Fully Implantable Peripheral Nerve Stimulation for Hemiplegic Shoulder Pain: A Multi-Site Case Series With Two-Year Follow-Up.

Objective: To explore the feasibility and safety of a single-lead, fully implantable peripheral nerve stimulation system for the treatment of chronic shoulder pain in stroke survivors.

Participants: Participants with moderate to severe shoulder pain not responsive to conservative therapies for six months.

Methods: During the trial phase, which included a blinded sham introductory period, a percutaneous single-lead peripheral nerve stimulation system was implanted to stimulate the axillary nerve of the affected shoulder.

Electrical stimulation of the urethra evokes bladder contractions in a woman with spinal cord injury.

Objective: Electrical stimulation of pudendal urethral afferents generates coordinated micturition in animals and bladder contractions in men after spinal cord injury (SCI), but there is no evidence of an analogous excitatory urethra-spinal-bladder reflex in women. The objective of this study was to determine whether electrical stimulation of the urethra could evoke bladder contractions in a woman with SCI.

Case Report: A 38-year-old woman with a C6 ASIA A SCI who managed her bladder with clean intermittent catheterization and oxybutynin demonstrated neurogenic detrusor overactivity on urodynamics.

Vena cava filters in spinal cord injuries: evolving technology.

Background: Asymptomatic deep venous thrombosis (DVT) has been reported in 60% to 100% of persons with spinal cord injury (SCI). Several guidelines have been published detailing recommended venous thromboembolism (VTE) prophylaxis after acute SCI. Low-molecular-weight heparin, intermittent pneumatic compression (IPC) devices, and/or graduated compression stockings are recommended.

Association between botulinum toxin injection into the arm and changes in gait in adults after stroke.

Botulinum toxin (BTX) is often used to improve arm function in persons with hemiparesis after stroke. Persons injected into the arm sometimes report changes in their gait. The purpose of this open-labeled pilot study was to investigate the association between injecting BTX into the upper limb and ankle and knee range of motion (ROM) and paretic-leg stride-time, defined as the time in seconds required to move the hemiparetic leg from initial contact of the foot to initial contact of the same foot.

Change and predictors of change in communication, cognition, and social function between 1 and 5 years after traumatic brain injury.

Objective: To study cognitive, communication, and social changes experienced by individuals between 1 and 5 years after traumatic brain injury (TBI).

Design: Prospective cohort.

Setting And Participants: TBI Model System Database with 927 eligible subjects using a cohort with complete 1- and 5-year data (N = 292).

Trowels labeled ergonomic versus standard design: preferences and effects on wrist range of motion during a gardening occupation.

Objective: The purposes of this study were to determine whether a garden trowel labeled ergonomic provided better wrist positioning when planting than a standard-designed trowel and whether participants perceived the ergonomic labeled trowel as more comfortable and easier to use than the standard-designed trowel.

Method: Participants included 64 females, ages 20-50 years, with no self-reported disease or disability impairing their preferred upper extremity. Participants used both trowels to fill flowerpots with soil in a randomized, repeated measures, counterbalanced design.

Five years after traumatic brain injury: a study of individual outcomes and predictors of change in function.

Objective: Study functional changes between one and five years after traumatic brain injury (TBI).

Design: Prospective cohort.

Setting And Participants: TBI Model Systems National Database subjects using cohort with complete one and five year data (n = 301).

Diagnosing depression in persons with brain injuries: a look at theories, the DSM-IV and depression measures.

There have been numerous articles published on the incidence of depression after brain injury.Unfortunately, the studies have shown the incidence of depression varies widely depending on multiple factors: definition of'depression', time of assessment post-injury and type of measure used. It is wellknown that traumatic brain injury (TBI) sequelae and depressive symptoms overlap, contributing further to measurement error and ultimately epidemiologic report of depression.

Clinical use of cholinomimetic agents: a review.

Background: There are many agents in clinical use that manipulate central nervous system levels of epinephrine, dopamine, and serotonin. However, development of pharmacological options to manipulate central acetylcholine systems has lagged behind because of poor penetration of the blood-brain barrier and significant peripheral nervous system side effects. Newer agents have demonstrated some efficacy in the management of behavioral and cognitive side effects in Alzheimer's disease, and preliminary data in traumatic brain injury suggest acetylcholine esterase inhibitors may play a significant role in the treatment of this patient population as well.

Return to productive activity after traumatic brain injury: relationship with measures of disability, handicap, and community integration.

Objectives: To identify which factors are associated with successful return to productive activity (RTPA) 1 year after hospitalization with traumatic brain injury (TBI) and to examine the relations between successful RTPA and other measures of impairment, disability, handicap, and integration into the community.

Design: Prospective study with 1-year follow-up.

Setting: Level I trauma center.

Long-term recovery course after traumatic brain injury: a comparison of the functional independence measure and disability rating scale.

Objectives: To study group changes over time after traumatic brain injury (TBI).

Design: Prospective cohort.

Setting And Participants: TBI Model System Database with 1160 subjects using cohort with complete data.

Use of injury severity variables in determining disability and community integration after traumatic brain injury.

Background: Long-term outcome is important in managing traumatic brain injury (TBI), an epidemic in the United States. Many injury severity variables have been shown to predict major morbidity and mortality. Less is known about their relationship with specific long-term outcomes.

Intentional traumatic brain injury: epidemiology, risk factors, and associations with injury severity and mortality.

Background: Intentional injury is associated with significant morbidity and mortality and has been associated with certain demographic and socioeconomic groups. Less is known about the relationship of intentional traumatic brain injury (TBI) to injury severity, mortality, and demographic and socioeconomic profile. The objective of this study was to delineate demographic and event-related factors associated with intentional TBI and to evaluate the predictive value of intentional TBI on injury severity and mortality.

The value of trauma scores: predicting discharge after traumatic brain injury.

Objective: To determine the association of acute variables with disposition after acute hospitalization.

Design: Revised Trauma Score (RTS), Injury Severity Score (ISS), and the Combined Trauma Score Injury Severity Score (TRISS(RTS)) were compared with discharge disposition after acute hospitalization of 378 consecutive patients who sustained a traumatic brain injury (TBI) and were treated at a level 1 trauma center between September 1997 and May 1998.

Results: Logistic regression modeling found TRISS(RTS) to predict discharge to home with or without home health assistance or inpatient rehabilitation vs.

An unusual complication during electroejaculation in an individual with tetraplegia.

Infertility in males is a common problem after spinal cord injury, often requiring interventional methods. In the authors' fertility program they have experienced 4 pregnancies and 3 live births using both electroejaculation (EEJ) and vibratory stimulation techniques. EEJ is a relatively safe procedure with few complications reported in the literature.

Systemic lupus erythematosus: a unique cause of central cord syndrome, a case report.

Central cord syndrome has classically been defined by disproportionately more motor impairment of the upper than the lower extremities, bladder dysfunction, and varying degrees of sensory loss below the level of the lesion. Review of the literature indicates that the majority of causes of central cord syndrome have a traumatic etiology and few are a consequence of connective tissue disorders. This is a case of a 53-year-old female with systemic lupus erythematosus who developed central cord syndrome due to an exacerbation of her disease.

Panic disorder in a patient with traumatic brain injury: a case report and discussion.

Individuals that may be especially susceptible to panic attacks in the rehabilitation setting are patients who have suffered traumatic brain injuries, post-concussion syndrome, lesions, or encephalopathy. An individual is described who suffered a traumatic brain injury and was determined to have suffered a panic attack during his rehabilitation stay. The manifestations of panic attacks are described, using the case report as an example.

Stroke rehabilitation. 3. Rehabilitation management.

This self-directed learning module highlights new advances in the treatment of patients after stroke by means of a case study format. It is part of the chapter on stroke rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article discusses both medical and rehabilitation issues that arise in the care of persons with strokes involving the right and left middle cerebral arteries and the vertebral artery.

Neural transplantation: potential role in traumatic brain injury.

Neuroscientists have been transplanting neurological tissue into humans and animals for more than a century. Recently, a number of animal studies have demonstrated a degree of central nervous system protection after brain injury using transplanted tissue. This article reviews the history of neural tissue transplantation.

Venous thromboembolism in the patient with acute traumatic brain injury: screening, diagnosis, prophylaxis, and treatment issues.

Venous thromboembolism is a life-threatening complication of traumatic brain injury. Consequently, knowledge of available screening, diagnostic, prophylactic, and treatment methods is critical to the management of the individual with traumatic brain injury. Venous thromboembolic risk varies among individuals, resulting in unique screening and prophylactic needs for each patient.

Pulmonary complications in traumatic brain injury.

Survivors of traumatic brain injury frequently develop respiratory complications that require specialized knowledge and management skills in both acute and postacute environments. This article discusses the pathophysiology of and treatment options for ventilatory failure, neurogenic pulmonary edema, and aspiration. Management of tracheostomies is also discussed, with particular attention paid to decision making regarding the removal of a tracheal appliance.

Potential role of serum prolactin measurement in the diagnosis of late posttraumatic seizures. A case report.

Posttraumatic seizures are an important medical complication after traumatic brain injury. However, the diverse clinical presentation of posttraumatic seizures, combined with the cognitive and behavior deficits frequently seen in this patient population, can make the diagnosis of posttraumatic seizures particularly challenging. Electroencephalography and imaging studies are often abnormal and nonspecific.