Validating the usefulness of the NSI validity-10 with the MMPI-2-RF.

The Neurobehavioral Symptom Inventory (NSI) is a 22-item self-report measure created to quantify the somatosensory, cognitive, and affective symptoms of Post-concussive Syndrome. Developers of the NSI used a subset of 10 items, the Validty-10, to measure symptom overreporting. We compared the Validity-10 versus the remaining NSI items (i.

Montreal Cognitive Assessment as a screening tool: Influence of performance and symptom validity.

Background: We evaluated Montreal Cognitive Assessment (MoCA) performance in a veteran traumatic brain injury (TBI) population, considering performance validity test (PVT) and symptom validity test (SVT) data, and explored associations of MoCA performance with neuropsychological test performance and self-reported distress.

Methods: Of 198 consecutively referred veterans to a Veterans Administration TBI/Polytrauma Clinic, 117 were included in the final sample. The MoCA was administered as part of the evaluation.

Suspiciously slow: timed digit span as an embedded performance validity measure in a sample of veterans with mTBI.

Objective: To explore the utility of Timed Digit Span (TDS) as an embedded performance validity test (PVT) in a sample of veterans with mild traumatic brain injury (mTBI). We hypothesize that TDS will predict PVT failure on an established stand-alone measure (Trial 1 of the Test of Memory Malingering; TOMM).

Methods: TDS was compared to Digit Span accuracy (DS), using TOMM as a criterion measure, in a sample of 99 veterans with mTBI.

Streamlining screening of emotional function in Veterans with traumatic brain injury.

Objectives: This study examined how depression, anxiety, and sleep items from the Neurobehavioral Symptom Inventory (NSI) predict results from longer inventories.

Method: This was a retrospective review from 484, predominantly male (96.1%) Veterans, mean age 29.

Neuropsychological test validity in Veterans presenting with subjective complaints of 'very severe' cognitive symptoms following mild traumatic brain injury.

Objective: This study explored the utility of combining data from measures of performance validity and symptom validity among Veterans undergoing neuropsychological evaluation for mild traumatic brain injury (mTBI).

Background: Persistent cognitive impairments following mTBI are often reported by returning combat veterans. However, objectively-measured cognitive deficits are not common among individuals with mTBI, raising the question of whether negative impression management influences self-ratings.

Reliability and factor structure of the Hospital Anxiety and Depression Scale in a polytrauma clinic.

The Hospital Anxiety and Depression Scale (HADS) is a brief self-report measure of anxiety and depression symptoms. This study examined the internal consistency and factor structure of the HADS among Veterans in a polytrauma/traumatic brain injury clinic. The sample consisted of 312 Veterans.

Limited usefulness of the Rey Fifteen-Item Test in detection of invalid performance in veterans suspected of mild traumatic brain injury.

Objective: This study explored using the FIT as a measure of performance validity among veterans undergoing neuropsychological evaluation for mild traumatic brain injury (mTBI).

Background: The Rey Fifteen-Item Memory Test (FIT) is a performance validity measure criticized for poor sensitivity.

Methods: Two hundred and fifty-seven veterans completed the FIT and Wechsler Adult Intelligence Scale, Fourth Edition, Digit Span (DS); 109 of whom completed the Test of Memory Malingering (TOMM).

Affect and psychiatric symptoms in a veteran polytrauma clinic.

Although the relationship between negative affect and psychiatric symptoms has been well-demonstrated in research, less is known about positive affect relative to negative affect, and its relationship to psychiatric symptoms, especially among veterans. This study examined how levels of positive and negative affect are associated with symptoms of depression, anxiety, and posttraumatic stress disorder (PTSD). Data were collected in a veteran polytrauma clinic; analyses were conducted using data from 94 veterans (87 males) with and without a mild traumatic brain injury (mTBI) diagnosis.

Postconcussive symptom report in polytrauma: influence of mild traumatic brain injury and psychiatric distress.

Many studies have evaluated the influence of mild traumatic brain injury (mTBI) on neuropsychological test performance and on report of postconcussive symptoms. However, most studies that examine postconcussion syndrome (PCS) do not address the issue of "polytrauma," which is common in military mTBI. This study investigated simultaneously demographic, injury-related, and psychiatric symptom predictors of PCS report in a veteran, polytrauma sample.

WAIS-IV reliable digit span is no more accurate than age corrected scaled score as an indicator of invalid performance in a veteran sample undergoing evaluation for mTBI.

Reliable Digit Span (RDS) is a measure of effort derived from the Digit Span subtest of the Wechsler intelligence scales. Some authors have suggested that the age-corrected scaled score provides a more accurate measure of effort than RDS. This study examined the relative diagnostic accuracy of the traditional RDS, an extended RDS including the new Sequencing task from the Wechsler Adult Intelligence Scale-IV, and the age-corrected scaled score, relative to performance validity as determined by the Test of Memory Malingering.

Report of traumatic brain injury information sources among OIF/OEF Veterans undergoing polytrauma evaluations.

Servicemembers returning from recent conflicts frequently report symptoms associated with traumatic brain injury (TBI) and are subsequently assessed within the Department of Veterans Affairs (VA) medical system. Information on potential cognitive and behavioral correlates of TBI is available from multiple sources. A Veteran's symptom presentation may be significantly influenced by the information he or she has received.

Home-based telerehabilitation shows improved upper limb function in adults with chronic stroke: a pilot study.

Objective: This pilot study investigates the use of telerehabilitation to improve upper limb performance in chronic stages of stroke recovery.

Design: Intervention study with pre/post/one month follow-up tests.

Methods: Seven adults with chronic stroke participated in the study.

Rehabilitation of the muscular dystrophies.

The muscular dystrophies (MD) are a heterogeneous group of inherited disorders characterized by findings on muscle biopsy. In general, they feature progressive muscle wasting and weakness. In addition to the musculoskeletal system, direct and indirect effects can be seen in a variety of organ systems.

The influence of sleep and mood on cognitive functioning among veterans being evaluated for mild traumatic brain injury.

Objective: Veterans undergoing evaluation for mild traumatic brain injury commonly report insomnia, psychiatric symptoms, and cognitive dysfunction. This study examines the effects of self-reported amount of sleep and subjective sleep quality on neuropsychological test performance.

Method: 262 veterans were seen for neuropsychological assessment in a Veterans Affairs traumatic brain injury clinic.

The contributions of self-reported injury characteristics and psychiatric symptoms to cognitive functioning in OEF/OIF veterans with mild traumatic brain injury.

Mild traumatic brain injury (mTBI) affects a significant number of combat veterans returning from Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF). Although resolution of mTBI symptoms is expected over time, some individuals continue to report lingering cognitive difficulties. This study examined the contributions of self-reported mTBI injury characteristics (e.

Disability attitudes in health care: a new scale instrument.

Objective: The aims of this study were to develop and validate an instrument measuring attitudes toward providing health care to patients with disability, to compare the attitudes of preclinical and clinical medical students, and to examine whether sex, a background in disability, or career interest in physical medicine and rehabilitation affect medical student attitudes toward working with patients with disability.

Design: A cross-sectional survey was conducted in an academic medical center with participants that included preclinical (n = 63) and clinical medical (n = 58) students, physical medicine and rehabilitation residents (n = 18), and internal medicine residents (n = 10). A 17-item Disability Attitudes in Health Care scale was developed based on existing, validated geriatrics attitudes scales.

Neuropharmacology in pediatric brain injury: a review.

In this review, the current evidence is examined regarding neuropharmacologic treatment for children and adolescents (under the age of 18 years) who sustained a traumatic brain injury (TBI). Although the focus is on the pediatric TBI population, there is a paucity of empirical data related to the role of medication with children and adolescents after brain injury. Therefore, findings from the adult TBI literature are incorporated where appropriate so as to identify potential agents that warrant further examination in pediatric populations.

Ultrasound evaluation of a spontaneous plantar fascia rupture.

Plantar fascia rupture is an occasional complication in patients with chronic plantar fasciitis or in patients with plantar fasciitis treated with steroid injection. Very few cases of spontaneous plantar fascia rupture have been reported in the literature (Herrick and Herrick, Am J Sports Med 1983;11:95; Lun et al, Clin J Sports Med 1999;9:48-9; Rolf et al, J Foot Ankle Surg 1997;36:112-4; Saxena and Fullem, Am J Sports Med 2004;32:662-5). Spontaneous medial plantar fascia rupture in a 37-yr-old man with no preceding symptoms or steroid injections was confirmed with diagnostic ultrasound, which revealed severe fasciitis at the calcaneal insertion with partial tearing.

Controversial topic: return to competitive sport after severe traumatic brain injury.

Various guidelines have been proposed for returning to sport after concussion or mild TBI. However, no such guidelines exist for severe TBI. This study presents three cases of athletes who sustained severe TBIs and returned to competition.

Wheelchair seating for children with Duchenne Muscular Dystrophy.

Duchenne Muscular Dystrophy (DMD) is an X-linked recessive disorder which features progressive muscle wasting and weakness. Despite advances in treatment, the weakness of DMD will eventually necessitate a wheelchair for almost all children. The goal of wheelchair use is to maximize function and mobility while minimizing discomfort and postural abnormalities.

Rehabilitation methods for the burn injured individual.

Physiatrists play a critical role in managing the medical and functional consequences of serious burn injuries. Goals of rehabilitation include wound healing, scar prevention, hypertrophic scarring suppression, full range of motion, strengthening, and independent mobility and activities of daily living. This article is an overview of burn rehabilitation principles and patient management.

Rehabilitation of children and adults who have neuromuscular diseases.

Neuromuscular diseases are a broad group of disorders that affect the motor unit. Recent advances in genetics and molecular biology have greatly furthered understanding of these diseases. Unfortunately, this has not greatly modified treatment strategies.

The stroke rehabilitation paradigm.

The matrix of stroke rehabilitation is evolving as we look outside the box of traditional therapy type, timing, and intensity of rehabilitation techniques. For inpatient wards, the goal of medical stability and prompt resolution of complications to maximize participation in therapy remains paramount. In the current medical model, we focus on teaching compensatory strategies and rarely on restorative approaches because of time and financial limitations.