Rehabilitation of the cancer patient.

Cancer patients often require extensive rehabilitation after treatment. Organization of a rehabilitation team and determination of its goals are a primary aim of such programs. Studies of job security and insurability demonstrate significant problems and biases toward the cancer patient. Discussion has been made of specific male and female sexual rehabilitation programs as well as programs directed at other physical disabilities secondary to head and neck or amputation surgery. Attention is drawn toward familiarizing the surgeon with these problems in order to enhance his treatment of the cancer patient.

Carpal tunnel syndrome in the nonparetic hands of hemiplegics. Stress-induced by ambulatory assistive devices.

Three patients who had earlier sustained an acute stroke were admitted to a rehabilitation bed service. Clinically, they developed symptoms suggestive of carpal tunnel syndrome (CTS) in their nonparetic hands during a progressive ambulation training program which included ambulatory assistive devices. In each patient, the diagnosis was confirmed by electrodiagnostic evaluation. Two of the three patients were subsequently provided with forearm platform attachments for their assistive devices, and cock-up wrist splints, in an attempt to decrease compression of the median nerve. Despite these measures, both remained symptomatic and had electrodiagnostic evidence of progressive CTS. They were referred for surgical decompression of the median nerve. The third patient had resolution of symptoms when she became able to ambulate without need of an assistive device. These cases are examples of CTS secondary to excessive pressure in the nonparetic hands of hemiparetic patients, believed to occur more frequently than is clinically recognized.

Evoked sensory nerve action potentials: effect of different recording electrodes on distal latencies and amplitudes.

The evoked sensory nerve action potentials (ESAP) of the median nerve were studied in 20 subjects using an antidromic technique, recording the distal latency to onset and to peak, and peak to peak amplitude, using three different recording electrodes. The electrodes used were the TECA digital ring electrodes, AERO MED wire loop stretch and squeeze-type electrodes, and Neurodiagnostic finger clip electrodes. Because the Neurodiagnostic finger clip electrodes are wider than the others, they were placed at different points over the proximal and distal interphalangeal joints to evaluate any changes in the ESAP caused by different interelectrode distance. The values obtained for the distal latencies and amplitudes for each electrode were compared using the unpaired Student's t-test. There were no statistically significant differences found in the ESAP distal latencies to onset or peak using any of the electrodes or various placements. When comparing the amplitude responses, the only statistically significant difference was noted when the TECA digital ring electrodes were compared to a particular arrangement of the Neurodiagnostic finger clip electrodes (p less than 0.05). It was therefore concluded that any of these electrodes can be used to obtain reliable reproducible data for nerve conduction studies.