{"title":"Perceptions of Telemedicine Among Physical Medicine and Rehabilitation Patients and Healthcare Providers.","authors":"Gabrielle Gilmer, Gwendolyn Sowa","doi":"10.1097/PHM.0000000000002608","DOIUrl":"10.1097/PHM.0000000000002608","url":null,"abstract":"<p><strong>Objective: </strong>Our purpose was to assess perceptions of telemedicine among physical medicine and rehabilitation patients and healthcare providers.</p><p><strong>Design: </strong>A 28-question online survey was conducted. Patients had to be 18 yrs or older who used telemedicine for a physical medicine and rehabilitation visit. Providers had to be a board-certified physical medicine and rehabilitation provider who has used telemedicine in their practice.</p><p><strong>Results: </strong>Sixty-eight patients and 46 providers completed the survey. Patients and providers reported an intention to continue using telemedicine, regardless of insurance coverage/reimbursement. Patients and providers reported circumstances, such as needing a physical examination or a first-time visit, as being preferable for an in-person visit. Patients who were younger or a caretaker were more likely to report being willing to change providers if telemedicine was no longer offered than older or noncaretaker patients. Patients who made less than $30,000 annually or who did not own a car were more likely to report comfortability with telemedicine than patients who made more than $30,000 annually or who owned a car.</p><p><strong>Conclusions: </strong>Telemedicine will continue as a staple of physical medicine and rehabilitation health care and is a particularly important resource for patients who are younger, caretakers, make less than $30,000 annually, or do not own a car.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":"104 4","pages":"349-356"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mahdis Hashemi, Fraser MacRae, Ève Boissonnault, Daniel Vincent, Jia Song, Sandy Shi, Paul Winston
{"title":"Measuring the Efficacy of Percutaneous Cryoneurolysis in Participants With Refractory or Plateaued Shoulder, Elbow, Wrist, or Finger Spasticity.","authors":"Mahdis Hashemi, Fraser MacRae, Ève Boissonnault, Daniel Vincent, Jia Song, Sandy Shi, Paul Winston","doi":"10.1097/PHM.0000000000002728","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002728","url":null,"abstract":"<p><strong>Objective: </strong>To investigate novel, minimally invasive cryoneurolysis for refractory or plateaued upper extremity spasticity.</p><p><strong>Design: </strong>This was a repeated-measures, single-center, observational pilot study (NCT04670783). Percutaneous cryoneurolysis was applied to the upper extremity nerves and intramuscular branches of 59 adults with upper extremity spasticity refractory to or plateaued on botulinum therapies. Maximal passive range of motion (ROM; V1), active ROM (AROM), and Modified Ashworth Scale (MAS) score were measured during shoulder flexion, abduction, and external rotation and elbow and wrist extension at baseline and follow-up to 1 year. Additional outcomes included pain, participant satisfaction, and upper extremity disability.</p><p><strong>Results: </strong>Overall, 59 participants received cryoneurolysis in ≥1 region targeting nerves that innervate muscles supporting shoulder (n = 47), elbow (n = 33), wrist (n = 18), and fingers/thumb (n = 29) movement. At 12 months, there was significant change from baseline in V1, AROM, and MAS score for shoulder flexion and abduction and in V1 and MAS score for external rotation. Similar results were observed for elbow extension V1, AROM, and MAS score and wrist extension MAS score. Average daily pain, participant satisfaction, and upper extremity disability improved.</p><p><strong>Conclusion: </strong>Participants with plateaued or refractory spasticity had improvements in upper extremity regions; future evaluations of cryoneurolysis treatment for spasticity are warranted.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Convergence of infection, CAR-T therapy, and neuralgic amyotrophy: A case report.","authors":"Kirk A Dettloff, Cody C Andrews, Sandra L Hearn","doi":"10.1097/PHM.0000000000002736","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002736","url":null,"abstract":"<p><strong>Abstract: </strong>Neuralgic amyotrophy (NA) is a multifocal, immune-mediated inflammatory disorder of peripheral nerves and/or portions of the brachial plexus, typically presenting as regional pain followed by weakness. Awareness and recognition of this entity in the cancer population is important and relevant to physiatrists, given the frequency of immune system activation in this population, whether mediated by cancer, its treatments, or infections associated with an immunocompromised status. We present a case of NA presenting primarily as bilateral anterior interosseous mononeuropathies of onset following influenza infection (about one month prior) and chimeric antigen receptor T-cell (CAR-T) therapy (2-4 days prior). We discuss diagnostic challenges in NA and highlight key features of the history, physical examination, and electrodiagnostic findings that can yield clues to an underlying multifocal or immunologic process masquerading as a focal injury. Finally, we discuss the uncertain but plausible role of CAR-T therapy as a potential immunologic trigger for NA and invite further exploration.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Prakash Jayabalan, Chad Hanaoka, Sanchita Sen, Sarah Libfraind, Avraham Eisenstein, Vikram Darbhe
{"title":"THE ACUTE IMPACT OF LOWER BODY POSITIVE PRESSURE TREADMILL WALKING IN INDIVIDUALS WITH KNEE OSTEOARTHRITIS: A PILOT STUDY.","authors":"Prakash Jayabalan, Chad Hanaoka, Sanchita Sen, Sarah Libfraind, Avraham Eisenstein, Vikram Darbhe","doi":"10.1097/PHM.0000000000002733","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002733","url":null,"abstract":"<p><strong>Objective: </strong>Determine acute symptomatic, gait, and biological effects of lower extremity loading during lower body positive pressure (LBPP) treadmill walking in individuals with knee osteoarthritis (OA).</p><p><strong>Methods: </strong>Participants with knee OA (n = 32) above the age of 50 performed two-45-minute walking sessions at least 1 week apart. Individuals walked at self-selected speed on the treadmill at 100% bodyweight (BW) or 50%BW. The primary outcome was change in serum cartilage oligomeric matrix protein (COMP), with other outcome measures including change in knee joint pain, exercise intensity, gait parameters, and the concentration of other serum biomarkers of joint disease.</p><p><strong>Results: </strong>Across all timepoints, 50%BW walking, was associated with significant reductions in knee pain compared to 100%BW (p < 0.05 for all) with no significant difference in duration of moderate-intensity exercise. 50%BW was associated with significant decreases in cadence (p < 0.001) and increased stride length (p = 0.008). Biomarker analyses demonstrated 100%BW walking was associated with a significant increase in COMP at 45 minutes compared to baseline (p = 0.032), not observed with 50% BW.</p><p><strong>Conclusion: </strong>50%BW walking in knee OA using an LBPP treadmill acutely reduces joint pain, improves gait parameters, and does not increase markers of cartilage turnover. Future studies should investigate the longitudinal benefits of this rehabilitation approach.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Xray prediction of MRI in low back pain.","authors":"Robert J McCormick, Michael D Perloff","doi":"10.1097/PHM.0000000000002741","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002741","url":null,"abstract":"<p><strong>Abstract: </strong>Magnetic resonance imaging (MRI) use in low back pain (LBP) management can be associated with added costs and increased surgical interventions. Lumbar Xray findings predicting MRI results were assessed in patients with LBP, excluding post-surgical, red flag, or spinal stenosis history. At an outpatient Pain clinic, one hundred patients were selected (sequentially) from 12/1/2021-3/15/2022 that had lumbar Xrays within 1 year prior to lumbar MRI. Xray and MRI reports were analyzed by 2 readers. Forty-six patients had moderate facet hypertrophy on Xray, 35 (76.1%) also had moderate facet hypertrophy on MRI (Spearman's rank correlation Rs = 0.386, p < 0.0001). Thirty-eight patients had moderate multilevel degenerative changes on Xray, 34 (89.5%) also had moderate disc bulge on MRI (Spearman's Rs = 0.360, p < 0.001). Eighteen patients that had moderate disc height loss on Xray, 14 (77.8%) also had moderate disc desiccation, height loss, or space narrowing on MRI (Spearman's Rs = 0.554, p < 0.00000001). Forty-three patients had a listhesis on Xray, 20 (46.5%) also had a listhesis on MRI (Spearman's Rs = 0.458, p < 0.0001). Lumbar Xray is a reasonable study in the setting of axial and subacute radicular LBP, where red flags are absent, predicting moderate pathology on MRI > 75% of the time, and being more sensitive for listhesis.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Katherine M Burke, Vishni Arulanandam, Erica Scirocco, Timothy Royse, Sydney Hall, Harli Weber, James Arnold, Prabhat Pathak, Conor Walsh, Sabrina Paganoni
{"title":"Assistive Technology in ALS: A Scoping Review of Devices for Limb, Trunk, and Neck Weakness.","authors":"Katherine M Burke, Vishni Arulanandam, Erica Scirocco, Timothy Royse, Sydney Hall, Harli Weber, James Arnold, Prabhat Pathak, Conor Walsh, Sabrina Paganoni","doi":"10.1097/PHM.0000000000002742","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002742","url":null,"abstract":"<p><strong>Abstract: </strong>Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease affecting upper and lower motor neurons that control voluntary muscles. With no known cure, clinical care is focused on symptom management to maximize function and quality of life. Assistive technology plays a crucial role and enables some restoration of movement and function despite disease progression. This scoping review assesses the effectiveness of assistive technologies tested in people living with ALS, specifically those designed to compensate for upper and lower extremity, trunk, and cervical muscle weakness. A comprehensive search was conducted across PubMed, CINAHL, ERIC, Google Scholar, and through citation chasing. We included 26 articles that tested an assistive device on at least one person living with ALS and evaluated the device's effectiveness in restoring movement or providing stabilization to support functional mobility or activities of daily living. Most studies were pilot feasibility or usability trials, with small numbers of ALS participants. The devices showed various benefits, including improved range of motion, function, and participation in daily activities. This review highlights the potential for assistive devices to enhance function in people living with ALS and underscores the need for comprehensive studies involving larger cohorts of individuals at different stages of ALS.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emeline Michel, Vincent Sarrazy, Fréderic Chorin, Charles Raffaelli, Olivier Guerin, Raphael Zory, Guillaume Sacco
{"title":"Ultrasonographic Measurement of Severe Sarcopenia in the Elderly Subject.","authors":"Emeline Michel, Vincent Sarrazy, Fréderic Chorin, Charles Raffaelli, Olivier Guerin, Raphael Zory, Guillaume Sacco","doi":"10.1097/PHM.0000000000002743","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002743","url":null,"abstract":"<p><strong>Objective: </strong>Sarcopenia is a progressive muscular disease. The European Working Group on Sarcopenia in Older People revised protocols to include the F-A-C-S procedure. Sarcopenia severity is assessed by physical performance tests. However, these tests can be influenced by various factors. Ultrasound offers a more objective method for measuring muscle mass and assessing sarcopenia severity. This study aims to determine reliable ultrasound measurements for objectively evaluating sarcopenia severity in older adults.</p><p><strong>Design: </strong>A prospective study was conducted, assessing 200 patients over 75, with sarcopenia identified via SARC-F questionnaire, grip strength, and chair stand test. Ultrasound measured muscle thickness in the rectus femoris and other muscles. Comparative analyses divided patients into non-severe sarcopenia and severe sarcopenia groups, with ROC curves and logistic regression to evaluate ultrasound measurements' discriminative power.</p><p><strong>Results: </strong>Muscle thickness, particularly of the rectus femoris, significantly correlated with sarcopenia severity. Ultrasound measurements accurately discriminated sarcopenia severity with a ROC curve AUC of 0.629. Logistic regression confirmed rectus femoris thickness as a predictive measure for severe sarcopenia.</p><p><strong>Conclusion: </strong>Ultrasound measurement of rectus femoris muscle thickness is a promising tool for diagnosing sarcopenia severity, enhancing early identification and improving management strategies for the elderly.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Murat Kara, Ahmad J Abdulsalam, Mahmud Fazıl Aksakal, Kübranur Demirel, Vincenzo Ricci, Levent Özçakar
{"title":"Ultrasound Imaging and Guidance for Bell's Palsy: EURO-MUSCULUS/USPRM Approach.","authors":"Murat Kara, Ahmad J Abdulsalam, Mahmud Fazıl Aksakal, Kübranur Demirel, Vincenzo Ricci, Levent Özçakar","doi":"10.1097/PHM.0000000000002729","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002729","url":null,"abstract":"<p><strong>Abstract: </strong>Bell's palsy, or idiopathic peripheral facial nerve palsy, is characterized by the sudden onset of facial muscle paralysis resulting from damage to the facial nerve fibers. The diagnosis is typically established through clinical evaluation, although in cases with atypical features, imaging modalities like magnetic resonance imaging (MRI) or computed tomography (CT) are indicated to rule out underlying lesions or temporal bone abnormalities compressing the facial nerve. High-resolution ultrasound (US) has emerged as a promising modality for evaluating peripheral neuropathies, including cranial nerve disorders. Recent studies have highlighted its potential in measuring facial nerve diameter, detecting nerve edema, and predicting clinical prognosis in Bell's palsy. Beyond its diagnostic role, US also facilitates precise perineural corticosteroid injections, offering an alternative to systemic corticosteroid therapy, which is commonly associated with adverse effects such as hyperglycemia and hypertension. US also plays a crucial role in guiding botulinum toxin (BoNT) injections, which are used to manage synkinesis and facial asymmetry in chronic Bell's palsy cases.This review discusses the role of US in the diagnosis and management of Bell's palsy, emphasizing its advantages in visualizing facial nerve edema and guiding perineural corticosteroid and intramuscular BoNT injections.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Evan Foster, Laura Langer, Mark Bayley, Paul Comper, Tharshini Chandra, Aidan Snaiderman, Ainsley Kempenaar, Elizabeth L Inness, Cynthia Danells, David W Lawrence
{"title":"Promoting Early Aerobic Exercise Initiation Post-Concussion: A pilot study examining how prescription method can influence recovery in a non-athlete, adult population. Results from the Toronto Concussion Study.","authors":"Evan Foster, Laura Langer, Mark Bayley, Paul Comper, Tharshini Chandra, Aidan Snaiderman, Ainsley Kempenaar, Elizabeth L Inness, Cynthia Danells, David W Lawrence","doi":"10.1097/PHM.0000000000002732","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002732","url":null,"abstract":"<p><strong>Objective: </strong>Research on aerobic exercise (AEx) post-concussion has focused on athletes recovering from sport-related concussion. The goal of this pilot study was to examine the feasibility and preliminary efficacy of three AEx prescription methods in a general adult population.DESIGNThis pilot study involves three cohorts of participants, including a nested randomized component. Participants who were not in the nested randomized component were followed regularly by the clinic physician (\"Usual Care\" [UC]). Participants in the nested randomized component were randomly assigned to either \"Exercise Testing (ET) + UC\", or \"Exercise Testing + Individualized Prescription (IP)\". All randomized participants completed a Buffalo Concussion Treadmill Test (BCTT). ET + UC received usual care AEx recommendations, while ET + IP received an individualized prescription based on their BCTT performance.</p><p><strong>Results: </strong>75 participants were included in this analysis. There was an observed longer time to recovery of UC compared to ET (p = 0.046). There was no significant difference in time to recovery between ET + UC and ET + IP (p = 0.35).</p><p><strong>Conclusion: </strong>Supervised initiation of AEx early after concussion appears to be feasible and improve outcomes compared to standard exercise recommendations. Individualized AEx prescription offered no additional recovery benefit in this sample; however, this finding is likely underpowered due to a small sample.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Raymond C Guo, Hye Chang Rhim, Lindsey S Caldwell, David M Robinson
{"title":"71-year-old man with subacute forearm pain associated with numbness and tingling: a clinical vignette.","authors":"Raymond C Guo, Hye Chang Rhim, Lindsey S Caldwell, David M Robinson","doi":"10.1097/PHM.0000000000002730","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002730","url":null,"abstract":"","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}