Begell House Inc.
Critical Reviews™ in Physical and Rehabilitation Medicine
CRP
0896-2960
16
4
2004
Hand Splints in Rehabilitation
24
10.1615/CritRevPhysRehabilMed.v16.i4.10
Tatjana
Paternostro-Sluga
Department of Physical Medicine and Rehabilitation, University of Vienna, General Hospital, Waehringer Guertel 18-20, A 1090 Vienna, Austria
Martina
Stieger
Department of Physical Medicine and Rehabilitation, University of Vienna, General Hospital, Waehringer Guertel 18-20, A 1090 Vienna, Austria
Hand splinting in rehabilitation has a long tradition and represents a well-established clinical treatment method. There are various therapeutic goals in hand splinting, from immobilization to functional improvement. Pathological conditions that frequently require splint treatment as a part of their rehabilitation management are rheumatoid arthritis (RA), osteoarthritis, tendinopathies, neurological diseases, and burn injuries. Moreover, splint treatment plays an important role in the aftercare of hand surgery. Scientific evidence is poor. There are a number of studies about RA demonstrating that working wrist splints do not have a detrimental effect on grip strength, but no beneficial effects can be statistically proven. The studies concerning splint treatment of carpal tunnel syndrome (CTS) report evidence for significant short-term relief from clinical symptoms. Following stroke there is insufficient evidence to support or refute the effectiveness of hand splinting. The lack of clinical evidence is in contrast to the widespread clinical use. It is our hope that this review article will encourage physicians and therapists to conduct randomized, controlled clinical trials to broaden the scope of available evidence of the efficacy of this treatment method.
Alcohol-Induced Osteonecrosis
18
10.1615/CritRevPhysRehabilMed.v16.i4.20
Christopher
Chang
University of California at Davis, Division of Rheumatology, Allergy and Clinical Immunology, 451 E. Health Sciences Drive, Suite 6510, Davis, CA 95616
M. Eric
Gershwin
University of California at Davis, Division of Rheumatology, Allergy and Clinical Immunology, 451 E. Health Sciences Drive, Suite 6510, Davis, CA 95616
Avascular necrosis, or osteonecrosis, occurs as a result of disruption of blood supply to a segment of bone. The etiology of this disruption is variable and potential causes include trauma, corticosteroids, alcoholism, fat emboli, systemic lupus erythematosus, organ transplantation, dysbaric osteonecrosis, Cushing's disease, pregnancy, cancer, pancreatitis, and infections caused by retroviral agents. The susceptibility of a segment of bone to develop osteonecrosis depends greatly on the vascular supply to that segment; the femoral head is the most common site and accounts for over 50,000 total hip joint replacements/year in the United States. In this review, we discuss the pathogenesis of avascular necrosis based on a review of 383 peer-reviewed manuscripts and including 78 articles selected for discussion. The focus of this article is, also, on the role of alcohol as the third most common cause of avascular necrosis. Alcohol is known to have detrimental effects on many organ systems and alcohol abuse can lead to cirrhosis of the liver. However, multiple studies have demonstrated that alcohol can adversely affect the musculoskeletal, nervous, cardiac, gastrointestinal, and endocrine systems. In genetically susceptible individuals, alcohol has a profound effect on fat metabolism, which directly influences blood supply to marginal areas of arterial perfusion such as the femoral heads. The medical practitioner should be aware that early diagnosis is essential. Conservative therapies, such as heat, massage, ultrasound, diathermy, electrostimulation, and exercise, will not work and may delay the diagnosis. The implications of alcohol usage can be profound, leading to irreversible necrosis, with attendant joint morbidity.
Treating Chronic Cognitive Impairment After Traumatic Brain Injury: A Review of Post-traumatic Neurotransmitter-Based Interventions
18
10.1615/CritRevPhysRehabilMed.v16.i4.30
Mark D.
Whiting
Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
Robert J.
Hamm
Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
Chronic cognitive impairment is a frequent and enduring aspect of traumatic brain injury in both humans and animals. Animal models of traumatically induced cognitive impairment provide the groundwork for future clinical studies aimed at treating chronic cognitive dysfunction after head injury. This article will review the results of posttraumatic neurotransmitter-based interventions aimed at improving cognitive recovery in animal models of traumatic brain injury. The scope of this review is limited to experiments designed to treat the chronic stages of head injury, and the interventions tested must have been initiated after injury and continued for a period of days. Where applicable, results from clinical studies are considered. A brief review of current techniques used in experimental traumatic brain injury are presented.
Evaluating and Retraining Driving Performance in Clients with Disabilities
36
10.1615/CritRevPhysRehabilMed.v16.i4.40
Barbara
Mazer
School of Physical and Occupational Therapy, McGill University, Montreal, Quebec H3G 1Y5, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Quebec H7V1R2, Canada
Isabelle
Gelinas
School of Physical and Occupational Therapy, McGill University, Montreal, Quebec H3G 1Y5, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Quebec H7V1R2, Canada
Dana
Benoit
McGill University, School of Physical and Occupational Therapy; Centre de readaptation Constance-Lethbridge, Montreal, Quebec, Canada
This critical review article summarizes the literature regarding the evaluation and retraining of driving skills in clients with a range of physical, perceptual, and cognitive disabilities. The impact of aging, as well as different disabling conditions, such as stroke, traumatic brain injury, spinal cord injury, and dementia, on the ability to drive safely, is discussed. The article first provides the conceptual framework for the psycho-motor, sensory/perceptual, and cognitive skills required for the driving task, as well as different driving models presented in the literature. Information regarding screening of fundamental driving skills, evaluating driving performance, and methods of retraining driving ability is then provided. Finally, this article examines current knowledge about the provision of adaptive equipment and managing driving cessation. The information reviewed in this article provides health care providers and researchers with the evidence available to-date in the field of driving for clients with disabilities.
Indexes
4
10.1615/CritRevPhysRehabilMed.v16.i4.50