Rehab Centers: Validity and Reliability of the Assessment and Diagnosis of Musculoskeletal Elbow Disorders Using Telerehabilitation.

Validity and reliability of the assessment and diagnosis of musculoskeletal elbow disorders using telerehabilitation.

Filed under: Rehab Centers

J Telemed Telecare. 2012 Oct 19;
Lade H, McKenzie S, Steele L, Russell TG

We examined the validity and reliability of a physiotherapy examination of the elbow, using telerehabilitation. The patho-anatomical diagnoses, systems diagnosis and physical examination findings of face-to-face physiotherapy examinations were compared with telerehabilitation examinations. Ten participants attended a single session, during which they were interviewed, a face-to-face physical examination was performed and a remote physical examination was conducted, guided by an examiner at a different location via a telerehabilitation system. Conventional face-to-face physiotherapy physical examination test results, diagnoses and systems diagnoses were compared to those produced by an examiner using the telerehabiliation system. There was substantial agreement for systems diagnosis (73%; P = 0.013) for validity and almost perfect agreement for intra-rater reliability (90%; P = 0.001). The inter-rater reliability had a weaker and non-significant agreement (64%; P = 0.11). Physical examination data demonstrated >68% agreement across all three datasets, between the examination methods. Performing a telerehabilitation physical examination to determine a musculoskeletal diagnosis of the elbow joint complex is both valid and reliable.
HubMed – rehab


[Extraction and purification of acidic polysaccharide from Moerella iridescens].

Filed under: Rehab Centers

Zhejiang Da Xue Xue Bao Yi Xue Ban. 2012 Sep; 41(5): 569-75
Xiang W, Ding X, Zhang XL, Wu YY, Chen SH

Objective: To optimize extraction and purification methods of acidic polysaccharide from Moerella iridescens (MIAP). Methods: With alkali extraction process and orthogonal experiment,the time consumption,temperature,pH value of the solution and alcohol concentration during the extraction were optimized. The crude products were deprived of protein,pigment and ion,then were purified with DEAE-cellulose ion-exchange chromatography and verified with Sephadex G-100 and cellulose acetate membrane electrophoresis,and examined with infrared spectrum. Results: The optimized extraction conditions were as follows: extraction time 6 h,extraction temperature 70 degree,the solution pH 8.0 and the concentration of alcohol precipitation 70%. Intuitive features showed that the MIAP was pure white crystalline granular with slight dark brown color. The purification results demonstrated that the target MIAP was eluted and identified as a homogeneous components by DEAE-cellulose ion exchange column,Sephadex G-100 and cellulose acetate membrane electrophoresis. Infrared spectral scanning suggested that MIAP was ?-D-type terminated glucopyranose. Intuitive features showed that MIAP was soft and cottony white. Conclusion: The extraction process with orthogonal test has been optimized and the acidic polysaccharide from Moerella iridescens is successfully isolated.
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Undetected Pectoralis Major Tendon Rupture in a Patient Referred to a Physical Therapist in a Combat Environment: A Case Report.

Filed under: Rehab Centers

Phys Ther. 2012 Oct 19;
Hoppes CW, Ross MD, Moore JH

BACKGROUND AND PURPOSE:/b>This case report describes a patient referred to a physical therapist for treatment of a shoulder strain who was eventually diagnosed with a rupture of his pectoralis major tendon that required surgical repair. The purpose of this case report is to highlight the management of this injury within the unique constraints of a combat environment. CASE DESCRIPTION: /b>A 29 year-old man, currently serving as an active duty Soldier in the U.S. Army in Iraq had a sudden onset of right shoulder pain during the concentric portion of a bench press. He was seen by a physician immediately following the injury, diagnosed with a shoulder strain, and referred to a physical therapist for a sling and exercise instruction. Based on the history and physical examination findings, which were consistent with a pectoralis major tendon rupture, the physical therapist placed a consult to an orthopaedic surgeon in the United States through teleconsultation since orthopaedic surgeons were not easily accessible in Iraq for nonemergent musculoskeletal referrals. Subsequently, the orthopaedic surgeon advised evacuating the patient out of Iraq for surgical management. OUTCOMES: /b>The patient was diagnosed via magnetic resonance imaging with a rupture of his pectoralis major at the musculotendinous junction near its insertion into the greater tubercle of the humerus that required surgical repair. At 3 months following surgery, the patient had full pain-free shoulder active range of motion and had progressed well through his strengthening program in a manner that allowed return to full duty. At 6 months following surgery, the patient maintained his full duty status and was performing a routine of strength training 3 times per week, and had met all of his rehabilitation and personal goals. DISCUSSION:/b>Successful management of this patient depended upon analysis of the history and physical examination findings by the physical therapist to form an accurate diagnosis. In addition, timely medical evacuation and referral to an orthopedic surgeon for surgical management were coordinated in a combat environment. Completion of a progressive rehabilitation program following pectoralis major tendon repair also contributed to this patient’s full recovery and return to duty. Had the physical therapist only followed the initial referral request, given this patient’s military duties and sports and recreational activities, this case would likely have resulted in suboptimal outcomes.
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Lack of severe long-term outcomes of acute, subclinical B(1) deficiency in 216 children in Israel exposed in early infancy.

Filed under: Rehab Centers

Pediatr Res. 2012 Oct 19;
Ornoy A, Tekuzener E, Braun T, Dichtiar R, Shohat T, Cassuto H, Keinan-Boker L

Background:A vitamin B(1)-deficient soy-based infant formula was marketed in Israel in 2003, exposing infants to clinical or subclinical B(1) deficiency. We investigated whether subclinical B(1) deficiency in early infancy had medical, neuro-developmental or cognitive effects at 3-5 years of age.Methods:A historical prospective cohort study was conducted consisting of 4 groups: ‘exposed’, consuming a B(1)-deficient soy-based formula exclusively for 4 consecutive weeks or longer; ‘control’, consuming no soy-based formula; ‘mixed’, consuming the formula nonexclusively or exclusively for less than 4 consecutive weeks; and ‘other’, consuming soy-based formulas other than Remedia. Participants were evaluated by medical examination, Stanford-Binet (SB) intelligence test, sensory profile evaluation, and Conners Scales (ADD/ADHD).Results:Following adjustment for gender, age and maternal education, there were no significant differences between the 4 groups on the mean SB scores, on the verbal and non-verbal scores, or the proportion of children in each group with scores <90. A significantly higher proportion of exposed children compared with control children had an impaired sensory profile and scores on the Conners Scales (ADD/ADHD)but these proportions were also high in the 'other' and 'mixed' groups.Conclusions:The results do not support an association between subclinical B(1) deficiency in infancy and long-term development.Pediatric Research (2012); doi:10.1038/pr.2012.140. HubMed – rehab


Using lean principles to manage throughput on an inpatient rehabilitation unit.

Filed under: Rehab Centers

Am J Phys Med Rehabil. 2012 Nov; 91(11): 977-83
Chiodo A, Wilke R, Bakshi R, Craig A, Duwe D, Hurvitz E

ABSTRACT: Performance improvement is a mainstay of operations management and maintenance of certification. In this study at a University Hospital inpatient rehabilitation unit, Lean management techniques were used to manage throughput of patients into and out of the inpatient rehabilitation unit. At the start of this process, the average admission time to the rehabilitation unit was 5:00 p.m., with a median time of 3:30 p.m., and no patients received therapy on the day of admission. Within 8 mos, the mean admission time was 1:22 p.m., 50% of the patients were on the rehabilitation unit by 1:00 p.m., and more than 70% of all patients received therapy on the day of admission. Negative variance from this performance was evaluated, the identification of inefficient discharges holding up admissions as a problem was identified, and a Lean workshop was initiated. Once this problem was tackled, the prime objective of 70% of patients receiving therapy on the date of admission was consistently met. Lean management tools are effective in improving throughput on an inpatient rehabilitation unit.
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