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   Table of Contents - Current issue
July-September 2020
Volume 3 | Issue 3
Page Nos. 75-100

Online since Friday, September 11, 2020

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The vital role of inpatient rehabilitation facilities in a large health system: The COVID-19 pandemic p. 75
Carolin Dohle, Mooyeon Oh-Park, Andrew Gitkind, Jeffrey Menkes, Matt Bartels
The current COVID-19 pandemic has put the global health-care system into an unprecedented crisis, leaving hospitals overwhelmed and desperate for additional capacity. As of April 20th, 2020, New York State had the most COVID-19 cases in the US. We here describe the process of transforming our freestanding rehabilitation hospital to help to create additional capacity for our parent system, the Montefiore Health System. This transformation required creating a capacity to handle an increased number of patients with higher medical complexity. The sequence of steps taken at Burke Rehabilitation Hospital to rise to the challenge is outlined in this article.
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An overview of acupuncture in stroke recovery: A narrative review p. 80
Ning Cao, Brian Nguyen, Stephani Li, Richa Lamba, Ryan Hafner, Sheng Li
Acupuncture has been used in stroke recovery in Eastern countries from ancient times. Increased interests and attention have been paid to understand how this oriental practice works for stroke patients in Western medicine. In particular, the effort has been made to study whether adjunct use of acupuncture to standard rehabilitation treatment could potentially further improve recovery after stroke. Therefore, in this comprehensive review of most recent literature, we are able to summarize some convincing evidence on beneficial effect of adjunct acupuncture treatment on poststroke recovery in the domains, including dysphagia, poststroke pain syndrome, and spasticity. Furthermore, some limited emerging evidence in the areas of motor recovery, insomnia, cognitive impairment, and depression is reviewed as well. This comprehensive review intends to provide insights about the potential clinical application of acupuncture for stroke rehabilitation and its future research direction.
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Intra-articular injections for musculoskeletal pain in a cancer rehabilitation clinic: A cross-sectional study p. 87
Victor F Leite, Jesuel Padro-Guzman
Objective: The objective of this study is to describe the individuals that undergo intraarticular injections for musculoskeletal pain in a cancer rehabilitation clinic, as well as the safety of those procedures. Materials and Methods: Retrospective cross-sectional study from July 2017 to May 2018. Results: We included 157 individuals in the study. Participants underwent a total of 546 injections, with a median of two injections per individuals. Osteoarthritis was the most common indication for injections (82.1%). Most injections were guided by ultrasound (62.2%). There were six AEs in our study: four procedure-related, none serious. Conclusions: Intraarticular injections were safe in the short-term in this population.
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Lyme neuroborreliosis in a critically ill patient p. 91
Rui Alexandre Do Prado Costa, Maria João Castro Santos Pinto, José Rogério Bernardo Ruas, Nilza Carvalho Pinto
Lyme neuroborreliosis (LNB) is a nervous system infection caused by the species of the spirochete Borrelia. A woman, with a history of right facial palsy, was admitted to the physical and rehabilitation medicine (PRM) unit for the rehabilitation of presumed sequalae of aneurism rupture and neuromuscular weakness related to critical illness. She presented in the PRM unit with flaccid quadriparesis, right facial nerve paresis, bulbar paresis, aphonia, dysphagia, and hypoactive deep-tendon reflexes. Electromyography (EMG) revealed multifocal neuropathy and serologic tests revealed positive for Borrelia (IgG). The patient was treated with 2 weeks of intravenous ceftriaxone with a marked improvement in the following days. LNB diagnosis was made due to the clinical presentation, positive Borrelia serology, and great improvement with targeted therapy. Neuromuscular weakness related to critical illness was the main differential diagnosis; however, weakness in bulbar and facial musculature and the EMG findings were not consistent with this diagnosis.
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Heterotopic ossification in a patient with cervical spinal cord injury and ankylosing spondylitis: The consequences of the late diagnosis p. 97
Celine Lakra, Manish Desai
Patients with ankylosing spondylitis (AS) are at an 11-fold greater risk of vertebral fracture, with higher mortality and morbidity rates than the general spinal cord injury (SCI) population. We present the case of a patient with established AS who suffered from a cervical SCI. Following admission to a specialist spinal injury rehabilitation unit, he was diagnosed with severe established heterotopic ossification (HO) and spasticity. The key considerations required to manage a case of significant disability in the rehabilitation setting are outlined. The need for earlier diagnosis of HO to prevent progression and associated complications is discussed.
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