NeuroRehabilitation - Volume 1, issue 4

Article Type: Other

DOI: 10.3233/NRE-1991-1401

Citation: NeuroRehabilitation, vol. 1, no. 4, pp. 4-4, 1991

Authors: Frank, Robert C.

Article Type: Introduction

DOI: 10.3233/NRE-1991-1402

Citation: NeuroRehabilitation, vol. 1, no. 4, pp. 6-6, 1991

Authors: Elliott, Timothy R. | Harkins, Stephen W.

Article Type: Research Article

Abstract: Although many persons with spinal cord injuries report problems with persistent, recurrent pain, very little empirical research has examined this issue. The impact of painful conditions on rehabilitation and subsequent adjustment has yet to be empirically clarified. Two studies are reported which (1) investigate differences between persons with and without persistent pain on measures of depression and psychosocial impairment, and (2) examine possible differences in the degree of pain-related suffering between persons with paraplegia and quadriplegia. Results from the first study demonstrate that pain is associated with more depressive behaviors and greater psychosocial impairment regardless oJ the time since the …onset of injury. in the second study, ratings of sensory and affective pain intensities were obtained from persons with paraplegia and quadriplegia. Results indicated that persons with paraplegia displayed more pain-related suffering than persons with quadriplegia for equal intensities of pain sensation. Recommendations for theoretical and clinical considerations in spinal cord injury rehabilitation are provided. Show more

DOI: 10.3233/NRE-1991-1403

Citation: NeuroRehabilitation, vol. 1, no. 4, pp. 7-16, 1991

Authors: Zafonte, Ross D. | Demangone, Dawn A. | Herbison, Gerald J. | Ditunno Jr., John F.

Article Type: Research Article

Abstract: The purpose of the present study was to relate motor function of 34 male C4-C8 motor complete quadriplegic patients to independence in the daily performance of 17 individual self-care activities (5 feeding, 7 dressing, and 5 bed mobility) identified in the Quadriplegia 1ndex of Function at 6 to 24 months after injury. All subjects with function limited to the biceps (bilateral manual muscle tests [ MMT ] ⩾ 3 / 5 ; n = 7 ) required maximal assistance in all evaluated activities, except for two subjects who were independent in supine to side turning and …maintaining sitting balance in bed. Subjects with function limited to the extensor carpi radialis (stronger side MMT ⩾ 3 / 5 ; n = 11 ) were independent in some feeding activities, but most appeared dependent in bed mobility and dressing. The majority of subjects with function limited to the triceps (stronger side MMT ⩾ 3 / 5 ; n = 11 ) performed all self-care tasks independently except for cutting food and lower extremity dressing. These results suggest that although subjects with function limited to the biceps or the extensor carpi radialis may be capable of performing some self-care independently as reported by previous investigators, many do not do so on a daily basis. Show more

DOI: 10.3233/NRE-1991-1404

Citation: NeuroRehabilitation, vol. 1, no. 4, pp. 17-24, 1991

Authors: Saltz, Constance Corley | Eisenberg, Myron | Fillenbaum, Gerda | George, Linda K.

Article Type: Research Article

Abstract: A national study of community-based spinal cord-injured male veterans was conducted by telephone interviews using a modified version of the Older Americans Resources and Services (OARS) Questionnaire (developed at Duke University). The final sample included 719 veterans showing varying degrees of impairment in five levels of functioning: social resources (29.5%), economic resources (40.9%), mental health (19.1%), physical health (62.5%), and activities of daily living (54.5%). Compared to representative community samples of elderly men, aging spinal cord-injured veterans are at greater risk of impairment in four of five dimensions of functioning and are more likely to have impairments in multiple dimensions. …More than 90% used supportive devices and prostheses, transportation, and medical services. Two-thirds used homemaker-household services, and approximately one-half used personal care, checking, and meal preparation services. A larger proportion of spinal cord-injured male veterans used services than did older men in two other samples, reflecting greater impairments in functioning as well as the existence of multiple chronic conditions five or more years after injury. Show more

DOI: 10.3233/NRE-1991-1405

Citation: NeuroRehabilitation, vol. 1, no. 4, pp. 25-35, 1991

Authors: Buckelew, Susan P. | Hanson, Stephanie | Frank, Robert G.

Article Type: Research Article

Abstract: There is a growing awareness of the importance of adjustment after spinal cord injury as lifetime expectancies after injury increase. There has also been an increase in the proportion of deaths after spinal cord injury that are attributable to behavioral and psychological factors such as self-neglect, suicide, and alcohol or drug abuse. This article outlines factors believed important in predicting adjustment after spinal cord injury, including stress, social support, and coping. Models focusing on coping techniques and cognitive appraisal are discussed as alternatives to the previously postulated stage theories for understanding adjustment after spinal cord injury.

DOI: 10.3233/NRE-1991-1406

Citation: NeuroRehabilitation, vol. 1, no. 4, pp. 36-45, 1991

Authors: Sipski, Marca L. | Delisa, Joel A.

Article Type: Research Article

Abstract: Electrical stimulation has been used increasingly in the past 20 years to provide function to persons who suffer from spinal cord injury. Functional electrical stimulation systems for the creation of upper extremity function in quadriplegics have been developed, as have systems enabling complete and incomplete paraplegics to ambulate. In addition, a computerized closed loop bicycle ergometer has been used clinically to allow active lower extremity exercise in persons with spinal cord injury. In this article, the physiological effects and methods of electrical stimulation are discussed, as well as the current status and prospects for clinical use of each type of …system. Show more

DOI: 10.3233/NRE-1991-1407

Citation: NeuroRehabilitation, vol. 1, no. 4, pp. 46-57, 1991

Authors: Allen, Joanne B. | Stover, Samuel L. | Jackson, Arnie B. | Richards, J. Scott

Article Type: Case Report

Abstract: Women with spinal cord injury (SCI) may have unique complications that have not yet been well described because their presence in the SCI population is so low compared with that of males. In particular, reproductive health complications unique to women with SCI are poorly understood. In this case report, an apparent relationship between autonomic dysreflexia and the menstrual cycle of a 38-year-old woman with paraplegia is described. The autonomic dysreflexia disappeared after total hysterectomy. Possible mechanisms for these relationships are discussed. The case illustrates the need for more quantitative investigation of the similarities and differences between the reproductive health cycle …of women with SCI and their able-bodied counterparts, so that more effective care can be provided. Show more

DOI: 10.3233/NRE-1991-1408

Citation: NeuroRehabilitation, vol. 1, no. 4, pp. 58-62, 1991

Authors: Kardesch, Cynthia B. | Donovan, William H.

Article Type: Research Article

Abstract: Physiatrists involved in spinal cord injury rehabilitation must be aware of the potential complications associated with anterior cervical corpectomy and fusion (ACCF) that may present in the rehabilitation setting. Documented neurological complications include myelopathy, radiculopathy, and recurrent laryngeal nerve palsy. We report a rarely encountered complication of ACCF: a recurrent retroesophageal abscess accompanied by left phrenic nerve damage and left hemidiaphragm paralysis with prolonged ventilatory dependency in a quadriplegic patient. Cervical osteomyelitis, spinal instability, aphonia, dysphagia, and a sacral decubitus ulcer caused by prolonged immobility were additional associated complications. The medical and rehabilitative management of recurrent cervico-esophageal abscess due to …the ACCF procedure and mechanical ventilatory weaning of the patient are discussed. Show more

DOI: 10.3233/NRE-1991-1409

Citation: NeuroRehabilitation, vol. 1, no. 4, pp. 63-67, 1991

Authors: Watts, Clark

Article Type: Research Article

Abstract: A major cause of rising health care costs in the United States is waste and redundancy due to a lack of uniformity in planning and executing health care delivery. This is especially notable with regard to rehabilitation and chronic care. Planning and execution would be more rational and less wasteful if it were based on the health care needs of a homogeneous population. The rehabilitation and chronic care needs of patients with central nervous system trauma are similar to those of 80 to 85% of the nonelderly population (persons less than 65 years of age). Thus, the planning of rehabilitation …and chronic care of the nonelderly may be modeled after the health care requirements of patients with central nervous system trauma. Lessons learned from such modeling may be applied to the entire United States health care system. Show more

DOI: 10.3233/NRE-1991-1410

Citation: NeuroRehabilitation, vol. 1, no. 4, pp. 68-73, 1991

Authors: Connally, Patrick | Roberts, Edward V. | Gold, Jonathan

Article Type: Research Article

Abstract: A brief overview of disability policy is presented from the independent living/civil rights point of view. Segregation and pity have been two traditional approaches to disability policy and have had tragic results for persons with disabilities.

DOI: 10.3233/NRE-1991-1411

Citation: NeuroRehabilitation, vol. 1, no. 4, pp. 74-80, 1991