2,923 results match your criteria: "Spaulding Rehabilitation Hospital; and VA Boston Healthcare System S.P.[Affiliation]"

Background: Contemporary surgical practices for traumatic brain injury (TBI) remain unclear. We describe the clinical profile of an 18-centre US TBI cohort with cranial surgery.

Methods: The prospective, observational Transforming Research and Clinical Knowledge in Traumatic Brain Injury Study (2014-2018; ClinicalTrials.

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The Endogenous Pain Modulatory System as a Healing Mechanism: A Proposal on How to Measure and Modulate It.

NeuroSci

September 2024

Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, 96 13th Street, Charlestown, Boston, MA 02141, USA.

Background: Chronic pain is highly burdening and multifactorial in etiology. The endogenous-pain-healing system restores body tissue to a non-painful state after an injury leading to pain, and its disruption could represent a relevant mechanism, especially for nursing interventions.

Aim: To review the literature and summarize the results that support this hypothesis.

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Lessons from the HEALEY adaptive platform trial in amyotrophic lateral sclerosis.

Nat Aging

November 2024

Sean M. Healey and AMG Center for ALS & the Neurological Clinical Research Institute, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

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Objective: The aim of this study was to assess whether a history of prior concussions, and especially multiple prior concussions, is associated with clinical recovery following a subsequent sport-related concussion among collegiate student athletes.

Design: A naturalistic observational cohort study.

Setting: Eleven National Collegiate Athletics Association Division III colleges.

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Clinical Implementation of fMRI and EEG to Detect Cognitive Motor Dissociation: Lessons Learned in an Acute Care Hospital.

Neurol Clin Pract

February 2025

Center for Neurotechnology and Neurorecovery (YGB, MF, HJF, WRS, AM, PKL, DF, LRH, SSC, MJY, BLE), Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA; Department of Physical Medicine and Rehabilitation (YGB), Spaulding Rehabilitation Hospital and Harvard Medical School, Charlestown, MA; Geisel School of Medicine at Dartmouth Medical School College (WRS), Hanover, NH; Athinoula A. Martinos Center for Biomedical Imaging (JEK, BLE), Massachusetts General Hospital, Charlestown, MA; Department of Radiology (JEK, JHH, PWS, OR), Massachusetts General Hospital and Harvard Medical School, Boston, MA; Department of Neurology (DF), Hospital of the University of Pennsylvania, Philadelphia, PA; and Departments of Neurology (JC) and Medicine (ER), Massachusetts General Hospital and Harvard Medical School, Boston, MA.

Article Synopsis
  • Cognitive motor dissociation (CMD) involves patients who can follow commands in brain scans like fMRI, despite showing no behavioral signs of language function, highlighting the importance of accurate diagnosis in severe brain injuries.
  • Recent findings outline a structured approach for assessing CMD at clinical institutions, underlining the need for ethical considerations, standardized protocols, and effective communication of results.
  • The proposed method for CMD assessment aims to be adaptable, allowing for updates and improvements as more evidence becomes available in the field.
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A New Horizon: The Promise of the National Institutes of Health's Landmark Designation of Persons With Disabilities as a Population With Health Disparities.

Ann Intern Med

November 2024

Harvard Medical School and Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Boston, Massachusetts, and Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts (D.W.T.).

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: Diagnosing concussions is problematic, in part due to the invisible nature of concussion symptoms, in addition to personal and interpersonal factors that influence symptom reporting. As a result, observable signs of concussion can ensure concussions are identified and appropriately treated. Here, we define a potential novel sign, the spontaneous headshake after a kinematic event (SHAAKE) and evaluate its utility in the diagnosis of concussion.

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Study Design/setting: Single center retrospective cohort study.

Objective: We performed a retrospective study evaluating the incidence and degree of L4-5 anterior spondylolisthesis in patients with standard supine MRI, standing flexion-extension radiographs, and prone CT. We hypothesize that prone CT imaging will provide greater sensitivity for instability compared with conventional flexion extension or supine positions.

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Article Synopsis
  • - The study examined the impact of social media usage (Instagram and Twitter) by Physical Medicine & Rehabilitation residencies on the number of applications received during the 2020-2021 NRMP application cycle.
  • - Out of 88 programs, a significant portion (77%) had Instagram, 51% had Twitter, and many created accounts during the pandemic, which correlated with an increase in applications.
  • - Findings indicated that programs with active social media, particularly Twitter, and larger sizes had higher application numbers, suggesting a need for further research on how social media influences applicants' choices.
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Background: Youth sports coaches play a critical role in proper concussion recognition and management, reinforcing the need for coach concussion education. As of 2021, most states have statutory and policy measures mandating concussion education for coaches. In practice, these mandates have been enacted through state legislatures and their respective youth sport governing bodies.

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Wheelchair Repairs: Delays, Causes, and Associated Outcomes.

Arch Phys Med Rehabil

October 2024

Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA.

Objective: To examine the length of time to complete wheelchair repairs and the relationship between negative outcomes and the factors that prevented or determined who performed the repairs.

Design: Survey, cross-sectional.

Setting: Nine spinal cord injury (SCI) Model Systems Centers.

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Objectives: Career duration is often used as a metric of neurotrauma exposure in studies of elite athletes. However, as a proxy metric, career length may not accurately represent causal factors, and associations with health outcomes may be susceptible to selection effects. To date, relationships between professional American-style football (ASF) career length and postcareer health remain incompletely characterised.

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Alpha (8-12 Hz) frequency band oscillations are among the most informative features in electroencephalographic (EEG) assessment of patients with disorders of consciousness (DoC). Because interareal alpha synchrony is thought to facilitate long-range communication in healthy brains, coherence measures of resting-state alpha oscillations may provide insights into a patient's capacity for higher-order cognition beyond channel-wise estimates of alpha power. In multi-channel EEG, global coherence methods may be used to augment standard spectral analysis methods by both estimating the strength and identifying the structure of coherent oscillatory networks.

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Article Synopsis
  • Concussions in contact sports pose significant challenges in prevention, detection, and management for athletes, medical professionals, and sporting organizations.
  • Recent technological advancements have led to the creation of a comprehensive database by researchers and clinicians from the Australasian National Rugby League to analyze head impacts and track clinical outcomes.
  • This protocol aims to enhance understanding of concussions in rugby through detailed data collection, informing injury prevention strategies and improving overall player safety.
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Periodic health evaluation in Para athletes: a position statement based on expert consensus.

BMJ Open Sport Exerc Med

October 2024

School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy, Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.

Para athletes present a broad range of sports-related injuries and illnesses, frequently encountering barriers when accessing healthcare services. The periodic health evaluation (PHE) is a valuable tool for continuously monitoring athletes' health, screening for health conditions, assisting in the surveillance of health problems by establishing baseline information and identifying barriers to athlete's performance. This position statement aims to guide sports healthcare providers in the PHE for Para athletes across key impairment categories: intellectual, musculoskeletal, neurological and vision.

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Article Synopsis
  • Disorders of Consciousness (DoC) from severe brain injuries may lead to discussions about withdrawing life-sustaining treatment (WLST), but new guidelines recommend waiting 28 days before determining a poor prognosis, allowing time for potential recovery.
  • Delayed WLST (D-WLST) could be a viable option post-discharge, but clinicians often struggle to define this process and properly inform surrogate decision makers about it.
  • The decision-making around D-WLST involves understanding post-acute care facilities, timing for implementation, and overcoming psychosocial issues, like regret from surrogates when patients don't meet recovery goals.
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Article Synopsis
  • The paper examines how an individual's environment influences brain development through neural mechanisms that support enrichment, emphasizing its role in enhancing both cognitive abilities and overall health.
  • It contrasts the positive effects of enriching environments with the negative impact of stress and trauma on the brain, highlighting key factors such as support, nutrition, physical activity, music, sleep, and cognitive strategies that contribute to healthy development.
  • Additionally, it advocates for integrating Gardner's intelligence types into school curriculums to create holistic educational strategies, while also addressing social determinants affecting health and education, particularly in vulnerable communities.
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Article Synopsis
  • Effective postoperative pain management is crucial for recovery, with opioids often leading to complications like longer hospital stays and nausea.
  • The study highlights the transversus abdominis plane block (USG-TAP) as a promising alternative that helps reduce opioid use in patients after laparoscopic bariatric surgery.
  • Meta-analysis of 11 trials involving 789 patients showed that USG-TAP significantly decreased opioid consumption and improved pain scores without affecting recovery time or other complications.
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High Body Mass Index Disrupts the Homeostatic Effects of Pain Inhibitory Control in the Symptomatology of Patients With Fibromyalgia.

J Pain

December 2024

Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address:

Article Synopsis
  • This study looks at how body mass index (BMI) impacts the relationship between sensory pain testing and clinical symptoms in fibromyalgia syndrome (FMS).
  • It finds that higher BMI, particularly being overweight or obese, affects how pain response mechanisms relate to symptoms like depression, and this influence is not seen in normal-weight individuals.
  • The research emphasizes the importance of considering BMI in FMS treatment strategies, suggesting that high BMI disrupts the body’s ability to manage pain, which can worsen overall health outcomes.
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Disruptive compensatory mechanisms in fibromyalgia syndrome and their association with pharmacological agents.

Exp Brain Res

December 2024

Neuromodulation Center, Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Article Synopsis
  • Fibromyalgia syndrome (FMS) is a complex, chronic condition often marked by widespread pain and fatigue, primarily affecting women, leading to challenges in diagnosis and treatment.
  • This study investigated the link between transcranial magnetic stimulation (TMS) metrics—like cortical excitability and inhibition—and various clinical characteristics in 108 FMS patients, revealing associations between TMS markers, pain severity, fatigue, and medication use.
  • Findings suggest that disrupted brain inhibitory functions are linked to FMS symptoms, with factors like gabapentinoids and nicotine potentially impacting the brain's pain modulation mechanisms.
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Effect of Neurostimulation on Chronic Pancreatic Pain: A Systematic Review.

Neuromodulation

December 2024

Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA. Electronic address:

Article Synopsis
  • Chronic pancreatic pain is a severe visceral pain condition with limited treatment options; neurostimulation techniques are explored as potential therapies targeting pain inhibition systems.
  • A systematic review analyzed 22 studies on neurostimulation for chronic pancreatic pain, focusing on pain scales and opioid usage, and included randomized clinical trials and case series.
  • Results indicated that repetitive transcranial magnetic stimulation (rTMS) significantly reduced pain levels by up to 36%, but other neurostimulation techniques like tDCS showed less clear results.
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