Service needs and barriers to care five or more years after moderate to severe TBI among Veterans.

Primary Objective: The objective of this paper is to identify the most frequent service needs, factors associated with needs, and barriers to care among Veterans and service members five or more years after moderate to severe traumatic brain injury (TBI).

Research Design: Survey administered via telephone 5-16 years after injury (median eight years) and subsequent acute inpatient rehabilitation at a regional Veterans Affairs (VA) medical centre.

Methods And Procedures: Participants were 119 Veterans and military personnel, aged 23-70 (median 35), 90% male.

Long-term outcomes after moderate-to-severe traumatic brain injury among military veterans: Successes and challenges.

Objective: To assess long-term outcomes after traumatic brain injury (TBI) among veterans and service members.

Setting: Regional Veterans Affairs medical centre.

Participants: One hundred and eighteen veterans and military personnel, aged 23-70 years (median = 35 years), 90% male, had moderate-to-severe TBI (82% in coma > 1 day, 85% amnesic > 7 days), followed by acute interdisciplinary rehabilitation 5-16 years ago (median = 8 years).

Rehabilitation of traumatic brain injury in active duty military personnel and veterans: Defense and Veterans Brain Injury Center randomized controlled trial of two rehabilitation approaches.

Objectives: To determine the relative efficacy of 2 different acute traumatic brain injury (TBI) rehabilitation approaches: cognitive didactic versus functional-experiential, and secondarily to determine relative efficacy for different patient subpopulations.

Design: Randomized, controlled, intent-to-treat trial comparing 2 alternative TBI treatment approaches.

Setting: Four Veterans Administration acute inpatient TBI rehabilitation programs.

Size and aggregation of corticosteroids used for epidural injections.

Objective: The purpose of this study was to document particulate size in commonly used corticosteroid preparations. Inadvertent injection of particulate corticosteroids into a vertebral or foraminal artery can cause brain and spinal cord embolic infarcts and the size of the particles could be directly related to the chance that a clinically significant infarct would occur. One might assume that corticosteroids with particles significantly smaller than red blood cells might be safer.

In vitro measurement of pressure differences using manometry at various injection speeds during discography.

Background Context: Lumbar discography has been widely used to evaluate discogenic low back pain. Anecdotal evidence suggests that pain reproduction during discography is more closely correlated with peak dynamic pressure than with static postinjection pressure. Although there can be a significant difference between dynamic and static pressures, to date most discographic evaluations use static pressure recorded postinjection (which is stable and easily measured).

Cervical paraspinal spontaneous activity in asymptomatic subjects.

Paraspinal fibrillation potentials or positive sharp waves (PSWs) reportedly may be the only electrodiagnostic abnormality in patients with radiculopathies. However, spontaneous activity may be present in muscles of asymptomatic subjects. To determine whether abnormal spontaneous activity in the cervical paraspinal muscles is clinically relevant, we evaluated the prevalence of such activity in asymptomatic individuals and examined its relationship with age.

Changes in stroke rehabilitation outcomes after the implementation of Japan's long-term care insurance system: a hospital-based study.

Objective: To explore the changes in stroke rehabilitation outcomes after the introduction of Japan's long-term care insurance (LTCI) system.

Design: Stroke patients discharged during a 3-yr period before and after the implementation of LTCI were compared (before-LTCI vs. after-LTCI).

Electromyographic technique for lumbar multifidus examination: comparison of previous techniques used to localize the multifidus.

Objectives: To verify and compare established techniques for needle localization in the multifidus muscle and to explore more practical techniques.

Design: Human cadaver study.

Setting: Anatomy laboratory in a university setting.

Distance measure error induced by displacement of the ulnar nerve when the elbow is flexed.

Objectives: To determine the presence of ulnar nerve displacement at the elbow when it is flexed and to determine its effect on distance measurements using the conventional measurement method for nerve conduction studies (NCSs).

Design: Comparing the ultrasonography-assisted distance measurement method with the conventional measurement method.

Setting: An electrodiagnostic laboratory at a university hospital.

Physiologic changes of compound muscle action potentials related to voluntary contraction and muscle length in carpal tunnel syndrome.

The affect of muscle length and voluntary contraction upon compound muscle action potentials (CMAPs) in subjects with carpal tunnel syndrome (CTS) has been evaluated. Twenty-five hands in a CTS patient group and 29 hands in a normal subject control group were studied. The CMAPs from the abductor pollicis brevis induced by median nerve stimulation at the wrist were obtained for five thumb positions: neutral, abduction for shortening with and without contraction, and adduction for lengthening with and without contraction.

Event-related potential in facial affect recognition: potential clinical utility in patients with traumatic brain injury.

Traumatic brain injury (TBI) frequently leads to deficits in social behavior. Prior research suggests that such deficits may result from impaired perception of basic social cues. However, these social-emotional deficits have not been studied electrophysiologically.

Sensitivity, specificity, and variability of nerve conduction velocity measurements in carpal tunnel syndrome.

Objective: To explore the diagnostic values of 8 commonly used electrodiagnostic techniques for measuring median nerve conduction velocity (NCV) in carpal tunnel syndrome (CTS).

Design: Sensitivity and specificity analyses.

Setting: A hospital-based electrodiagnostic laboratory.

Disabling foot cramping in a runner secondary to paramyotonia congenita: a case report.

An 18-year-old male runner was referred to the authors' clinic with a 1-year history of cramping left foot pain. His symptoms developed insidiously when he increased his training, with an onset of severe left foot pain and tightness that would develop after about 20 minutes of exercise. The more he continued to run, the more the symptoms were aggravated and evolved to the toes curling with intrinsic muscle spasm.

Unilateral all ulnar hand including sensory without forearm communication.

The prevalence of "ulnar hand" is extremely rare. In the ulnar hand, all the intrinsic hand muscles are innervated exclusively by the ulnar nerve; however, all reported cases have been limited to ulnar motor innervation. We present a case that demonstrated exclusive unilateral ulnar motor and sensory innervation.

Electrophysiologic abnormalities of auditory and visual information processing in patients with traumatic brain injury.

Objective: Through both auditory and visual modalities, we sought to explore the efficacy of event-related potentials in detecting residual cognitive impairments in patients with traumatic brain injury (TBI).

Design: Control subjects and TBI patients with favorable recovery were recruited. Pure tone and primary color discrimination tasks were utilized to elicit auditory and visual event-related potentials, respectively.

Brainstem auditory-evoked potentials as an objective tool for evaluating hearing dysfunction in traumatic brain injury.

Because of the violent nature of traumatic brain injury, traumatic brain injury patients are susceptible to various types of trauma involving the auditory system. We report a case of a 55-yr-old man who presented with communication problems after traumatic brain injury. Initial results from behavioral audiometry and Weber/Rinne tests were not reliable because of poor cooperation.

Influence of medical comorbidities and complications on FIM change and length of stay during inpatient rehabilitation.

Objective: This study was performed to evaluate the influence of medical problems on functional outcome measures of patients admitted for comprehensive inpatient rehabilitation.

Design: In this retrospective database review of patients, demographic information, length of stay, FIM scores at admission and discharge, and FIM efficiency were collected and analyzed. Preexisting comorbidities and acute medical complications of all patients were identified, tabulated, and analyzed.

Rehabilitation of a patient with heat stroke: a case report.

The recent death of a famous football player raised public awareness of the fatal nature of heat stroke, which is actually the third leading cause of death among American athletes. We present a typical case of heat stroke to illustrate its clinical manifestation and recovery process; risk factors, treatment options, and the importance of prevention are also discussed. Although heat stroke is not a common admission diagnosis for inpatient rehabilitation, physiatrists need to be aware of its pathophysiology, rehabilitation management, and prevention.