Indirect Ultrasound Guidance Increased Accuracy of the Glenohumeral Injection Using the Superior Approach: A Cadaveric Study of Injection Accuracy.

Indirect Ultrasound Guidance Increased Accuracy of the Glenohumeral Injection Using the Superior Approach: A Cadaveric Study of Injection Accuracy.

Ann Rehabil Med. 2013 Apr; 37(2): 202-207
Kim JS, Kim MW, Park DY

To investigate whether or not indirect ultrasound guidance could increase the accuracy of the glenohumeral joint injection using the superior approach.Twelve shoulders from 7 adult cadavers were anatomically dissected after a dye injection had been performed, while the cadavers were in the supine position. Before the injection, a clinician determined the injection point using the ultrasound and the more internal axial arm rotation was compared to how it was positioned in a previous study. Injection confidence scores and injection accuracy scores were rated.The clinician’s confidence score was high in 92% (11 of 12 shoulders) and the injection accuracy scores were 100% (12 of 12 shoulders). The long heads of the biceps tendons were not penetrated.Indirect ultrasound guidance and positioning shoulder adducted at 10° and internally rotated at 60°-70° during the superior glenohumeral joint injection would be an effective method to avoid damage to the long head of biceps tendons and to produce a highly accurate injection. HubMed – rehab

 

Effect of Medial Branch Block in Chronic Facet Joint Pain for Osteoporotic Compression Fracture: One Year Retrospective Study.

Ann Rehabil Med. 2013 Apr; 37(2): 191-201
Park KD, Jee H, Nam HS, Cho SK, Kim HS, Park Y, Lim OK

To evaluate the outcomes of medial branch block in facet joint pain for osteoporotic compression fracture and utilize multiple regression, the relationship between their impact on treatment outcome and other factor, such as the radiologic finding, clinical parameters was analyze.Fifty-three patients with axial back pain from osteoporotic compression fracture were enrolled. The clinical outcomes were measured by Verbal Numeric Rating Scale (VNS) and Oswestry Disability Index (ODI) before treatment, 2 weeks, 3 months, and 12 months after the medial branch block. Radiographic analysis included measurement of overall sagittal alignment, collapsed vertebral height, and vertebral kyphotic angle. After 12 months, patients’ satisfaction was classified to five categories: excellent, good, fair, poor or fail. Statistical analysis of both radiographic and clinical parameters along with treatment outcome was performed to determine any significant correlations between the two.VNS and ODI was improved 2 weeks after the injection and continued to improve until 12 months. Significant improvement with significant pain relief (>40%), functional improvement (>20%), and the patients rated their satisfaction level as “excellent” or “good” at 12 months after the first injection were observed in 78.9%. The radiographic and clinical parameters were not significantly correlated with treatment outcome.Our retrospective study demonstrated that the medial branch block provided significant pain relief and functional recovery to the patients with osteoporotic spinal compression fractures complaining of continuous facet joint pain after vertebroplasty or conservative treatment. A placebo-controlled prospective randomized double-blind study should be conducted in the future to evaluate the treatment effects. HubMed – rehab

 

The Cervical Range of Motion as a Factor Affecting Outcome in Patients With Congenital Muscular Torticollis.

Ann Rehabil Med. 2013 Apr; 37(2): 183-190
Lee JY, Koh SE, Lee IS, Jung H, Lee J, Kang JI, Bang H

To investigate the factors affecting rehabilitation outcomes in children with congenital muscular torticollis (CMT).We retrospectively reviewed the medical records of 347 patients who were clinically suspected as having CMT and performed neck ultrasonography to measure sternocleidomastoid (SCM) muscle thickness. Fifty-four patients met the inclusion criteria. Included were demographic characteristics as well as measurements of cervical range of motion (ROM), SCM muscle thickness, and the abnormal/normal (A/N) ratio, defined as the ratio of SCM muscle thickness on the affected to the unaffected side.Subjects were divided into three groups depending on degree of cervical ROM (group 1A: ROM>60, n=12; group 1B: 60?ROM>30, n=31; group 1C: ROM?30, n=11), the SCM muscle thickness (Th) (group 2A: Th<1.2 cm, n=23; group 2B: 1.2?Th<1.4 cm, n=18; group 2C: Th?1.4 cm, n=13), and the A/N ratio (R) (group 3A: R<2.2, n=19; group 3B: 2.2?R<2.8, n=20; group 3C: R?2.8, n=15). We found that more limited cervical ROM corresponded to longer treatment duration. The average treatment duration was 4.55 months in group 1A, 5.87 months in group 1B, and 6.50 months in group 1C. SCM muscle thickness and the A/N ratio were not correlated with treatment duration.Infants with CMT who were diagnosed earlier and had an earlier intervention had a shorter duration of rehabilitation. Initial cervical ROM is an important prognostic factor for predicting the rehabilitation outcome of patients with CMT. HubMed – rehab

 

Videofluoroscopic Swallowing Study Findings in Full-Term and Preterm Infants With Dysphagia.

Ann Rehabil Med. 2013 Apr; 37(2): 175-182
Uhm KE, Yi SH, Chang HJ, Cheon HJ, Kwon JY

To determine the clinical characteristics and videofluoroscopic swallowing study (VFSS) findings in infants with suspected dysphagia and compare the clinical characteristics and VFSS findings between full-term and preterm infants.A total of 107 infants (67 full-term and 40 preterm) with suspected dysphagia who were referred for VFSS at a tertiary university hospital were enrolled in this retrospective study. Clinical characteristics and VFSS findings were reviewed by a physiatrist and an experienced speech-language pathologist. The association between the reasons of referral for VFSS and VFSS findings were analyzed.Mean gestational age was 35.1±5.3 weeks, and mean birth weight was 2,381±1,026 g. The most common reason for VFSS referral was ‘poor sucking’ in full-term infants and ‘desaturation’ in preterm infants. The most common associated medical condition was ‘congenital heart disease’ in full-term infants and ‘bronchopulmonary dysplasia’ in preterm infants. Aspiration was observed in 42 infants (39.3%) and coughing was the only clinical predictor of aspiration in VFSS. However, 34 of 42 infants (81.0%) who showed aspiration exhibited silent aspiration during VFSS. There were no significant differences in the VFSS findings between the full-term and preterm infants except for ‘decreased sustained sucking.’There are some differences in the clinical manifestations and VFSS findings between full-term and preterm infants with suspected dysphagia. The present findings provide a better understanding of these differences and can help clarify the different pathophysiologic mechanisms of dysphagia in infants. HubMed – rehab