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To investigate the clinical features and outcome of outpatient-based physiotherapy (manual stretch) of congenital muscular torticollis (CMT) with passive neck motion limitation (≥10°) according to whether the finding on ultrasonography (US) is normal or abnormal.Case-control study.Institutional practice.A total of 149 patients with CMT who met eligibility criteria were included: age at presentation...
Ventilation-to-carbon dioxide ratio is comparable with peak oxygen uptake in the prognosis of cardiovascular disorders. Currently, there are no established indices to determine the submaximal effects of functional electrical stimulation on cardiovascular performance in persons with spinal cord injury.To determine the effects of an acute bout of functional electrical stimulation-lower extremity cycling...
To assess the frequency and spectrum of referrals to rehabilitation disciplines in a concussion clinic population and factors associated with need for referral.Retrospective study.Concussion clinic within the Physical Medicine and Rehabilitation Department of an academic medical center.Patients receiving physiatric management for concussion care.Referral to physical therapy (PT), occupational therapy,...
This case series describes 3 cases in which ultrasound-guided intercostobrachial perineural injection was used for intercostobrachial neuralgia, a common cause of postmastectomy pain syndrome. All cases had undergone modified radical mastectomy with axillary lymph node dissection for breast cancer. Two cases developed axillary and unilateral chest wall pain. The third case initially presented with...
Treatment intensity is a critical component to the delivery of speech-language pathology and rehabilitation services. Within aphasia rehabilitation, however, insufficient evidence currently exists to guide clinical decision making with respect to the optimal treatment intensity. This review considers perspectives from 2 key bodies of research, the neuroscience and cognitive psychology literature,...
Exercise-associated hyponatremia (EAH) is one of the most common causes of exercise-associated collapse. The primary pathogenesis of EAH is largely the result of excessive fluid intake but is influenced by other factors, including hormonal abnormalities (ie, inappropriate arginine vasopressin secretion), renal abnormalities, and mobilization of sodium stores. Early recognition of EAH is crucial to...
Lactic acid has played an important role in the traditional theory of muscle fatigue and limitation of endurance exercise performance. It has been called a waste product of anaerobic metabolism and has been believed to be responsible for the uncomfortable “burn” of intense exercise and directly responsible for the metabolic acidosis of exercise, leading to decreased muscle contractility and ultimately...
There are different modalities of exercise testing that can provide valuable information to physicians about patient and athlete fitness and cardiopulmonary status. Cardiopulmonary exercise testing (CPX) is a form of exercise testing that measures ventilatory and gas exchange, heart rate, electrocardiogram, and blood pressures to provide detailed information on the cardiovascular, pulmonary, and muscular...
Evaluation of an athlete's report of “hip pain” is challenging. Many conditions involving the pelvic girdle can present with overlapping pain distributions, and athletes often may have coexisting disorders. Appropriate evaluation requires thorough, systematic consideration of intra-articular hip disease, extra-articular local causes of hip pain, and referred pain from other musculoskeletal or even...
The repetitive nature of throwing manifests characteristic adaptive changes to the shoulder, scapulothoracic, and hip/pelvis complexes that result in a set of unique physical traits in the overhead throwing athlete. An effective rehabilitation program is dependent upon an accurate evaluation and differential diagnosis to determine the causative factors for the athlete's pathologic features. The treatment...
Evaluation and treatment of pediatric elbow injuries in sport can be difficult because of the complex anatomy, evolving bony and cartilaginous composition, and multiple varied forces applied during athletic competition. In addition, youth sports are now putting even greater demands on the elbow of young athletes. It is important to understand the risk factors for injury, age-appropriate conditions...
Stress fractures are common overuse injuries in athletes. They occur during periods of increased training without adequate rest, disrupting normal bone reparative mechanisms. There are a host of intrinsic and extrinsic factors, including biochemical and biomechanical, that put athletes at risk. In most stress fractures, the diagnosis is primarily clinical, with imaging indicated at times, and management...
Historical reports of doping in sports date as far back as the ancient Greek Olympic Games. The anti-doping community considers doping in sports to be cheating and a violation of the spirit of sport. During the past century, there has been an increasing awareness of the extent of doping in sports and the health risks of doping. In response, the anti-doping movement has endeavored to educate athletes...
Diagnostic and interventional ultrasound is a rapidly evolving field in sports medicine. The use of ultrasound has increased exponentially during the past decades. This imaging modality is appealing to sports medicine physicians because of its broad diagnostic and interventional capabilities. In sports medicine, the indications for diagnostic ultrasound extend well beyond the musculoskeletal realm...
Sudden cardiac death (SCD) is the leading cause of death during exercise for athletes younger than 35 years. Structural cardiac abnormalities are responsible for the majority of SCDs among competitive athletes. The screening protocol that is best for detecting athletes at risk for SCD has been the subject of considerable and long-standing debate. The American Heart Association recommends the use of...
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