Κυριακή, 9 Δεκεμβρίου 2018

Relations between sensory symptoms, touch sensation, and sensory neurography in the assessment of the ulnar neuropathy at the elbow

Differences in biophysical properties of sensory and motor axons make the former more predisposed to the injury by the identical mechanical stress (Lin et al., 2002). In addition, cutaneous afferents appear to depend more on Na+/K+ pump action than motor fibers to keep resting membrane potentials (Burke et al., 1997; Kiernan et al., 2004). Therefore, sensory axons show greater tendency to develop ectopic activity than motor axons. Accordingly, the entrapment nerve syndrome generally presents sensory symptoms in the cutaneous territory of the injuried nerve as the first complaint.

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Diagnostic criteria for amyotrophic lateral sclerosis: a multicentre study of inter-rater variation and sensitivity

Diagnostic criteria for amyotrophic lateral sclerosis (ALS) have been developed to standardise diagnosis and patient recruitment in trials. A research group of the World Federation of Neurology (WFN) devised the "El Escorial criteria" (EEC) (Brooks et al., 1994), which were later modified to increase their diagnostic sensitivity as the "revised El Escorial Criteria" (rEEC) (Brooks et al., 2000) with the objective of encouraging earlier inclusion in trials (Ross et al., 1998). The rEEC have been found to have high specificity, but to lack sensitivity, thus failing to promote earlier patient inclusion in clinical trials (Traynor et al., 2000; Zoccolella et al., 2006; Turner et al., 2009).

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Measurement of radioxenon and radioargon in air from soil with elevated uranium concentration

Publication date: February 2019

Source: Journal of Environmental Radioactivity, Volume 197

Author(s): J. Kastlander, M. Aldener, T. Fritioff, L. Raghoo, R. Purtschert

Abstract

Among the most important indicators for an underground nuclear explosion are the radioactive xenon isotopes 131mXe, 133Xe, 133mXe and 135Xe and the radioactive argon isotope 37Ar. In order to evaluate a detection of these nuclides in the context of a nuclear test verification regime it is crucial to have knowledge about expected background concentrations. Sub soil gas sampling was carried out on the oil shale ash waste pile in Kvarntorp, Sweden, a location with known elevated uranium content where 133Xe and 37Ar were detected in concentrations up to 120 mBq/m3 and 40 mBq/m3 respectively. These data provides one of the first times when xenon and argon were both detected in the same sub soil gas. This, and the correlations between the radionuclides, the sub soil gas contents (i.e. CO2, O2, and radon) and uranium concentration in the pile, provide very interesting information regarding the natural background and the xenon concentration levels and can most likely be used as an upper limit on what to be expected naturally occurring.



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Measuring Value in Post-Acute Care

Publication date: Available online 8 December 2018

Source: Archives of Physical Medicine and Rehabilitation

Author(s): John F. Butzer, Allan J. Kozlowski, Roberta Virva

Abstract

The value of post-acute care is unclear. While experienced clinicians understand the appropriateness of each specific site of post-acute care, clear evidence-based guidelines are not available, and many referrals to post-acute care today are made based on bed availability rather than patient need. Measuring value (value = outcomes / cost) for the entire episode of care has been proposed as an effective method to both evaluate and enable faster innovation in care. Instituting value-based care will increase patient engagement, improve quality and reduce cost with the potential of unifying the goals for all stakeholders—patients/families, providers, and payers. To achieve a goal of value-based care, rehabilitation researchers will need to measure outcomes and cost for the entire episode of care. Recent laudatory CMS efforts to standardize data across post-acute care may not include the entire episode of care since outpatient care and measurement from home are not included. In addition, the true cost of services delivered is rarely measured. To implement value-based care in rehabilitation and facilitate cost-effective care improvements, outcomes research in post-acute care should focus on four areas. First, outcome measures need to reflect the patient's perspective. Second, new methods must be implemented to acquire comparable valid and reliable data from all post-acute settings and the home. Third, a predictive model for individual patients should be utilized to guide patient referral from acute care to post-acute care and monitor progress. And fourth, timely specific measures of true cost (resources consumed) for the outcomes achieved are needed.



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Group Differences Among Caregivers of Civilians and Service Members or Veterans with Traumatic Brain Injury

Publication date: Available online 8 December 2018

Source: Archives of Physical Medicine and Rehabilitation

Author(s): Eva Keatley, Robin Hanks, Angelle M. Sander, Anna L. Kratz, David S. Tulsky, Phillip Ianni, Jennifer Miner, Noelle E. Carlozzi

Abstract
Objective

To examine group differences among caregivers of service members/veterans (SMVs) and civilians with traumatic brain injury (TBI).

Design

An observational research study examining the group differences between caregivers of SMVs and civilians with TBI. The data presented was collected as part of a larger study that calibrated and validated the TBI-CareQOL item banks.

Setting

Participants in this multicenter study completed an online survey via a study-specific website. Surveys were completed at the study site, at home or via phone interview. Civilian caregivers were recruited from four rehabilitation hospitals and caregivers of SMVs were recruited through community outreach and collaboration with the Hearts of Valor.

Participants

Participants consisted of 344 caregivers of civilians with TBI and 129 caregivers of SMVs with TBI.

Interventions

Not applicable.

Main Outcome Measures

Zarit Burden Interview Scale, TBI-CareQOL, and Mayo Portland Adaptability Inventory, 4th revision (MPAI-4)

Results

Of the independent variables included in the logistic regression model that classified military-affiliated versus civilian caregivers five were statistically significant: age, spousal status, time since injury, MPAI-4 Adjustment, and TBI-CareQOL Feeling Trapped.

Conclusions

The results indicate that caregivers of SMVs were more likely to report worse emotional and social adjustment among the individuals with TBI and caregivers of SMVs were more likely to report greater levels of feeling trapped by their caregiving duties.



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Dynamic ultrasound imaging of peroneus longus muscle herniation- a case report and review of the literature

No abstract available

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A therapeutic exercise program improves pain and physical dimension of health-related quality of life in young adults. A Randomized Controlled Trial

Objective The aim of this study was to evaluate the effects of an exercise therapy program on pain and physical dimension of health-related quality of life for young adults with musculoskeletal pain. Design Randomized controlled single-blind trial. Fifty-seven subjects (58% women) were randomly assigned to experimental (n=28; 21.4±2.9 yrs) and control (n=29; 21.0±4.2 yrs) groups. The experimental group participated in a 9-week stabilization exercise therapy program, 60 minutes/once a week, while the control group did not exercise, with a pre- and post-intervention assessment. Primary outcome was Physical Component Summary of SF-36. Secondary outcomes were Nordic Musculoskeletal Questionnaire, Visual Analogue Scale, Oswestry Disability Index, Neck Disability Index, and trunk flexor endurance test. The Shapiro-Wilk, Independent t-test or Mann-Whitney U test, Chi-square (X2), or Fisher's exact test were used for statistical analysis. Results After intervention, the experimental group improved by 3.2±4.5 points on the Physical Component Summary (p=0.01); decreased prevalence of low back pain in the last month (p=0.02) and cervical disability (p=0.02); and increased flexor trunk endurance (p=0.005). Conclusions This study confirmed that a 9-week progressive exercise therapy program can improve physical health, and reduce the prevalence of cervical disability and low back pain in the last month in young adults with musculoskeletal pain. Correspondence: Beatriz Rodríguez-Romero, Psychosocial Intervention and Functional Rehabilitation Research Group, Department of Biomedical Sciences, Medicine and Physiotherapy, Faculty of Physiotherapy, University of A Coruña, A Coruña Campus, 15071 A Coruña, Spain. Tel +34981167000, Fax +34981167155. beatriz.romero@udc.es Author disclosures: Competing Interests The authors declare that they have no competing interests. Funding or grants or equipment provided for the project from any source Funding for this research, specifically for its translation, was provided by the Official Association of Physiotherapists of Galicia (Cofiga, Spain). Financial benefits to the authors None of the authors have anything to declare. Details of any previous presentation of the research, manuscript, or abstract in any form This study has never been published before. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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