Patient management problem-preferred responses.

Following are the preferred responses for the Patient Management Problem in this CONTINUUM issue. The case, questions, and answer options are repeated, and the preferred response appears in bold print, followed by an explanation and a reference with which you may seek more specific information. You are encouraged to review the responses and explanations carefully to evaluate your general understanding of the material.

Neurorehabilitation for other neurologic disorders.

Rehabilitation treatment and the interdisciplinary approach to care may improve the function of those with progressive neurologic disorders such as multiple sclerosis, Parkinson disease, ALS, muscular dystrophy, and neuropathy. Appropriate goals and therapies are specific to the stage of the disease as well as the needs and values of the individual patient. Preliminary evidence exists to support moderate aerobic and strengthening regimens in these patients.

Traumatic brain injury.

Traumatic brain injury (TBI) is a leading cause of death and disability in both children and adults. TBI is complex, as it involves injury to multiple brain areas caused by both the initial injury and secondary events. The most persistent sequelae of TBI are cognitive and behavioral, reflecting the fact that the preponderance of damage is to the frontal lobes.

Emerging therapies in neurorehabilitation.

Just as advancing technology has furthered our understanding of how the nervous system recovers, technology also enables the development of novel approaches to treatment. Because nervous system disease and injury often lead to severely impaired function, patients and families are willing to try anything, so therapies are often adopted with little evidence that they actually work. Evidence shows that comprehensive rehabilitation programs produce better outcomes, but it is still not understood what components of these multifaceted programs are critical to their success.

Introduction: the evolving field of neurorehabilitation.

Over the past 15 years, our understanding of how the nervous system responds to brain injury, spinal cord injury, and stroke has expanded exponentially. Research demonstrates that the CNS, once thought to be unable to regenerate, maintains a degree of plasticity that responds to activity and pharmacologic therapy, producing both neurophysiologic changes and clinical recovery. Removing barriers to optimize axonal regrowth appears to further enhance this plasticity.

Maximizing recovery from stroke: new advances in rehabilitation.

Stroke is the leading cause of disability in the United States. The magnitude of its economic impact is growing due to improved survival and the aging of the population. Acute interventions for stroke have had little effect on cost.

Understanding stroke recovery and rehabilitation: current and emerging approaches.

Although stroke is the third leading cause of death in the United States, it is the significant disability among survivors that has the greatest impact on healthcare and society. It is currently accepted that comprehensive rehabilitation programs improve outcome following stroke. We are now trying to discern which specific therapeutic approaches work and which do not.

U.S. health care in conflict--Part II. The challenges of balancing cost quality and access.

Faced with the technology explosion, the aging population and the growing uninsured, our health care system confronts an uncertain and troubling future. In this second part of a two-part series, look at some proposed solutions to the problems.

U.S. health care in conflict--Part I. The challenges of balancing cost, quality and access.

Grappling with a technology explosion, an aging population and a growing number of uninsured, our health care system faces an uncertain and troubling future. Examine the critical issues influencing health care policy development and think about ways to address the dilemma of balancing cost, quality and access.