Content JRM CC - Articles available online

Objective: To describe a case of early management of post-stroke spasticity treated with incobotulinumtoxinA (IncoA) in a patient with SARS-CoV-2 (COVID-19). Scarce information is available on this subject, as the COVID-19 pandemic has necessitat-ed postponement of interventions in infected and clinically suspicious patients. Case report: A 58-year-old woman presenting with ischaemic stroke, was ...

Evidence shows that, in order to attain optimum outcomes, rehabilitation interventions should be delivered by multi-professional teams. A rehabilitation nurse is one of the relevant rehabilitation professionals. The model of nursing care has shifted from the traditional model (a passive role of patients) to a complex and modern concept of nursing in supporting patients to independently and activel ...

Phantom limb pain is clinically defined as the perception of pain or discomfort in a limb that no longer exists. Most amputees will experience phantom limb pain, which is associated with a low health-related quality of life. Phantom limb pain represents an important challenge in finding an effective therapy. The scientific evidence for best practice is weak, and is characterized by various clinica ...

Pain, stiffness and joint deformity can result in significantly reduced hand function in people with osteoarthritis. Characteristic finger deformities in osteoarthritis are swan neck deformity and boutonnière deformity. Several studies have reported that an orthosis decreases pain and increases function during daily activities for patients with arthritis. The aim of this study was to review patie ...

The consequences and optimal treatment of quadriceps fibrosis following intramuscular quinine injection during childhood remain unclear. We report here a case of a 17-year-old girl who experienced unilateral quadriceps fibrosis following intramuscular injection of quinine as a baby. This case report describes the evolution of the condition during the child's growth, the long-term impact of early f ...

Objective: Toe walking due to progressive shortening of the calf muscles is common in people with hereditary spastic paraplegia. Achilles tendon lengthening is a treatment option, but clinicians are often hesitant to use this procedure, as it may result in weakening of the calf muscles and, subsequently, in reduced ankle power and knee instability during the stance phase of gait. We report here a ...

For special populations such as people with a mental health issue or learning disability, a disconnect between the ability to accurately monitor and regulate exercise behaviour can lead to reduced levels of physical activity, which, in turn, is associated with additional physical or mental health problems. Activity pacing is a strategy used in clinical settings to address issues of pain ameliorati ...

Objective: To assess satisfaction of prosthesis users with their prostheses, and the problems they experience with the residual limb, using a checklist, in order to evaluate potential benefits of checklist use and to summarize issues and problems with the prosthesis and/or residual limb presented by prosthesis users. Design: Cross-sectional study. Subjects: Participants were adult trans-tibial p ...

Despite increasing evidence for, and heightened awareness of, the importance of exercise in Parkinson's disease, many patients remain sedentary. This tendency to lead an inactive lifestyle has various underlying reasons, including the presence of gait and balance impairments that complicate the patients' ability to perform sports activities. This case report illustrates that a personally tailored ...

Objective: Low back pain caused by osteoporosis-induced thoracolumbar vertebral compression fractures is a common debilitating disorder. The aims of this study were to determine the accuracy and efficacy of spinal dorsal ramus injection and radiofrequency neurolysis for pain reduction in patients with this condition. Methods: This study was a retrospective chart review of 46 patients with low ba ...

Objective: To describe the sociodemographic features, impairments, and functional changes of COVID-19-positive individuals who underwent inpatient rehabilitation at three rehabilitation hospitals in Toronto, Canada. Design: Retrospective chart review of patients admitted to three COVID-19 rehabilitation units between 20 April 2020 and 3 June 2020. Sociodemographic factors, impairments, length of ...

Background: Intrathecal baclofen is considered an adjuvant therapy for patients with intractable spasms due to stiff-person syndrome. There is increasing evidence to support the use of intrathecal baclofen in the management of symptomatic stiff-person syndrome, with improvement in function. Case report: A 38-year-old woman with stiff-person syndrome initially presented to inpatient rehabilitatio ...

Objective: Periods of lockdown due to coronavirus disease 2019 (COVID-19) have a negative effect on individuals’ physical health and quality of life, and may result in a weakened immune response, leading to enhanced risk of infection. Due to lack of access to public resources during periods of lockdown many individuals cannot perform their usual daily physical activities. The aim of this short r ...

Objective: Alien hand syndrome is a rare neurological disorder in which the patient makes seemingly purposeful movements of one hand, which are dissociated from any conscious intent. These abnormal movements are very annoying, and can be disabling, for the patient. There is no established effective treatment for alien hand syndrome. Methods: Report of a case of a 61-year old man with frontal var ...

Objective: Hand orthoses are often prescribed for persons with chronic hand and wrist impairments. This study assessed the feasibility, in terms of production time and user satisfaction, of 3-dimensional printed hand orthoses compared with conventional hand orthoses for this population. Methods: In this prospective case series, both a conventional hand orthosis and a 3-dimensional printed hand o ...

Objective: To evaluate the effects of personalized exposure in vivo on level of physical activity and quality of life in patients with painful diabetic neuro-pathy. Design: Randomized, single-case, ABC design. Subjects: Twelve patients with painful diabetic neuropathy, age >18 years, diabetes mellitus type II, Clinical Neurological Examination score >5, Diabetic Neuropathy Symptom Score ≥1 a ...

Cancer itself can have lifelong devastating effects, but radiation treatment can often also result in long-lasting neurological and musculoskeletal complications, leading to subsequent severe functional impairments. Physiatrists caring for the cancer rehabilitation population must be able to recognize and treat radiation-induced peripheral nerve in-juries. This report presents a rare case of radia ...

Objective: To evaluate the effect of whole-body vibration training on working-age people on haemodialysis. Design: Consecutive case series study. Subjects: Seventeen working-age participants on maintenance haemodialysis were enrolled. Methods: A 12-week whole-body vibration training programme, including different postures, was designed. The study evaluated and compared phys-ical fitness, includ ...

Objective: To elucidate the characteristics of recovery progression during long-term rehabilitation after moderate-to-severe traumatic brain injury. Methods: Longitudinal changes in consciousness, swallowing disorders, activities of daily living, and psychological and behavioural status were studied in 7 patients with moderate-to-severe traumatic brain injury, using scores of the National Agency ...

Objective: To report the functional outcomes of two patients with morbid obesity (> 250 kg) who received in-reach rehabilitation after hospitalization for sepsis in Sydney, Australia. Case reports: A retrospective review of hospital charts was performed with the informed consent of both patients. Body mass index, demographics, length of stay, functional status at admission and discharge, ...

Platypnea-orthodeoxia syndrome, characterized by dyspnoea and arterial desaturation while upright, is a rare complication of acute respiratory distress syndrome. We report here 2 patients with COVID-19 pneumonia, who were diagnosed with platypnea-orthodeoxia syndrome during commence-ment of rehabilitation, 18 and 9 days respectively after admission to the intensive care unit. Both patients present ...

Introduction: Spinal and bulbar muscular atrophy is a progressive neuromuscular disease that leads to muscle weakness and reduced physical function. Benefits of physical therapy for people with spinal and bulbar muscular atrophy have not been report-ed in the literature. Case report: A 62-year-old male patient with spinal and bulbar muscular atrophy reported falling, difficulty walking and compl ...

With the increasing popularity of extreme conditioning programmes, athletes and patients are searching for new, engaging, high-intensity, total-body workouts. The sport of Hooverball is increasingly used as a workout. First devised in the USA in 1929 to keep President Hoover physically fit, Hooverball has experienced increasing popularity in the past 15 years. The game is scored like tennis and pl ...

We report a case of a Chinese man who developed retroperitoneal haemorrhage almost 1 year after surgery for pelvic fracture (1). To the best of our knowledge, this type of delayed haemorrhaging is rarely observed in clinical practice. We also review the literature to identify the common causes of retroperitoneal haemorrhage in patients undergoing surgery for pelvic fracture and to examine the aeti ...

Objective: To evaluate spasticity and below-level spinal cord injury neuropathic pain after spinal cord injury in patients with, or without, damage to the lumbar spinal cord and roots. Design/patients: Chart review of 269 patients with spinal cord injury from segments C1 to T11. Methods: Patients were interviewed concerning leg spasticity and below-level spinal cord injury neuropathic pain in t ...

Respiratory and neurological complications in patients in various stages of COVID-19 emphasize the role of speech-language pathologists in the assessment and management of swallowing and communication deficits in these patients. The speech-language pathologist works within a multidisciplinary team to identify these deficits, and aims to improve swallowing, nutrition, hydration, speech, and quality ...

Objective: Public health legislation during the COVID-19 pandemic has resulted in forced transitioning to the use of remote care in order to continue the provision of pain rehabilitation worldwide. The objective of this study was to gain insight into clinicians´ initial experiences with the provision of interdisciplinary pain rehabilitation via videoconferencing. Design: Observational, cross-se ...

Objective: To describe a case of nerve kinking correlating with surgical findings in neurogenic thoracic outlet syndrome in a patient with history of brachial neuritis. Thoracic outlet syndrome and brachial neuritis are briefly reviewed. Case report: A 32-year-old woman with a history of bilateral brachial neuritis presented with paraesthesias in her hand when abducting her shoulder to 45° or h ...

Objective: To verify the safety and effectiveness of manual therapy intervention using fascial therapy in adult patients with haemophilic elbow arthropathy. Methods: Prospective cohort study. A total of 28 patients with haemophilic elbow arthropathy was recruited in 3 cities in Spain. Patients received onefascial therapy session per week for 3 weeks. The dependent variables were: frequency of joi ...

Background: To determine whether adolescents with generalized hypermobility spectrum disorder/hypermobile Ehlers-Danlos syndrome (G-HSD/hEDS) show changes in the level of disability, physical functioning, perceived harmfulness and pain intensity after completing multidisciplinary rehabilitation treatment. Methods: Pre-test post-test design. Fourteen adole-scents with G-HSD/hEDS participated. The ...

Objective: Diagnoses of anaplastic oligodendrogliomas are rare. For cancer rehabilitation practitioners, anaplastic oligodendroglioma may impact on the development and maintenance of prescriptive exercise. Exercise interventions for healthy individuals and cancer patients have been shown to increase functional capacity, psychosocial functioning, and aspects of cognitive function. However, there is ...

Objective: It is recommended that cancer survivors incorporate physical activity into their daily lives after in-hospital rehabilitation. However, there is a lack of training programmes focusing on the specific needs of cancer survivors. TriaGO! – an 8-month intervention study of aerobic endurance training for cancer survivors was therefore examined. The training programme aims to meet the parti ...

Issues connected with the reintegration of individuals affected by severe brain injury are numerous and complex. Extensive data indicate the effectiveness of treatments based on an holistic approach, which integrates medical interventions with social programmes and offers continuity, leading to the rapid achievement of independent living outcomes and return to work. In Italy, extensive resources a ...

Objective: To investigate whether intervention to prevent falls is necessary in prior polio patients, by identifying the frequency, circumstances and consequences of falls among patients in Sweden with prior polio. Subjects: Patients with prior polio diagnosis. Methods: A falls history questionnaire was completed by patients with prior polio visiting the outpatient clinic at the Department of ...

Objective: Fabry disease, a rare X-linked disorder, can lead to exercise intolerance. In Taiwan, the cardiac variant of Fabry disease has a significantly higher prevalence than the classic variant. The cardiac variant of Fabry disease primarily involves the heart. Enzyme replacement therapy has been used to treat both variants. We aimed to study the impact of enzyme replacement therapy on exercise ...

Objective: To evaluate the effects of analgesia by sacral surface electrical stimulation on lower abdominal pain in women with primary dysmenorrhoea. Design: Explorative study. Participants: Eleven female university students, who regularly experience difficulty in their university work due to menstrual pain, or who use analgesics for more than one day each month, were recruited. Methods: Sacral ...

Objective: Sleep disturbance in hospital is common. This pilot randomized controlled trial assessed a sleep clinical pathway compared with standard care in improving sleep quality, engagement in therapy and length of stay in musculoskeletal inpatient rehabilitation. Methods: Participants (n = 51) were randomized to standard care (“control”, n = 29) or sleep clinical pathway (“interv ...

Context: Serotonin syndrome is a drug-induced condition related to an increased level of serotonin in the brain, which may induce neuromuscular, auto-nomic and mental symptoms. Case report: A 40-year-old woman with hereditary spastic paraparesis (Strumpell-Lorrain disease) with an implanted intrathecal baclofen pump for severe spasticity. Two days after starting a medication known to inhibit ser ...

Objective: To determine current international practice regarding physiotherapy input for children with ataxia following surgery for posterior fossa tumour. Design: An e-survey covering the following domains: participant demographics, treatment/intervention, virtual training, intensity/timing of treatment, and aims and outcomes of physiotherapy management. Participants: Physiotherapists involved ...

Objectives: Hyper-Acute Rehabilitation Units (HARUs) provide multidisciplinary rehabilitation to patients with acute neurological injuries. This includes managing patients with tracheostomies. This is the first study of its kind to examine clinical outcomes in patients with brain injury and tracheostomy managed in a HARU. Methods: Retrospective analysis of clinical outcomes in tracheostomy patien ...

Background: Creating a custom prosthetic device is challenging. The requirements of the patient’s life must be taken into consideration when manufacturing the device. After having met the requirements for an autonomous daily life, adjustments can be made for recreational activities. Subject and methods: A 67-year-old patient with an above-elbow amputation following a hunting accident want ...

Intrathecal baclofen therapy is a recognized treatment for severe spasticity. We report here a case of stiff person syndrome in Australia, treated with intrathecal baclofen followed by a rehabilitation programme with substantial clinical and functional improvements. A 59-year-old woman diagnosed with stiff person syndrome had become hoist-dependent and required full care due to severe spasticity o ...

Objective: To assess and describe the involvement of all speech subsystems, including respiration, phonation, articulation, resonance, and prosody, in an individual with cervical spinal cord injury. Methods: Detailed speech and voice assessment was performed that included Frenchay Dysarthria Assessment, cranial nerve examination, voice (perceptual and instrumental) and nasometric evaluation, and ...

Objective: To examine the feasibility and practicality of whole body vibration therapy for individuals with dystonic or spastic dystonic cerebral palsy. Design: Pilot study. Subjects: Children and adults with dystonic or spastic dystonic cerebral palsy. Methods: Study participants received total body vibration therapy when standing still on a vibration platform for 3 bouts, duration 3-min, of v ...

Objective: To evaluate comprehensive unmet rehabilitation needs by using a novel graphic screening tool, Rehab-Compass, among individuals in the sub-acute stage after first-ever transient ischaemic attack. Methods: A pilot prospective cohort study investigated 47 individuals with first-ever transient ischaemic attack in an outpatient clinic setting. By using Rehab-Compass, based on well-validated ...

Objective: Sacral insufficiency fractures should be considered in differential diagnosis as a cause of autonomic dysreflexia and other vague symptoms in patients with spinal cord injury. Setting: The Supra Regional Tertiary Centre, Midlands Centre for Spinal Injuries, Oswestry, UK. Method: Outpatient clinic review of 2 patients with long-standing spinal cord injury presenting with vague symptoms ...

Objective: Painful diabetic neuropathy is associated with low quality of life, depression and anxiety. Patients are limited in their performance of activities of daily living due to fears related to their condition. Treatment modalities are needed to help patients cope with their pain and pain-related disability. Exposure in vivo is an effective treatment in other chronic pain syndromes, increasin ...

Objective: Total knee arthroplasty is an effective surgical approach used to treat arthritis and knee trauma. Its utilization has grown, as has the accompanying financial impact, resulting in an equal need to advance physical therapy practice. One emerging approach improving patient outcomes and reducing cost is the inclusion of a preoperative physical therapy visit. The aim of this study was to q ...

Objective: Long-lasting pain is a challenge for patients’ everyday lives. The aim of this study was to examine how women and men who have participated in multimodal pain rehabilitation experience its impact in their everyday lives. Patients and methods: Individual semi-structured interviews with 5 women and 3 men who had participated in multimodal pain rehabilitation at a clinic in Sweden, ana ...

Background: Physical impairment or frailty due to sarcopaenia is common in patients with chronic kidney disease and those receiving dialysis. This study examined the association between muscle weakness and kidney function in Japanese patients with chronic kidney disease. Methods: A total of 23 stable outpatients were enrolled in the study. Several indices were used to assess muscle function; hand ...

Background: The course of Parkinson's disease is characterized by gait disturbance and falls, which affect patients' quality of life and engender high healthcare costs. These factors are not greatly improved by levodopa therapy or deep brain stimulation of the subthalamic nuclei. Indeed, the symptoms may even worsen with these treatment. Physiotherapy may be the most appropriate treatment to reduc ...

Objective: Gait rehabilitation is a major concern for adults with an intellectual disability or a neuropsychological disorder. This study evaluated a collective task exercise that could complement an individual rehabilitation routine in such individuals. The movements of 3 individuals (2 patients and 1 healthy individual) were measured while walking alone and in pairs. The recovery rate, amplitude ...

Osteoarthritis is a group of multiple overlapping pathological conditions that cause destruction of articular cartilage and other structures of the joint. It is a progressive disease that leads to limitations of physical activity. New forms of treatment are therefore sought to alleviate the clinical symptoms of osteoarthritis and avoid surgery. Stem cell based therapy is an emerging field in ortho ...

Background: Growth hormone deficiency is a recognized consequence of traumatic brain injury. The aim of this study was to determine adherence to human growth hormone therapy among patients with traumatic brain injury compared with patients with hypothalamic or pituitary disease. Methods: A retrospective chart review of patients with traumatic brain injury referred for growth hormone stimulation ...

Objective: To compare the number of review papers published in rehabilitation journals during recent years with the number published a decade ago. Methods: PubMed search for review papers publi-shed in 7 major rehabilitation journals in 2005–2007 and 2015–2017. Results: Of the 940 review papers identified, 659 were published in 2015–2017, and 281 in 2005–2007. Two journals: Disability a ...

Background: Within the practice of physical medicine, instrument-assisted soft-tissue mobilization (IASTM) is increasing in popularity. However, the intervention is still in its infancy and important clinical issues require elucidation; among these are the effects on asymptomatic individuals. Methods: Twenty healthy males were allocated randomly to either 3 minutes of high-pressure IASTM or activ ...

Neuropathies of the muscles surrounding the shoulder joint are a well-documented cause of pain and weakness in sports people. Repetitive or excessive traction on the nerve supplying the affected muscle is believed to be the primary mechanism. We describe a case of this phenomenon in a young amateur boxer which has never been described in the literature previously. We document our hypothesis on the ...

Objective: To identify barriers to appropriate referral and treatment for patients with spasticity and present solutions that address these in a pragmatic way. Methods: Using the findings of interviews conducted with UK healthcare professionals on the management of post-stroke spasticity, a consensus meeting was held involving 7 UK spasticity experts. The panel identified barriers to timely iden ...

Objective: To evaluate the safety and outcomes of aerobic and resistance training in patients undergoing cardiac rehabilitation after spontaneous coronary artery dissection. Methods: Eleven patients with spontaneous coronary artery dissection at 2 academic centres were studied retrospectively during cardiac rehabilitation from July 2013 to September 2017. Patients underwent maximal effort exercis ...