Healthcare professionals perceive multiple sex and gender-related differences in patients with knee OA, especially in the pre- and perioperative phases of TKA. Sex and gender bias sensitivity training for physicians can potentially improve the objectivity of care for knee OA among TKA candidates.
Topics: Female; Humans; Male; Osteoarthritis, Knee; Sexism; Arthroplasty, Replacement, Knee; Pain Measurement; Pain
PubMed: 34363604
DOI: 10.1007/s12306-021-00725-8 -
PM & R : the Journal of Injury,... Jul 2010Venous thromboembolism (VTE) is a disease entity that encompasses both deep venous thrombosis and pulmonary embolism. During the past decade there have been significant... (Review)
Review
Venous thromboembolism (VTE) is a disease entity that encompasses both deep venous thrombosis and pulmonary embolism. During the past decade there have been significant advances in the understanding of prophylaxis and treatment of VTE. There is an extensive research base from which conclusions can be drawn, but the heterogeneity within the rehabilitation patient population makes the development of rigid VTE protocols challenging and overwhelming for the busy clinician. Given the prevalence of this condition and its associated morbidity and mortality, we review the evidence for the prevention, identification, and optimal treatment of VTE in the rehabilitation population. Our goal is to highlight studies that have the most clinical applicability for the care of VTE patients from a physiatrist's perspective. At times, information about acute care protocols is included in our discussion because these situations are encountered during the consultation process that identifies patients for rehabilitation needs.
Topics: Amputees; Brain Injuries; Burns; Craniotomy; Enzyme-Linked Immunosorbent Assay; Humans; Multiple Trauma; Neoplasms; Orthopedic Procedures; Orthotic Devices; Physical and Rehabilitation Medicine; Postoperative Complications; Pulmonary Embolism; Risk Factors; Spinal Cord Injuries; Stroke; Venous Thrombosis; Wounds and Injuries
PubMed: 20659721
DOI: 10.1016/j.pmrj.2010.03.029