Medicine and Health Sciences Commons^™

An Umbrella Review Of Self-Management Interventions For Health Conditions With Symptom Overlap With Traumatic Brain Injury, Angelle Sander, Monique Pappadis, Tamara Bushnik, Nancy Chiaravalloti, Simon Driver, Robin Hanks, Kirk Lercher, Dawn Neumann, Amanda Rabinowitz, Ronald T Seel, Erica Weber, Rick Ralston, John Corrigan, Kurt Kroenke, Flora Hammond

Department of Rehabilitation Medicine Faculty Papers

OBJECTIVE: To synthesize evidence for the effectiveness of self-management interventions for chronic health conditions that have symptom overlap with traumatic brain injury (TBI) in order to extract recommendations for self-management intervention in persons with TBI.

DESIGN: An umbrella review of existing systematic reviews and/or meta-analyses of randomized controlled trials or nonrandomized studies targeting self-management of chronic conditions and specific outcomes relevant to persons with TBI.

METHOD: A comprehensive literature search of 5 databases was conducted using PRISMA guidelines. Two independent reviewers conducted screening and data extraction using the Covidence web-based review platform. Quality assessment was conducted using criteria adapted from …

Remote Ischaemic Conditioning Combined With Bimanual Task Training To Enhance Bimanual Skill Learning And Corticospinal Excitability In Children With Unilateral Cerebral Palsy: A Study Protocol Of A Single Centre, Phase Ii Randomised Controlled Trial, Swati M Surkar, John D Willson, Jessica M Cassidy, Shailesh Kantak, Charity G Patterson

Department of Rehabilitation Medicine Faculty Papers

INTRODUCTION: Children with unilateral cerebral palsy (UCP) have difficulty in bimanual coordination that restricts the child's independence in daily activities. Although several efficacious interventions to improve bimanual coordination exist, these interventions often require higher training doses and have modest effect sizes. Thus, there is a critical need to find an effective priming agent that, when paired with task-specific training, will facilitate neurobiological processes to enhance the magnitude of training effects and subsequently improve functional capabilities of children with UCP. The aim of this study is to determine the effects of a novel priming agent, remote ischaemic conditioning (RIC), combined with …

Developing Guiding Principles For Technology-Based Rehabilitation Program By Engaging People With Motor Incomplete Tetraplegia, Alison Bell, Namrata Grampurohit, Gabrielle Kains, Ralph J. Marino

Department of Rehabilitation Medicine Faculty Papers

Background: Technology-aided rehabilitation is well established in the field of neurologic rehabilitation. Despite the widespread availability, the development of technology-based interventions that incorporate perspectives of the people who will use them is lacking.

Objectives: This qualitative study aims to understand how people with chronic motor incomplete cervical spinal cord injury view rehabilitation technology to improve upper extremity function and neuromuscular recovery to inform future intervention development.

Methods: Seven participants with chronic upper extremity impairment due to spinal cord injury/dysfunction trialed five rehabilitation technology devices. After a 30-45 min trial for each device, participants engaged in a semi-structured interview. Interviews were …

Combination Intrathecal Drug Therapy Strategies For Pain Management, Jay Karri, Mani Singh, Devas J Modi, Vwaire Orhurhu, Caleb Seale, Michael Saulino, Anuj Marathe, Darrell Vydra, Jonathan M Hagedorn, Brian Bruel, Alaa Abd-Elsayed

Department of Rehabilitation Medicine Faculty Papers

Background: Numerous combination intrathecal drug therapy (CIDT) strategies exist and are utilized for varying pain syndromes, typically when monotherapy dose escalation or medication alternation is deemed untenable or unfeasible. Unfortunately, the supportive evidence basis for the use of these strategies and specific drug combinations is generally lacking and unclear, with many medications being used for off-label indications.

Objective: In this manuscript, we provide a robust exploration and analysis of the literature to provide an evidence-based narrative for the use of CIDT strategies in regard to clinical indications, pharmacologic parameters, specific drug combinations, safety profiles, and future directions.

Study design: Narrative …

Applying The Who Icf Framework To The Outcome Measures Used In The Evaluation Of Long-Term Clinical Outcomes In Coronavirus Outbreaks, Kajal Patel, Sofia Straudi, Ng Yee Sien, Nora Fayed, John L. Melvin, Manoj Sivan

Department of Rehabilitation Medicine Faculty Papers

(1) Objective: The World Health Organization's (WHO) International Classification of Functioning, Disability and Health (ICF) classification is a unified framework for the description of health and health-related states. This study aimed to use the ICF framework to classify outcome measures used in follow-up studies of coronavirus outbreaks and make recommendations for future studies. (2) Methods: EMBASE, MEDLINE, CINAHL and PsycINFO were systematically searched for original studies assessing clinical outcomes in adult survivors of severe acute respiratory distress syndrome (SARS), middle east respiratory syndrome (MERS) and coronavirus disease-19 (COVID-19) after hospital discharge. Individual items of the identified outcome measures were linked …

Franklin Delano Roosevelt: The Diagnosis Of Poliomyelitis Revisited., John F. Ditunno, Jr, Bruce E. Becker, Gerald J. Herbison

Department of Rehabilitation Medicine Faculty Papers

Revisiting the ailments of famous historical persons in light of contemporary medical understanding has become a common academic hobby. Public discussion of Franklin Delano Roosevelt's (FDR) diagnosis of poliomyelitis after his sudden onset of paralysis in 1921 has received just such a revisitation. Recently, this 2003 historical analysis has been referenced widely on the Internet and in biographies, raising speculation that his actual diagnosis should have been Guillain-Barré Syndrome, a noncontagious disease of the peripheral nervous system rather than poliomyelitis. The authors of that 2003 analysis used a statistical analysis of his case by selectively choosing some of his reported …

The International Society Of Physical And Rehabilitation Medicine: The Way Forward - Ii., Marta Imamura, Christoph Gutenbrunner, Gerold Stucki, Jianan Li, Jorge Lains, Walter Frontera, John Olver, Levent Özçakar, Joel Delisa, Linamara Rizzo Battistella, John L. Melvin

Department of Rehabilitation Medicine Faculty Papers

This paper reports on recent changes and future plans concerning the International Society of Physical and Rehabilitation Medicine. Issues discussed are its structural organization, collaboration and recognition, liaison with the World Health Organization , work in strengthening science, and its future agenda.

Two Phase 3, Multicenter, Randomized, Placebo-Controlled Clinical Trials Of Fampridine-Sr For Treatment Of Spasticity In Chronic Spinal Cord Injury., D. D. Cardenas, J. F. Ditunno, V. Graziani, A. B. Mclain, D. P. Lammertse, P. J. Potter, M. S. Alexander, R. Cohen, A. R. Blight

Department of Rehabilitation Medicine Faculty Papers

STUDY DESIGN: Two randomized, double-blind, placebo-controlled trials.

OBJECTIVE: To evaluate the efficacy and safety of fampridine sustained-release tablets (fampridine-SR) 25 mg twice daily for moderate-to-severe spasticity in patients with chronic spinal cord injury (SCI).

SETTING: United States and Canada.

METHODS: Patients with incomplete chronic SCI were randomized to twice daily fampridine-SR 25 mg or placebo, with a 2-week single-blind placebo run-in, a 2-week titration, 12 weeks of stable dosing, 2 weeks of downward titration and 2 weeks of untreated follow-up. Co-primary end points were the change from baseline, averaged over the double-blind treatment period, for Ashworth score (bilateral knee flexors …

The Walking Index For Spinal Cord Injury (Wisci/Wisci Ii): Nature, Metric Properties, Use And Misuse., J. F. Ditunno, Jr, P. L. Ditunno, G. Scivoletto, M. Patrick, M. Dijkers, H. Barbeau, A. S. Burns, R. J. Marino, M. Schmidt-Read

Department of Rehabilitation Medicine Faculty Papers

STUDY DESIGN: Literature review.

OBJECTIVE: To critically review all publications/internet sites that have described/used the Walking Index for Spinal Cord Injury (WISCI II), as a measure of impairment of walking function after spinal cord injury (SCI), in order to identify its psychometric properties, clarify its nature, specify misuse and incorporate the findings in an updated guide.

METHOD: A systematic literature search was done of Ovid MEDLINE, CINAHL, PsychINFO, Cochrane Central Register of Controlled Trials, Scopus and electronic sites using key words: WISCI or WISCI II, SCI, paraplegia/ tetraplegia/ quadriplegia and ambulation/gait/walking. Among 1235 citations retrieved, 154 relevant articles/sites were identified, …

Dr. Robert L. Bennett: Pioneer And Definer Of Modern Physiatry., John F. Ditunno, Jr, Richard E. Verville

Department of Rehabilitation Medicine Faculty Papers

Few physiatrists today would appreciate Dr. Robert L. Bennett’s contributions to our specialty, since he most commonly was associated with poliomyelitis, a cured disease for over a half century. Less are aware of the pioneering fusion of physical medicine in 1941 by Krusen’s first resident with the independent living environment of the Georgia Warm Spring Foundation (GWSF) created by a USA president. Bennett recognized polio/GWSF as the workshop and laboratory for showcasing the new specialty of Physical Medicine and Rehabilitation (PMR). He taught us that accurate muscle testing determined the plan of muscle reeducation, which led to functional training with …

Developing "Human Functioning And Rehabilitation Research" From The Comprehensive Perspective., Gerold Stucki, Jan Dietrich Reinhardt, Gunnar Grimby, John Melvin

Department of Rehabilitation Medicine Faculty Papers

With the International Classification of Functioning, Disability and Health (ICF) the World Health Organization (WHO) has prepared the ground for a comprehensive understanding of Human Functioning and Rehabilitation Research, integrating the biomedical perspective on impairment with the social model of disability. This poses a number of old and new challenges regarding the enhancement of adequate research capacity. Here we will summarize approaches to address these challenges with respect to 3 areas: the organization of Human Functioning and Rehabilitation Research into distinct scientific fields, the development of suitable academic training programmes and the building of university centres and collaboration networks.