Approach to gait disorders and orthotic management in adult onset neuromuscular diseases.

In order to understand abnormal gait, this article will first review normal gait, discuss how neuromuscular diseases disturb gait patterns and review orthotic interventions. In normal gait, concentric contractions accelerate and eccentric contractions decelerate the limb. Neuromuscular gait disorders can be grouped into (1) proximal weakness, (2) distal weakness, (3) nonlength-dependent or generalized weakness, (4) asymmetric weakness, and (5) sensory disorders.

Special anatomy series. Imaging inner ear structures with high-frequency ultrasound: Application to physical rehabilitation space medicine.

Objective: The objective of this paper is to document the feasibility of image acquisition, image optimization, and sonographic appearance of the exposed anatomic windows of cadaveric inner ear dissection for purposes of potential future clinical evaluation as part of the developing area of physical and rehabilitation space medicine.

Methods: Cadaveric dissection of the inner ear was conducted with the goal of exposing areas relevant to vestibular balance. Middle and inner ear structures of 3 human cadavers were imaged with multiple broadband transducers, including emphasis with higher frequency transducers.

Musculoskeletal mimics of cervical radiculopathy.

Musculoskeletal mimics of cervical radiculopathy will be explored in this AANEM monograph. A review of the literature and textbooks was conducted. Musculoskeletal cervical radiculopathy mimics include: (1) head/neck pain, such as neck tension, cervicogenic headache, and temporomandibular disorder; (2) referred pain from shoulder pathology, such as rotator cuff tears/impingement; (3) elbow region abnormalities, including medial/lateral epicondylitis; (4) wrist/hand conditions, such as DeQuervain's tenosynovitis and intersection syndrome; (5) muscle connective tissue disorders, including myofascial trigger points; (6) conditions that have decreased range of motion, including frozen shoulder and rounded shoulders with tight pectoral/scalene muscles; (7) conditions with joint hyperlaxity and instability, as seen in post-stroke shoulder subluxation; (8) vascular conditions, such as thoracic outlet syndrome; and (9) autonomic controlled soft tissue changes associated with complex regional pain syndrome.

Musculoskeletal ultrasound for traumatic and torsional alterations.

The sonographic appearance of soft tissue can be altered by trauma and positional change with torsional stress. This creates challenges for ultrasonographic interpretation, because most descriptive literature and standard instructional references are displayed in anatomically neutral or other conventional positions. Knowledge of anatomic alteration and changes in sonographic appearance with torsional stress is essential for accurately assessing soft tissue abnormalities in conditions of spasticity, traumatic and post-surgical changes, and other conditions that distort musculoskeletal relationships.

Ultrasound Visualization of Torsional Anatomic Changes From External Rotation of the Anterior Shoulder.

Unlabelled: The sonographic appearance of soft tissue can be altered with movement. This can be related to both position change as well as torsional stress. The objective of this article is to demonstrate sonographic anatomy of the anterior shoulder as it moves into full external rotation.

Torsional Anatomy of the Lower Limb: The Appearance of Anatomy in Hemispastic Position.

Objective: The aim of the study was to determine whether there are relevant anatomical variations to the typical injection sites for antispasticity procedures in the lower limb.

Methods: Sonographic images were obtained at traditional injection locations for spasticity in the lower limb. Images were recorded in neutral and contracted postures.

Rehabilitation Traumatology: A Narrative Review.

Unlabelled: Rehabilitation traumatology has developed within the field of physical medicine and rehabilitation as a specialized area of knowledge in which the physiatrist works with the traumatology team to enhance the functional outcome of trauma patients. Based on the definition of traumatology in the American Heritage Dictionary, the authors propose rehabilitation traumatology be "the branch of medicine that deals with the treatment of serious wounds, injuries, and disabilities," "to restore [the patient] to good health or useful life." This article reviews the history of traumatology, special considerations of the traumatology patient through the continuum of care, and concepts toward the creation of a rehabilitation traumatology program.

Procedure-Oriented Torsional Anatomy of the Hand for Spasticity Injection.

Objectives: To provide musculoskeletal ultrasound (MSKUS) images of hand anatomy in the position of hemiparetic flexion as a reference for spasticity injections. After a stroke, spasticity can result in anatomic distortion of the hand. Spasticity may require treatment with botulinum toxin or phenol injections.

Procedure Oriented Torsional Anatomy of the Forearm for Spasticity Injection.

Unlabelled: : This is the second in a series of articles related to the concept of "torsional" anatomy. The objective of this article is to provide musculoskeletal ultrasound (MSKUS) anatomy of the forearm in the position of hemispastic flexion as a reference relevant to needle procedures.

Methods: The MSKUS images were obtained in a healthy human subject.

Repetitive nerve stimulation and single-fiber electromyography in the evaluation of patients with suspected myasthenia gravis or Lambert-Eaton myasthenic syndrome: Review of recent literature.

Introduction: Our aim in this study was to provide an updated literature review of electrodiagnostic testing in myasthenia gravis and Lambert-Eaton myasthenic syndrome.

Methods: A systematic review of the recent literature was performed using the following key words: myasthenia gravis (MG); Lambert-Eaton myasthenic syndrome (LEMS); electromyography (EMG); repetitive nerve stimulation (RNS); single-fiber electromyography (SFEMG); nerve conduction study; and normative values.

Results: Several articles supported testing of facial, bulbar, and respiratory muscles in the diagnosis of neuromuscular junction (NMJ) disorders, including muscle-specific kinase antibody (MuSK)-seropositive MG.

Procedure-oriented torsional anatomy of the proximal arm for spasticity injection.

Unlabelled: This is the first in a series of papers related to the new concept of "torsional" anatomy. The objective of this article is to provide musculoskeletal ultrasound (MSKUS) anatomy of the upper arm in the position of hemispastic flexion as a reference relevant to needle procedures.

Methods: The MSKUS images were obtained in a healthy human subject.

Procedure-oriented sectional anatomy of the foot.

This is the seventh and last in a series of studies related to procedure-oriented joint anatomy. This article reviews the anatomy of the foot and its relationship to procedures in the clinical setting with or without ultrasound guidance. Anatomically correct axial schematics allow injections to be envisioned relative to clinically important anatomy for common forefoot procedures.

Procedure-oriented sectional anatomy of the ankle.

This is the sixth in a series of articles related to procedure-oriented joint anatomy. This article reviews the anatomy of the ankle and its relationship to procedures in the clinical setting with or without ultrasound guidance. Anatomically correct axial and oblique axial schematics allow injections to be envisioned relative to clinically important anatomy for common ankle procedures.

Procedure-oriented sectional anatomy of the knee.

This is the fifth in a series of articles related to procedure-oriented joint anatomy. This article reviews the anatomy of the knee and its relationship to procedures in the clinical setting with or without ultrasound/electromyographic guidance. Anatomically correct axial schematics allow injections to be envisioned relative to clinically important anatomy for common knee procedures.

Procedure-oriented sectional anatomy of the hip.

This is the fourth in a series of articles related to procedure-oriented joint anatomy. This article reviews the anatomy of the hip and its relationship to procedures in the clinical setting with or without imaging guidance. Anatomically correct axial and coronal schematics allow injections to be envisioned relative to clinically important anatomy for common hip procedures.

Procedure-oriented sectional anatomy of the wrist and hand.

This is the third in a series of papers related to procedure-oriented joint anatomy. This article reviews the anatomy of the wrist and hand and its relationship to procedures in the clinical setting with or without ultrasound/electromyography (EMG) guidance. Anatomically correct axial and coronal schematics allow injections to be envisioned relative to clinically important anatomy for common wrist and finger procedures.

Procedure-oriented sectional anatomy of the elbow.

This is the second in a series of papers related to procedure-oriented joint anatomy. This article will review the anatomy of the elbow and its relationship to procedures in the clinical setting. Needle procedures of the elbow joint include medial and lateral epicondyle injections, olecranon bursa injection, elbow joint aspiration, phlebotomies in the antecubital fossa, and intramuscular injections such as trigger point and botulinum toxin injections.

Caregiver characteristics and their relationship to health service utilization in minority patients with first episode stroke.

The purpose of the current study was to investigate the contribution of caregivers' characteristics to health service utilization by minority persons with first episode stroke. Participants were 61 primary caregivers of minority persons (41% African American; 59% Hispanic) with first episode symptomatic stroke consecutively admitted to an inpatient rehabilitation unit at a county hospital. Caregiver characteristics included resources for daily living, general health, social support, and health beliefs.

Sectional neuroanatomy of the pelvic floor.

This is the sixth in a series of articles on the spine. The first 5 reviewed the sectional anatomy of the cervical, thoracic, and lumbosacral spines. This paper will review both the male and female pelves.

Procedure-oriented sectional anatomy of the shoulder.

This is the first in a series of papers on procedure-oriented joint anatomy. This paper will review anatomy of the shoulder joint and focus on non-imaging-guided procedures. Needle procedures of the shoulder include glenohumeral, subacromial, and acromioclavicular joint injections; electromyography; trigger point and other intramuscular injections; bicipital tendon sheath injection; suprascapular nerve blocks; and botulinum toxin injections.

Neuroimaging in posttraumatic hypopituitarism.

Posttraumatic hypopituitarism is the failure of the hypothalamic-pituitary axis secondary to traumatic brain injury. It can clinically present as decreased muscle mass, concentration, libido, and fertility. It can also present as increased fatigue, depression, and cognitive deficits.