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Full-Text Articles in Medicine and Health Sciences
Deep Vein Thrombosis In An Ambulatory Hemiparetic Stroke Patient Probably Due To Exercise-Related Repetitive Impact: A Casereport, Kun-Chang Lee, Chien-Ting Liu, Pi-Wei Wang, An-Fang Hsiao, Yi-Shiung Horng
Deep Vein Thrombosis In An Ambulatory Hemiparetic Stroke Patient Probably Due To Exercise-Related Repetitive Impact: A Casereport, Kun-Chang Lee, Chien-Ting Liu, Pi-Wei Wang, An-Fang Hsiao, Yi-Shiung Horng
Rehabilitation Practice and Science
Deep vein thrombosis (DVT) of the lower extremity is a multifactorial and potentially fatal complication following stroke. However, repetitive impact on the lower extremity is a relatively uncommon risk factor for DVT. We report an ambulatory hemiparetic stroke patient who, without classic DVT risk factors, developed a lower extremity DVT probably due to repetitive impact on the popliteal fossa after the inappropriate use of a seated leg flexion machine. This case can remind physiatrists and therapists of the importance of preventing patients from using non-ergonomic postures during training sessions.
Spondylolysis And Spondylolisthesis In Baseball Athletes: Five Casereports, Chun-Yao Yu, Hsiao-Yun Chang, Chuan-Chao Lin, Yi-Luen Hung, Su-Ju Tsai
Spondylolysis And Spondylolisthesis In Baseball Athletes: Five Casereports, Chun-Yao Yu, Hsiao-Yun Chang, Chuan-Chao Lin, Yi-Luen Hung, Su-Ju Tsai
Rehabilitation Practice and Science
Low back pain is one of the commonest complaints of young athletes who visit the physical medicine and rehabilitation outpatient department. Spondylolysis and spondylolisthesis are frequent causes of low back pain in young athletes. The pain in these conditions is exacerbated by lumbar extension and relieved by rest. Although genetic predisposition plays an important role in the development of pars defect, certain activities involving lumbar hyperextension and rotation movements result in spondylolysis and spondylolisthesis.From December 2005 to March 2009, there were five baseball athletes who visited our outpatient department because of low back pain. The diagnosis was grade I spondylolisthesis …
Carpal Tunnel Syndrome As An Initial Presentation Of Glioblastoma Multiforme: A Casereport, Chih-Hung Tseng, Kun-Lin Wu, Sin-Hao Ho, Su-Ju Tsai
Carpal Tunnel Syndrome As An Initial Presentation Of Glioblastoma Multiforme: A Casereport, Chih-Hung Tseng, Kun-Lin Wu, Sin-Hao Ho, Su-Ju Tsai
Rehabilitation Practice and Science
A 43-year-old woman was clinically diagnosed as carpal tunnel syndrome due to the presentation of intermittent numbness, tingling and pain in her right thumb and index finger. The symptoms gradually exacerbated together with positive Phalen's test and Tinel's sign. Endoscopic carpal tunnel release procedure failed to relieve her symptoms. Ensuing symptoms developed such as headache, extensive numbness and mild weakness in her right upper and lower limbs. MRI of brain revealed a left thalamic tumor. Stereotactic biopsy confirmed the pathologic diagnosis as glioblastoma. Post-operative radiotherapy and temozolomide chemotherapy were performed to suppress disease progression. She also received comprehensive rehabilitation program, …
Posterior Interosseous Neuropathy Related To Cumulative Trauma Disorder: A Casereport, Cheng-Hao Tseng, Tsung-Cheng Huang, Jen-Wen Hung, Bin-Chi Chang
Posterior Interosseous Neuropathy Related To Cumulative Trauma Disorder: A Casereport, Cheng-Hao Tseng, Tsung-Cheng Huang, Jen-Wen Hung, Bin-Chi Chang
Rehabilitation Practice and Science
Work related cumulative posterior interosseous neuropathy is a rare cumulative trauma disorder. To the best of our knowledge, a locksmith with this kind of disorder has never been reported. The locksmith was a 57-year-old man, and he had to perform repeated supination and pronation movements when working. He complained of weakness of right third and fourth finger extension when typing on a computer keyboard. Radial deviation was also noted when his wrist was extended. Electromyography was performed and right posterior interosseous neuropathy was suspected. Magnetic resonance imaging (MRI) showed perineural muscle edema, obliteration and fluid accumulation at the level of …
Primary Reasons For Rehabilitation Service Referrals: The Recent Experience Of A Medical Center In Taiwan, Chung-Po Su, Ssu-Yuan Chen, Tyng-Guey Wang, Yen-Ho Wang, I-Nan Lien
Primary Reasons For Rehabilitation Service Referrals: The Recent Experience Of A Medical Center In Taiwan, Chung-Po Su, Ssu-Yuan Chen, Tyng-Guey Wang, Yen-Ho Wang, I-Nan Lien
Rehabilitation Practice and Science
Objectives: To better understand the current utilization of rehabilitation services and to project future trends, this study investigated the primary reasons for rehabilitation services referrals in a medical center in Taiwan. Methods: We reviewarticleed records of those patients who visited rehabilitation clinics (4,305 new and 12,163 returned patients) or received a rehabilitation consultation during their hospital stay (1,345 patients) between June and October 2007 at the National Taiwan University Hospital. The primary diagnoses of study patients were classified into 12 groups: musculoskeletal and soft tissue diseases, brain diseases, spinal cord diseases, peripheral neuropathy, myopathy, fractures and amputations, language disorders, cardiovascular …
Assessment Of Individual Activities Of Daily Living And Its Association With Self-Rated Health Status In Elderly People, Yu-Ning Hu, Chin-Ching Li, Chia Lee, Rung-Huei Lin, Gwo-Chi Hu
Assessment Of Individual Activities Of Daily Living And Its Association With Self-Rated Health Status In Elderly People, Yu-Ning Hu, Chin-Ching Li, Chia Lee, Rung-Huei Lin, Gwo-Chi Hu
Rehabilitation Practice and Science
Health-related quality-of-life in the elderly generally encompasses freedom from disease, good physical and psycho-social well-being, and preventing the loss of function in activities of daily living (ADL). Some indices of ADL, such as basic ADL and instrumental ADL, are considered to be measures of functional status in the elderly. However, in most studies, functional status is evaluated by either the summed ADL score or disability score in one or more ADLs. No studies have investigated the association between an individual's ADL function and self-rated health status. The purpose of this study was to investigate the relationship of functional status (i.e., …
Clinical Experience Of Ventriculoperitoneal Shunt Dysfunction In A Patient With Hydrocephalus After Brain Injury: A Casereport, Shean-Jing Lin, Yun-Yee Chen, Mu-Jung Kao, Ching-Yang Lin, Sheng-Huang Hsiao
Clinical Experience Of Ventriculoperitoneal Shunt Dysfunction In A Patient With Hydrocephalus After Brain Injury: A Casereport, Shean-Jing Lin, Yun-Yee Chen, Mu-Jung Kao, Ching-Yang Lin, Sheng-Huang Hsiao
Rehabilitation Practice and Science
We report a case of an adult patient with post-traumatic hydrocephalus who was treated using a ventriculoperitoneal (VP) shunt with a fixed pressure setting valve. Slit ventricle syndrome was found two months later and an antisiphon device (ASD) was added. A fixed pressure valve with ASD was found not to be optimal in terms of improving his neurological symptoms and a programmable valve system was therefore implanted with a pressure setting of 140 mmH2O in the beginning. The valve then was gradually programmed to reduce down to 70 mmH2O over two months. This case demonstrates that selection of a shunting …
Femoral Nerve Injury Following Transfemoral Angiography: A Casereport, Chien-Ching Yu, Ying-Ju Shih, Su-Ju Tsai
Femoral Nerve Injury Following Transfemoral Angiography: A Casereport, Chien-Ching Yu, Ying-Ju Shih, Su-Ju Tsai
Rehabilitation Practice and Science
Femoral nerve injury is a rare complication after femoral angiography. Symptoms including quadriceps weakness and atrophy, absent or reduced knee jerk and sensory impairment along the anterior thigh and medial lower leg have been found. This leads to both muscular weakness and sensory deficit, which impairs walking and interferes with quality of life. Early identification and management of femoral nerve injury could result in better prognosis.We report on the history, diagnosis and rehabilitative outcome of a 54-year-old woman with a medical history of peripheral arterial occlusion disease. She developed significant femoral neuropathy one month after angiography. Severe neurological deficits were …
Spontaneous Spinal Epidural Hemorrhage With Shoulder And Neck Pain As Initial Presentation: A Casereport, Yu-Min Kuo, Wai-Keung Lee, Cheng-Chih Liao, Li-Rong Chen
Spontaneous Spinal Epidural Hemorrhage With Shoulder And Neck Pain As Initial Presentation: A Casereport, Yu-Min Kuo, Wai-Keung Lee, Cheng-Chih Liao, Li-Rong Chen
Rehabilitation Practice and Science
Spontaneous spinal epidural hemorrhage is a very rare disease, with an annual incidence estimated at one per million. Emergency surgery is indicated for a good prognosis, without which the death rate would be higher. Although the initial symptoms of cervical, thoracic, and back pain make it difficult to differentiate spontaneous spinal epidural hemorrhage from other common disease with similar symptoms, magnetic resonance imaging (MRI) is a highly sensitive diagnostic method.We report the case of a 22-year-old male patient who initially complained of pain over the left shoulder and left cervical area. After nine days, numbness was noted in his left …
Rehabilitation In A Patient With Delayed Post-Hypoxic Encephalopathy: A Casereport, Yao-Jen Chen, Su-Ju Tsai, Yueh-Lin Tsai
Rehabilitation In A Patient With Delayed Post-Hypoxic Encephalopathy: A Casereport, Yao-Jen Chen, Su-Ju Tsai, Yueh-Lin Tsai
Rehabilitation Practice and Science
Carbon monoxide poisoning from accidents or suicide attempts often result in delayed post-hypoxic encephalopathy. Patients with delayed post-hypoxic encephalopathy typically present with recurrent apathy, confusion, agitation, and/or progressive neurological deficits, despite apparent transient recovery. Autopsy reports often reveal diffuse demyelination of subcortical white matter, but the exact pathogenesis is not clear. While comprehensive physical examination and history taking is necessary in diagnosing delayed post-hypoxic encephalopathy, magnetic resonance imaging can be very helpful in the diagnostic work-up. Rehabilitation for severe post-hypoxic encephalopathy can prevent complications such as immobilization and can improve patients' functional status.We report the history, diagnosis, and rehabilitative outcome …
Clinical Features And Rehabilitation Of Systemic Lupus Erythematosus Complicated With Moyamoya Syndrome: A Casereport, Wei-Chih Lien, Jo-Tong Chen, Shu-Cheng Lin, Nai-Wen Guo, Da-Shen Kuan
Clinical Features And Rehabilitation Of Systemic Lupus Erythematosus Complicated With Moyamoya Syndrome: A Casereport, Wei-Chih Lien, Jo-Tong Chen, Shu-Cheng Lin, Nai-Wen Guo, Da-Shen Kuan
Rehabilitation Practice and Science
Moyamoya disease is an uncommon clinical entity characterized by progressive narrowing and occlusion of the bilateral distal internal carotid arteries, as well as the proximal parts of their major branches, namely, the middle and anterior cerebral arteries. Concomitant development of prominent collateral vascularity in the basal regions of the brain results in the typical angiographic appearance of moyamoya, which literally means a wavering puff of smoke. Moyamoya syndrome refers to findings of moyamoya vasculopathy in the context of known systemic disease. We present a 26-year-old woman with systemic lupus erythematosus who had several episodes of ischemic stroke. Her cerebral angiograms …
Self-Assessment Examination For Residents In Physical Medicine And Rehabilitation: First Experience In Taiwan, I-Nan Lien, Tyng-Guey Wang, Shin-Liang Pan, Rai-Chi Chan
Self-Assessment Examination For Residents In Physical Medicine And Rehabilitation: First Experience In Taiwan, I-Nan Lien, Tyng-Guey Wang, Shin-Liang Pan, Rai-Chi Chan
Rehabilitation Practice and Science
Objective: The national Self-Assessment Examination (SAE) for residents has been held in the United States for many years. However, no similar test has been held by any medical specialty association in Taiwan. The first national SAE in Physical Medicine and Rehabilitation (PM & R) aimed to provide a benchmark for residents and medical institutes.Material and Methods: The written questions of the Certification Examination 2005 of the Taiwan Board of PM & R were used in the SAE for residents. Participants were first to third year residents in PM & R from various medical institutes and candidates for the board examination …
Rehabilitation Of Middle-Aged And Elderly Patients With Rotator Cuff Tear, Chen-Liang Chou, Yuan-Yang Cheng, Ching-Chun Chen, Chia-Ling Chang, Tung-Fu Huang, Shun-Ping Cheng, Tcho-Jen Liu
Rehabilitation Of Middle-Aged And Elderly Patients With Rotator Cuff Tear, Chen-Liang Chou, Yuan-Yang Cheng, Ching-Chun Chen, Chia-Ling Chang, Tung-Fu Huang, Shun-Ping Cheng, Tcho-Jen Liu
Rehabilitation Practice and Science
Rotator cuff tear is one of the most common causes of shoulder disability in middle-aged and elderly people. Although many patients with rotator cuff tear have pain and dysfunction, there is a great variability in the clinical manifestations. The management of rotator cuff tear includes non-operative and operative methods. The purpose of this study was to evaluate the therapeutic effect of rehabilitation and to compare the rehabilitation effects between patients receiving operation or not.Twenty-two patients were enrolled in this study (13 operative and 9 non-operative). Each subject received rehabilitation therapy (including heat packing, TENS, massage, and therapeutic exercise) twice a …
Rehabilitation Of Patients With Melas Syndrome: A Casereport, Chia-Sho Yang, Tsung-Ying Li, Shuu-Hai Jiang, Chang-Hung Hsu, Yaw-Don Hsu, Shin-Tsu Chang
Rehabilitation Of Patients With Melas Syndrome: A Casereport, Chia-Sho Yang, Tsung-Ying Li, Shuu-Hai Jiang, Chang-Hung Hsu, Yaw-Don Hsu, Shin-Tsu Chang
Rehabilitation Practice and Science
MELAS (mitochondrial encephalomyopathy, lactic acidosis, and recurrent stroke-like episodes) syndrome is a mitochondrial disorder. Patients with mitochondrial myopathies typically have exercise-induced symptoms. Thus, patients are often advised to avoid exercise, which leads to deconditioning. Currently, the concept of aerobic exercise training as therapy for mitochondrial disease is not well established. We report the case of a patient with adult-onset MELAS, who responded positively to a low intensity rehabilitation program. Low intensity training was safe and significantly improved our patient's physical fitness. During the 20-month follow-up period, there was no significant reduction in muscle strength and function. Therefore, short-term endurance training …
Spontaneous Intracranial Hypotension With Multiple Ischemic Stroke: A Casereport, Won-Jean Lin, Wai-Keung Lee, Yau-Wai Wai, Li-Rong Chen, Cheng-Chih Liao
Spontaneous Intracranial Hypotension With Multiple Ischemic Stroke: A Casereport, Won-Jean Lin, Wai-Keung Lee, Yau-Wai Wai, Li-Rong Chen, Cheng-Chih Liao
Rehabilitation Practice and Science
The causes of cerebrospinal fluid leakage leading to intracranial hypotension are generally iatrogenic or due to trauma. Postural headache is usually a characteristic symptom of intracranial hypotension, although other presenting neurologic symptoms occur, such as cranial nerve injury, vomiting, dizziness, photophobia, ataxia, dementia, coma, or death. A spontaneous cause for intracranial hypotension is uncommon. Intracranial hypotension with ischemic stroke, as described herein, has not been previously reported.A 43-year-old man complained of intermittent headaches for approximately one year, but the symptoms remitted with bedrest. He was ultimately sent to the hospital due to a severe headache. Although there were no significant …
Bilateral Sciatic Neuropathy Due To Drug Overdose With Coma, Susan Y Fan, Chang-Zern Hong, Lin-Fen Hsieh, Yii-Jiun Shao, Hsu-Yi Chen
Bilateral Sciatic Neuropathy Due To Drug Overdose With Coma, Susan Y Fan, Chang-Zern Hong, Lin-Fen Hsieh, Yii-Jiun Shao, Hsu-Yi Chen
Rehabilitation Practice and Science
Limb compression in an unattended comatous patient often results in peripheral nerve injuries; however, bilateral sciatic neuropathy in these patients has rarely been described in literature. A 37-year-old woman with bilateral numbness and paralysis of the lower limb after drug overdose with coma was reported. After onset of unconsciousness, she was in a seated position with trunk and hips flexed and knees nearly fully extended for approximately ten hours. In the department of emergency, she was found to have bilateral thighs and buttocks swollen as well as myoglobulinuria. Electrodiagnostic studies supported a diagnosis of complete denervation bilaterally in the distribution …
Rehabilitation Problems In An Adult Patient After Acute Disseminated Encephalomyelitis: A Casereport, Hsiao-Huei Chen, Lin-Fen Hsieh, Feng-Chu Tseng
Rehabilitation Problems In An Adult Patient After Acute Disseminated Encephalomyelitis: A Casereport, Hsiao-Huei Chen, Lin-Fen Hsieh, Feng-Chu Tseng
Rehabilitation Practice and Science
Acute disseminated encephalomyelitis is a monophasic disorder of unknown pathogenesis, characterized by demyelination of the central nervous system. The possible T-cell immune-mediated inflammatory process, affecting mainly children and young adults, typically follows a recent infection or immunization. Meningeal symptoms are common early in the course and often begin 1-3 weeks after infection. Abnormalities of motor, sensory, gait, visual, and cognitive function are variable and depend on the location (cerebral white matter, brainstem, cerebellum, or spinal cord) of the most severely damaged areas of the nervous system. Acute disseminated encephalomyelitis is unusual in middle-aged or elderly adults. The mortality rate is …
Vertebroplasty On Patients With Osteoporotic Vertebral Compression Fractures, Tsung-Ying Li, Shuu-Hai Jiang, Ho-Jui Tung, Ming-Chi Lin, Kao-Chung Tsai
Vertebroplasty On Patients With Osteoporotic Vertebral Compression Fractures, Tsung-Ying Li, Shuu-Hai Jiang, Ho-Jui Tung, Ming-Chi Lin, Kao-Chung Tsai
Rehabilitation Practice and Science
Introduction: There are more than three hundred thousand cases of osteoporotic vertebral compression fractures in Taiwan. To hasten the healing process and minimize the related complications of fracture, various treatments have been evolved. In 1987, the technique of percutaneous vertebroplasty was first developed in Europe by a group of radiologists. Before that, conservative treatment, rehabilitation intervention and a surgical approach had been used, with diverse outcomes, as reported in various studies. Although these methods had been developed over several years, they had rarely been compared in terms of outcome and prognosis, in our hospital. Methods: A retrospective study of treatment …
Trauma-Related Vertebral Artery Dissection With Delayed Onset Cerebellar Infarction: A Casereport, Tsung-Ying Li, Liang-Cheng Chen, Shuu-Hai Jiang, Shiou-Ping Lin, Kao-Chung Tsai
Trauma-Related Vertebral Artery Dissection With Delayed Onset Cerebellar Infarction: A Casereport, Tsung-Ying Li, Liang-Cheng Chen, Shuu-Hai Jiang, Shiou-Ping Lin, Kao-Chung Tsai
Rehabilitation Practice and Science
Cerebellar stroke is uncommon in young patients. We report the case of a 22-year-old man with a delayed cerebellar infarction secondary to vertebral artery dissection caused by trauma. While riding a bicycle as part of an extreme sport, his left clavicle struck a bicycle handle. Evaluation in the emergency room led to a diagnosis of left shoulder contusion without fracture of clavicle or cervical spine. Headache, severe vomiting, and weakness of the right-sided limbs developed three days later, and he presented to emergency staff again. Head injury was initially suspected, but the diagnosis was left vertebral artery dissection with delayed-onset …
Churg-Strauss Syndrome: A Casereport, Wan-Chia Lee, Cheng-Liang Chou, Po-Zong Pan, Tcho-Jen Liu, Rai-Chi Chan
Churg-Strauss Syndrome: A Casereport, Wan-Chia Lee, Cheng-Liang Chou, Po-Zong Pan, Tcho-Jen Liu, Rai-Chi Chan
Rehabilitation Practice and Science
Churg-Strauss syndrome (CSS) is a rare systemic vasculitis of unknown cause, occurring in patients with asthma and accompanied by hypereosinophilia. Pathologically, CSS is characterized by necrotising eosinophilic vasculitis which may involve multiple organ systems, commonly including the lungs, skin, and peripheral nervous system. Corticosteroids are the first-line therapy, with cyclophosphamide as adjuvant therapy. The overall prognosis is good.We report a case of CSS with the clinical pattern of asthma, hypereosinophlilia (＞10%), pulmonary infiltration, and mononeuritis multiplex. Progressive weakness and numbness in the bilateral hands and lower limbs, with associated walking inability, remained a concern despite steroid treatment. The patient underwent …