Qualitative Analysis of Initial Palliative Care Consultations in Amyotrophic Lateral Sclerosis.

Background: Palliative care (PC) benefits patients with amyotrophic lateral sclerosis (ALS), however the needs of patients and caregivers and the optimal timing of PC discussions remains unclear. This study reports the analysis of PC consult notes from a larger feasibility trial. The specific aims of this analysis were to i) identify the PC needs of patients with ALS via qualitative analysis and ii) identify characteristics of patients and caregivers that could predict specific PC needs.

Scaffold protein SH3BP2 signalosome is pivotal for immune activation in nephrotic syndrome.

Despite clinical use of immunosuppressive agents, the immunopathogenesis of minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS) remains unclear. Src homology 3-binding protein 2 (SH3BP2), a scaffold protein, forms an immune signaling complex (signalosome) with 17 other proteins, including phospholipase Cγ2 (PLCγ2) and Rho-guanine nucleotide exchange factor VAV2 (VAV2). Bioinformatic analysis of human glomerular transcriptome (Nephrotic Syndrome Study Network cohort) revealed upregulated SH3BP2 in MCD and FSGS.

A multi-center international study on the spinal cord independence measure, version IV: Rasch psychometric validation.

Context: The Spinal Cord Independence Measure is a comprehensive functional rating scale for individuals with spinal cord lesion (SCL).

Objective: To validate the scores of the three subscales of SCIM IV, the fourth version of SCIM, using advanced statistical methods.

Study Design: Multi-center cohort study.

Design and evaluation of a hip prosthesis simulator: A technical note.

People with a limb loss at the level of the hip or pelvis have the most difficulty returning to walking compared with those with a lower amputation. This is because their prosthesis must replace the hip, knee, and ankle joints. An adjustable hip-disarticulation/hemipelvectomy prosthesis simulator that allows able-bodied individuals to wear and assess a prosthesis can help researchers and manufacturers when designing new prosthetic components (ie, hip joints).

Understanding the experiences of lung volume recruitment among boys with Duchenne muscular dystrophy: A multicenter qualitative study.

Background: Despite recommendations for regular lung volume recruitment (LVR) use in clinical practice guidelines for children with neuromuscular disease, adherence to LVR is poor. We aimed to describe the experience of LVR by boys with Duchenne muscular dystrophy (DMD), their families, and healthcare providers (HCPs), as well as to identify the barriers and facilitators to LVR use.

Methods: This multicenter, qualitative study evaluated boys with DMD (n = 11) who used twice-daily LVR as part of a randomized controlled trial, as well as their parents (n = 11), and HCPs involved in the clinical use of LVR (n = 9).

Feasibility of an Interactive Coaching App to Enhance Post-concussion Outpatient Care.

To determine the feasibility of patients to use a web-based health app for management of post-concussion (mTBI) symptoms in an out-patient setting. Seven (7) patients who were referred to an outpatient specialist clinic (physiatry) with persisting symptoms following a concussion. Participants had to be 18 years of age or older and more than 3 months post injury.

Improving practice through collaboration: Early experiences from the multi-site Spinal Cord Injury Implementation and Evaluation Quality Care Consortium.

Context: Dedicated implementation efforts are critical to bridging the gaps between current practices and best practices. A quality improvement collaborative (QIC), the Spinal Cord Injury Implementation and Evaluation Quality Care Consortium (SCI IEQCC), was established to meet this need, bringing together a network of clinicians and administrators to systematically improve the quality and equity of tertiary spinal cord injury or disease (SCI/D) rehabilitation care in Ontario, Canada.

Methods: Clinicians and leaders from five tertiary SCI/D rehabilitation centers and two not-for-profit SCI/D advocacy groups comprised a network dedicated to supporting implementation of the SCI-High quality indicators in prioritized domains of SCI rehabilitation and related best practices by: (1) building capacity through implementation science education of frontline clinicians; (2) providing resources and support to empower frontline clinicians to lead quality improvement efforts within their institutions; (3) promoting wider learning through a network for sharing ideas, efforts, and experiences; and (4) collecting indicator data to facilitate provincial evaluation of goal attainment.

Reliability Validity and Responsiveness of the Spinal Cord Independence Measure 4th Version in a Multicultural Setup.

Objective: To examine the fourth version of the Spinal Cord Independence Measure for reliability and validity.

Design: Partly blinded comparison with the criterion standard Spinal Cord Independence Measure III, and between examiners and examinations.

Setting: A multicultural cohort from 19 spinal cord injury units in 11 countries.

Rotator cuff anchor repair: Histological changes associated with the recovering mechanical properties in a rabbit model.

Rotator cuff anchor repair is an increasingly common surgical procedure but the failure rate remains high. In order to improve surgical outcomes, a better understanding of postrepair histological and cellular responses at the tendon-bone attachment site (enthesis) is needed. We examined operated shoulders from 42 New Zealand female white rabbits.

Patient tolerability of suprascapular and median nerve blocks for the management of pain in post-stroke shoulder-hand syndrome.

Background: Current management options for pain in stroke patients with the shoulder-hand syndrome (SHS) are limited and often ineffective. The use of peripheral nerve blocking in SHS has been limited due to concerns of hyperalgesia and allodynia in these patients. This study assessed the tolerability of suprascapular nerve (SSN) and median nerve blocks for acute control of pain in patients with post-stroke SHS.

Validity of the Comprehensive High-Level Activity Mobility Predictor in a heterogeneous population with lower extremity amputations.

Background And Objective: Lower extremity amputee outcome measures assess basic mobility. The Comprehensive High-Level Activity Mobility Predictor was developed to assess high-level mobility. Validity evidence was collected in military men with traumatic lower extremity amputations.

The effect of various arm and walking conditions on postural dynamic stability when recovering from a trip perturbation.

Background: Appropriately responding to unexpected perturbations, such as a trip, is critical to sustain balance and avoid falling during walking.

Research Question: How do arm motion and walking asymmetry affect postural stability when recovering from a trip perturbation?

Methods: Fifteen healthy young individuals, who had no experience with treadmill induced perturbations, participated in this study. The Computer-Assisted Rehabilitation Environment system (CAREN-Extended) was used to simulate unexpected perturbations while walking symmetrically and asymmetrically with various arm swings (normal, bound, released).

Knee joint stiffness following immobilization and remobilization: A study in the rat model.

Deficits in extension can limit the function and performance of the knee joint. The range of motion (ROM) deficit in knee extension is often measured and reported at a single torque value applied in the flexion-extension axis. This static measurement of ROM omits key details about the biomechanical properties of the knee, such as its mechanical stiffness.

Awareness, potential factors, and post-amputation care of stump flexion contractures among transtibial amputees.

Objectives: This study aims to assess the level of awareness of transtibial amputee patients on stump contractures and their compliance with efforts implemented to prevent the condition.

Patients And Methods: This study included 50 unilateral transtibial amputees (26 males, 24 females; mean age 55.4±14.

Effect of arm motion on postural stability when recovering from a slip perturbation.

The aim of this study was to examine the effects of various arm swing on postural stability and recovery responses to an unexpected slip during treadmill walking. Fifteen healthy young adults (23.4 ± 2.

Orthosis Comfort Score: Establishing initial evidence of reliability and validity in ankle foot orthosis users.

Background: Comfort of an orthosis is an important characteristic that is likely to dictate use of and satisfaction with a device. However, instruments to assess only orthosis user comfort do not exist. The Prosthetic Socket Fit Comfort Score, developed previously for prosthesis users, may be adapted to serve this purpose.

Development of a robotic walker for individuals with cerebral palsy.

This study describes the first use of a robotic walker in youth and young adults with cerebral palsy (CP) Gross Motor Function Classification (GMFCS) IV. Semi-structured interviews were conducted before and after each robotic walker trial. Interviews were recorded, then transcribed and subjected to thematic analysis.

Using a Knee Arthrometer to Evaluate Tissue-specific Contributions to Knee Flexion Contracture in the Rat.

Normal knee range of motion (ROM) is critical to well-being and allows one to perform basic activities such as walking, climbing stairs and sitting. Lost ROM is called a joint contracture and results in increased morbidity. Due to the difficulty of reversing established knee contractures, early detection is important, and hence, knowing risk factors for their development is essential.

Validation of a Limitations in Daily Activities Scale for Chronic Pain.

Limitations in physical function and participation are important domains of assessment in chronic pain. In 1995, the International Association for the Study of Pain distributed a self-report measure of functional limitations. Although the questionnaire has been used in research studies, it has never been subjected to a thorough investigation of its measurement properties.

Effects of the unity vacuum suspension system on transtibial gait for simulated non-level surfaces.

Walking on various surfaces encountered in everyday life requires lower limb prosthesis users to continually adapt their movement patterns. Elevated vacuum suspension systems could improve transtibial amputee gait on non-level surfaces; however, research is lacking to guide clinical practice. Twelve transtibial amputees were fitted with the Össur sleeveless vacuum suspension system (Unity).

Supraspinatus tendon repair using anchors: a biomechanical evaluation in the rabbit.

Background: Arthroscopic rotator cuff repairs are mostly secured with suture anchors and often supplemented by footprint decortication. The objectives of this study were to characterize the strength of bone-tendon healing following anchor repair and assess the effect of channeling the supraspinatus (SSP) humeral footprint 1 week ahead of reattachment surgery.

Methods: One hundred twelve rabbits underwent unilateral detachment of one SSP tendon and were randomly assigned to two groups: channeling the footprint at time of detachment and no channeling.

Mechanism-specific rehabilitation management of complex regional pain syndrome: Proposed recommendations from evidence synthesis.

Study Design: Narrative review.

Introduction: There are a variety of treatments with demonstrated effectiveness for the management of complex regional pain syndrome (CRPS). However given the variability in symptom presentation in this population, therapists may be unsure what treatments would be most effective for individual clients.

Intra-articular collagenase injection increases range of motion in a rat knee flexion contracture model.

Objectives: A knee joint contracture, a loss in passive range of motion (ROM), can be caused by prolonged immobility. In a rat knee immobilization flexion contracture model, the posterior capsule was shown to contribute to an irreversible limitation in ROM, and collagen pathways were identified as differentially expressed over the development of a contracture. Collagenases purified from are currently prescribed to treat Dupuytren's and Peyronie's contractures due to their ability to degrade collagen.