Paretic propulsion changes with handrail Use in individuals post-stroke.

Background: Roughly 800,000 people experience a stroke every year in the United States, and about 30% of people require walking assistance (walker, cane, etc.) after a stroke. Gait training on a treadmill is a common rehabilitation activity for individuals post-stroke and handrails are typically used to assist with walking during this training, however individual interaction with these handrails are not usually considered and quantitatively reported.

Treadmill Handrail-Use Increases the Anteroposterior Margin of Stability in Individuals' Post-Stroke.

Treadmills are important rehabilitation tools used with or without handrails. The handrails could be used to attain balance, prevent falls, and improve the walking biomechanics of stroke survivors, but it is yet unclear how the treadmill handrails impact their stability margins. Here, we investigated how 3 treadmill handrail-use conditions (no-hold, self-selected support, and light touch) impact stroke survivors' margins of stability (MoS).

Real-Time Visual Kinematic Feedback During Overground Walking Improves Gait Biomechanics in Individuals Post-Stroke.

Treadmill-based gait rehabilitation protocols have shown that real-time visual biofeedback can promote learning of improved gait biomechanics, but previous feedback work has largely involved treadmill walking and not overground gait. The objective of this study was to determine the short-term response to hip extension visual biofeedback, with individuals post-stroke, during unconstrained overground walking. Individuals post-stroke typically have a decreased paretic propulsion and walking speed, but increasing hip extension angle may enable the paretic leg to better translate force anteriorly during push-off.

A portable visual biofeedback device can accurately measure and improve hip extension angle in individuals post-stroke.

Background: Visual biofeedback has shown success in improving gait mechanics in individuals post-stroke but has typically been restricted to use on a treadmill or a short walkway. Using real-time visual biofeedback during overground walking could increase the ease of clinical translation of this method. The objective was to investigate the reliability of a real-time hip extension feedback device during unconstrained, overground walking.

Phrenic nerve palsy in patients with neuralgic amyotrophy: case series study.

Background: Neuralgic amyotrophy (NA) is a relatively uncommon syndrome causing brachial nerves dysfunction. However, it can also affect other nerves including phrenic nerve, which is often misdiagnosed.

Case Report: To determine the incidence and characteristics of phrenic nerve palsy in patients with NA in our population, we analyzed the records of all patients with phrenic nerve palsy and/or NA at the University Hospital and the county hospital within the last 10 years.

Intra-articular Triamcinolone Versus Hyaluronate Injections for Low Back Pain With Symptoms Suggestive of Lumbar Zygapophyseal Joint Arthropathy: A Pragmatic, Double-Blind Randomized Controlled Trial.

Objective: The aim of the study was to compare hyaluronate with triamcinolone injections in treating chronic low back pain suggestive of lumbar zygopophyseal joint arthropathy.

Design: This was a prospective, double-blind, randomized controlled trial. Thirty subjects were randomly assigned to receive bilateral L3-S1 lumbar zygopophyseal joint injections with triamcinolone (KA) or Synvisc-One (HA).

Does lumbar dorsal ramus syndrome have an objective clinical basis?

Background: Degenerative processes can cause chronic low back pain that occasionally creates impingement of the lumbar dorsal rami, resulting in a clinical syndrome previously described as lumbar dorsal ramus syndrome (LDRS).

Objectives: To evaluate the clinical basis of LDRS by comparing pain, disability, and objective measures of pathophysiology in 3 groups of subjects defined by needle electromyography examination (NEE) findings.

Design: Prospective group cohort study with retrospective chart review.

Role of electrodiagnosis in patients being considered for epidural steroid injections.

Electrodiagnostic (EDX) evaluation, and, more specifically, electromyography (EMG), has a well-established role in the diagnostic confirmation of cervical and lumbar radiculopathy. The role of EMG in prognostication, however, is less established and remains a topic of debate. The purpose of this article is to evaluate the diagnostic and prognosticating role of EMG in cervical and lumbar radiculopathies, and to assess the utility of EMG in predicting outcomes after epidural steroid injections (ESI).

Needle electromyography predicts outcome after lumbar epidural steroid injection.

Introduction: Needle electromyography (NEE) would be more valuable if it could predict outcomes after lumbar epidural steroid injections (LESIs) in lumbosacral radiculopathy (LSR).

Methods: We investigated the predictive value of NEE for outcome after LESI compared with other known predictive variables in 89 subjects with clinical LSR. Seventy patients completed the study, which included diagnostic lower extremity NEE and LESI.

Interrater reliability of needle electromyographic findings in lumbar radiculopathy.

Objective: This study was performed to investigate the interrater reliability of needle electromyographic findings and electrodiagnostic impressions among expert electrodiagnosticians.

Design: Twenty-nine electromyographic recordings were chosen for this study from a larger prospective, observational cohort of 89 consecutive subjects, who were referred for electrodiagnostic evaluation of the lower limbs in a hospital-based spine clinic. The parent study was designed to evaluate the utility of electrodiagnostic findings in predicting outcomes after epidural steroid injections in lumbar radiculopathy.

A cost utility analysis of interdisciplinary early intervention versus treatment as usual for high-risk acute low back pain patients.

Chronic pain is a costly and debilitating condition that has proven difficult to treat, solely with medical interventions, due to the complex interplay of biological, psychological, and social factors in its onset and persistence. Many studies have demonstrated the effectiveness of interdisciplinary treatment that includes psychosocial interventions for low back pain. Nevertheless, these interventions continue to be under-utilized due to concerns of cost and applicability.

Early intervention options for acute low back pain patients: a randomized clinical trial with one-year follow-up outcomes.

Introduction: In an earlier study, Gatchel et al. (J Occup Rehabil 13:1-9, 2003) demonstrated that participants at high risk for developing chronic low back pain disability (CLBPD), who received a biopsychosocial early intervention treatment program, displayed significantly more symptom improvement, as well as cost savings, relative to participants receiving standard care. The purpose of the present study was to expand on these results by examining whether the addition of a work-transition component would further strengthen the effectiveness of this early intervention treatment.