ABSTRACT
OBJECTIVE: The aim of this study was to assess the impact of cognition, baseline motor function, and co-morbid medical conditions on functional change, discharge destination, and discharge needs in patients admitted to acute rehabilitation for Parkinson-related impairments. DESIGN: This retrospective chart review study evaluated the records of patients admitted to acute rehabilitation over a 5-yr period with a primary impairment category of parkinsonism. Functional status was measured at admission and discharge; 3-mo follow-up function was also collected in a sample of discharged patients. RESULTS: Eighty-nine patients (mean age, 74.26 yrs) were admitted over the 5-yr time frame. A more complicated Medicare tier diagnosis (tier 2) was associated with lower total and motor score Functional Independence Measure gains compared with tier 3 (P = 0.009 and P = 0.016, respectively). Cognitive scores at admission were not related to need for caregivers upon discharge. Overall Functional Independence Measure gain (adjusted R(2) = 0.073, P = 0.006) and Functional Independence Measure gain efficiency (adjusted R(2) = 0.142, P < 0.001) inversely correlated with age. At the 3-mo follow-up, a random sample (38%) of patients contacted postdischarge demonstrated continued improvements. CONCLUSIONS: Significant improvement may be seen after acute rehabilitation in patients with Parkinson disease, irrespective of cognitive impairment. More complicated medical tier diagnoses result in less Functional Independence Measure gain, and older individuals with Parkinson disease are more likely to show less functional change. However, functional improvements are still statistically significant.
Subject(s)
Cognition/physiology , Motor Activity/physiology , Parkinson Disease/physiopathology , Parkinson Disease/psychology , Patient Discharge , Recovery of Function/physiology , Adult , Aged , Aged, 80 and over , Female , Humans , Length of Stay , Male , Middle Aged , Parkinson Disease/rehabilitation , Physical Therapy Modalities , Retrospective Studies , Treatment OutcomeABSTRACT
UNLABELLED: This self-directed learning module highlights general considerations in sports and performing arts medicine. It is part of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. OVERALL ARTICLE OBJECTIVE: To discuss similarities and differences of injuries sustained in sports and performing arts using case vignettes.
Subject(s)
Athletic Injuries/therapy , Occupational Diseases/therapy , Sports Medicine , Anxiety/psychology , Anxiety/therapy , Athletic Injuries/complications , Athletic Injuries/diagnosis , Dancing/injuries , Humans , Music/psychology , Occupational Diseases/complications , Occupational Diseases/diagnosis , Occupational Diseases/psychology , Spasm/diagnosis , Spasm/etiologyABSTRACT
UNLABELLED: This self-directed learning module discusses classic topics and highlights new advances in this area. This article discusses upper-limb sports injuries as part of a section of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article uses case vignettes as a vehicle to elaborate on shoulder and elbow pain in the athlete. OVERALL ARTICLE OBJECTIVE: To discuss shoulder and elbow overuse injuries in sports.
Subject(s)
Athletic Injuries/diagnosis , Athletic Injuries/therapy , Cumulative Trauma Disorders/diagnosis , Cumulative Trauma Disorders/therapy , Elbow Injuries , Shoulder Injuries , Athletic Injuries/complications , Brachial Plexus Neuritis/diagnosis , Brachial Plexus Neuritis/etiology , Brachial Plexus Neuritis/therapy , Cumulative Trauma Disorders/complications , Humans , Rotator Cuff Injuries , Scapula/injuries , Tendinopathy/diagnosis , Tendinopathy/etiologyABSTRACT
UNLABELLED: This self-directed learning module highlights new advances in this topic area. It is part of the study guide on sports medicine and performing arts in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article uses case vignettes as a vehicle to elaborate on (1) ankle pain in a runner, (2) heel pain in an adolescent, (3) anterior knee pain in a runner, (4) lateral knee pain in a cyclist, (5) shin splints in a runner, (6) buttock pain in a hiker, and (7) collapse of a marathoner from hyponatremia. OVERALL ARTICLE OBJECTIVE: To summarize lower-limb injuries commonly seen in endurance sports.
Subject(s)
Athletic Injuries/diagnosis , Athletic Injuries/therapy , Lower Extremity/injuries , Physical Endurance , Athletic Injuries/complications , Humans , Hyponatremia/physiopathology , Hyponatremia/therapy , Pain/etiology , Pain Management , Running/physiologyABSTRACT
UNLABELLED: This self-directed learning module focuses on injuries often seen in contact sports. It includes information on trauma to the cervical spine, wrist, shoulder, knee, ankle, foot, and chest and also discusses concussion in sport. It is part of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article specifically focuses on the etiology, differential diagnoses, treatment, and return-to-play criteria for traumatic sports injuries. OVERALL ARTICLE OBJECTIVE: To summarize the approach to common traumatic sports injuries.
Subject(s)
Athletic Injuries/complications , Athletic Injuries/therapy , Algorithms , Athletic Injuries/physiopathology , Brain Concussion/diagnosis , Brain Concussion/etiology , Brain Concussion/therapy , Cervical Vertebrae/injuries , Humans , Leg Injuries/diagnosis , Leg Injuries/etiology , Leg Injuries/therapy , Pain/etiology , Pain/physiopathology , Shoulder Injuries , Thoracic Injuries/diagnosis , Thoracic Injuries/etiology , Thoracic Injuries/therapy , Wrist/physiopathologyABSTRACT
UNLABELLED: This self-directed study module highlights biomechanics unique to dance that predispose to common injuries of the lower extremity and discusses preventative strategies. It is part of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. OVERALL ARTICLE OBJECTIVE: To summarize lower-limb and back injuries commonly seen in dancers.
Subject(s)
Dancing/injuries , Lower Extremity/physiopathology , Occupational Diseases/physiopathology , Biomechanical Phenomena , Dancing/physiology , Humans , Occupational Diseases/diagnosis , Occupational Diseases/etiology , Occupational Diseases/therapyABSTRACT
UNLABELLED: This self-directed learning module discusses classic topics and highlights new advances in this topic area. This article, which discusses upper-limb injuries in musicians, is a section of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article uses case vignettes to elaborate on issues relating to musicians. OVERALL ARTICLE OBJECTIVE: To summarize overuse injury, nerve entrapment, and focal dystonia in instrumental musicians.