Abstract：
:Termination of motor rehabilitation is often recommended as patients with cerebrovascular accident (CVA) become more chronic and/or when they fail to respond positively to motor rehabilitation (commonly termed a "plateau"). Managed-care programs frequently reinforce this practice by restricting care to patients responding to therapy and/or to the most acute patients. When neuromuscular adaptation occurs in exercise, rather than terminating the current regimen, a variety of techniques (eg, modifying intensity, attempting different modalities) are used to facilitate neuromuscular adaptations. After presenting the concepts of the motor recovery plateau and adaptation, we similarly posit that patients with CVA adapt to therapeutic exercise but that this is not indicative of a diminished capacity for motor improvement. Instead, like traditional exercise circumstances, adaptive states can be overcome by modifying regimen aspects (eg, intensity, introducing new exercises). Findings suggesting that patients with chronic CVA can benefit from motor rehabilitation programs that apply novel or different parameters and modalities. The objectives of this commentary are to (1) to encourage practitioners to reconsider the notion of the motor recovery plateau, (2) to reconsider chronic CVA patients' ability to recover motor function, and (3) to use different modalities when accommodation is exhibited.
journal_name
Arch Phys Med Rehabiljournal_title
Archives of physical medicine and rehabilitationauthors
Page SJ,Gater DR,Bach-Y-Rita Pdoi
10.1016/j.apmr.2003.12.031subject
Has Abstractpub_date
2004-08-01 00:00:00pages
1377-81issue
8eissn
0003-9993issn
1532-821Xpii
S0003-9993(04)00261-8journal_volume
85pub_type
杂志文章,评审abstract：:The field of rehabilitation has increasingly called for the use of patient-reported outcome measures (PROMs) in research and practice. Given that many rehabilitation patients present with conditions associated with cognitive impairments, it is imperative to reduce barriers to PROM use for this population. The purpose ...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2017.03.011
更新日期：2017-08-01 00:00:00
abstract：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...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章,评审
doi：10.1053/j.apmr.2003.12.004
更新日期：2004-03-01 00:00:00
abstract：UNLABELLED:Pua Y-H, Cowan SM, Wrigley TV, Bennell KL. Discriminant validity of the Western Ontario and McMaster Universities Osteoarthritis Index Physical Functioning Subscale in community samples with hip osteoarthritis. OBJECTIVE:To evaluate, in a community hip osteoarthritis (OA) sample, the discriminant validity o...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2009.04.011
更新日期：2009-10-01 00:00:00
abstract：OBJECTIVE:To investigate the association between propulsion biomechanics, including variables that describe smoothness of the applied forces, and shoulder pain in individuals with spinal cord injury (SCI). DESIGN:Cross-sectional, observational study. SETTING:Non-university research institution. PARTICIPANTS:Communit...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2020.10.114
更新日期：2020-11-05 00:00:00
abstract：OBJECTIVE:To determine whether family functioning is uniquely associated with caregiver depressive symptoms in the immediate aftermath of stroke. DESIGN:Cross-sectional data from the baseline assessment of an intervention study for stroke survivors and their families. SETTING:Neurology inpatient service of a large ur...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2008.12.014
更新日期：2009-06-01 00:00:00
abstract：OBJECTIVE:To examine whether commonly used comorbidity indexes (Deyo-Charlson comorbidity index, Elixhauser comorbidity index, the Centers for Medicare and Medicaid Services [CMS] comorbidity tiers) capture comorbidities in the acute traumatic and nontraumatic SCI inpatient rehabilitation population. DESIGN:Retrospect...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2020.04.025
更新日期：2020-10-01 00:00:00
abstract：OBJECTIVES:To investigate whether extra physical therapy intervention reduces length of stay and improves patient outcomes in people with acute or subacute conditions. DATA SOURCES:Electronic databases CINAHL, MEDLINE, AMED, PEDro, PubMed, and EMBASE were searched from the earliest date possible through May 2010. Addi...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章,评审
doi：10.1016/j.apmr.2011.04.005
更新日期：2011-09-01 00:00:00
abstract：:All patients admitted during a 6-month period to an inpatient geriatric rehabilitation unit were started on a medication education program incorporated into the rehabilitation program and utilizing existing staff. Patients were evaluated at admission, discharge, 90-day, and 1 year follow-up, using an 8-point medicatio...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：
更新日期：1986-01-01 00:00:00
abstract：OBJECTIVES:To (1) compare energy expenditure during seated rest, standing, and prolonged bionic ambulation or bipedal ambulation in participants with spinal cord injury (SCI) and noninjured controls, respectively, and (2) test effects on postbionic ambulation glycemia in SCI. DESIGN:Two independent group comparison of...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2019.07.014
更新日期：2020-01-01 00:00:00
abstract：OBJECTIVE:To resolve the debate over whether lumbar repositioning acuity is reduced in patients with chronic low back pain (CLBP) by using a study design and methodology to minimize the effects of potential confounders. DESIGN:A single-blinded, controlled, multigroup comparative study. SETTING:Vocational rehabilitati...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2006.05.020
更新日期：2006-09-01 00:00:00
abstract：OBJECTIVE:To examine the relative association between daily change in pain, fatigue, depressed mood, and cognitive function and 4 outcomes-positive affect and well-being, ability to participate in social roles and activities, upper extremity (UE) functioning, and lower extremity (LE) functioning. DESIGN:Data analysis,...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2017.07.004
更新日期：2017-11-01 00:00:00
abstract：:The purpose of this study was to determine, in ten healthy subjects, the extent of soleus motoneuronal excitability during conditions of increased (transcutaneous electrical nerve stimulation [TENS]), decreased (Xylocaine [lidocaine]a anaesthesia) and normal (placebo anaesthesia) cutaneous inputs. Increased cutaneous ...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 临床试验,杂志文章
doi：
更新日期：1993-01-01 00:00:00
abstract：:This report discusses the successes and problems associated with the development of a family support system designed to improve outcomes in a pediatric trauma population. Studies have demonstrated lowered health-related quality of life among injured children during rehabilitation, along with substantial parental stres...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2004.02.026
更新日期：2005-01-01 00:00:00
abstract：:Conservative care of the athlete with shoulder impingement includes activity modification, application of ice, nonsteroidal anti-inflammatory drugs, subacromial corticosteroid injections, and physiotherapy. This case report describes the clinical treatment and outcome of three patients with shoulder impingement syndro...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/s0003-9993(00)90053-4
更新日期：2000-05-01 00:00:00
abstract：:Stroke frequently results in psychologic distress and activity limitations across multiple domains of functioning. However, most stroke outcome measurement tools and clinical trial endpoints are narrowly focused on neurologic symptom status and physical aspects of functioning, and rarely assess other important compone...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1053/apmr.2002.36838
更新日期：2002-12-01 00:00:00
abstract：OBJECTIVE:To determine the effect of cycling, electrical stimulation, or both, on thigh muscle volume and stimulated muscle strength in children with spinal cord injury (SCI). DESIGN:Randomized controlled trial. SETTING:Children's hospital specializing in pediatric SCI. PARTICIPANTS:Children (N=30; ages, 5-13y) with...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.apmr.2011.06.031
更新日期：2011-12-01 00:00:00
abstract：OBJECTIVE:To evaluate the efficacy of a replicable group treatment program to improve social communication skills after traumatic brain injury (TBI). DESIGN:Randomized treatment and deferred treatment controlled trial, with follow-up at 3, 6, and 9 months post-treatment. SETTING:Community. PARTICIPANTS:Volunteer sam...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.apmr.2007.07.033
更新日期：2007-12-01 00:00:00
abstract：OBJECTIVE:To establish the test-retest and interrater reliability as well as the concurrent construct validity of the Dynamic Gait Index (DGI) as a measure for dynamic balance in people with chronic stroke. DESIGN:Cohort study. SETTING:Day hospital and ambulatory care at a rehabilitation center. PARTICIPANTS:A conse...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2007.08.109
更新日期：2007-11-01 00:00:00
abstract：:Of the several roads that lead to practice in the specialty of physical medicine and rehabilitation (PM&R), the most common is from a US medical school to a PM&R residency to specialty practice. To reduce the predicted shortage of PM&R physicians, more medical students must be attracted to the specialty. Past studies ...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：
更新日期：1986-11-01 00:00:00
abstract：OBJECTIVE:To determine immunogenicity and optimum timing for administering the 23-valent pneumococcal vaccine after spinal cord injury (SCI). DESIGN:Double-blind, randomized, placebo control study. SETTING:SCI unit in a tertiary care medical center and community. PARTICIPANTS:Eighty-seven persons with recent SCI. I...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0003-9993(98)90410-5
更新日期：1998-12-01 00:00:00
abstract：OBJECTIVE:To determine the reliability, validity, and responsiveness of the modified Kapandji index (MKI). DESIGN:Prospective study. A cohort of patients planned for surgery of the wrist and/or fingers was evaluated within 48 hours before surgery and at least 6 months after surgery. SETTING:Patients were in hospitali...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/s0003-9993(03)00128-x
更新日期：2003-07-01 00:00:00
abstract：OBJECTIVES:(1) To evaluate the measurement reliability and construct validity of the Mayo-Portland Adaptability Inventory, 4th revision (MPAI-4) in a sample consisting exclusively of patients with cerebrovascular accident (CVA) using single parameter (Rasch) item-response methods; (2) to examine the differential item f...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2012.06.013
更新日期：2012-12-01 00:00:00
abstract：:Hospitalized patients often experience unnecessary immobility and inactivity leading to direct harms and poor outcomes. Despite growing evidence that early and regular mobility and activity are safe and helpful for patients in the hospital, there remains substantial room for improvement in clinical practice. Key to im...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2020.10.142
更新日期：2020-12-26 00:00:00
abstract：:The purpose of this study was to determine the 1-week test-retest reliability of the Sensory Organization Test (SOT), using computer-generated scores and loss of balance (LOB) episodes in noninstitutionalized older adults. The SOT was administered to each subject on two separate days 1 week apart in an out-patient cli...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/s0003-9993(95)80047-6
更新日期：1995-01-01 00:00:00
abstract：OBJECTIVE:To examine incidence and predictors of employment stability in veterans and military service members with traumatic brain injury (TBI) who return to work. DESIGN:Prospective observational cohort study. SETTING:Four rehabilitation centers. PARTICIPANTS:Veterans and military service members (N=110) with mild...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章,多中心研究
doi：10.1016/j.apmr.2017.05.012
更新日期：2018-02-01 00:00:00
abstract：OBJECTIVE:To demonstrate that after spinal cord injury (SCI) suppression of the parathyroid-vitamin D axis is associated with the degree of neurologic impairment and not the level of injury. DESIGN:A retrospective analysis of clinical and biochemical data obtained from hospital records of patients with SCI compared to...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/s0003-9993(97)90075-7
更新日期：1997-07-01 00:00:00
abstract：UNLABELLED:Krause JS, Zhai Y, Saunders LL, Carter RE. Risk of mortality after spinal cord injury: an 8-year prospective study. OBJECTIVE:To evaluate a theoretical model for mortality after spinal cord injury (SCI) by sequentially analyzing 4 sets of risk factors in relation to mortality (ie, adding 1 set of factors to...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2009.04.020
更新日期：2009-10-01 00:00:00
abstract：OBJECTIVES:To establish self-efficacy and depressive mood trajectories in adults with spinal cord injury (SCI), determine their interrelationship over time, and determine the influence that appraisals and comorbid physical conditions have on the development of self-efficacy. DESIGN:A prospective cohort design. SETTIN...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2018.07.442
更新日期：2019-03-01 00:00:00
abstract：OBJECTIVES:To conduct evidence-based review of cognitive rehabilitation intervention research conducted in persons with multiple sclerosis (MS), to classify level of evidence, and to generate recommendations for interventions in this area. DATA SOURCES:An open (no year limits set) search of Medline, PsychInfo, and CIN...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章,评审
doi：10.1016/j.apmr.2007.10.019
更新日期：2008-04-01 00:00:00
abstract：OBJECTIVE:To synthesize the best available evidence regarding the risk of dementia and chronic cognitive impairment (CCI) after mild traumatic brain injury (MTBI). DATA SOURCES:MEDLINE and other databases were searched (2001-2012) using a previously published search strategy and predefined criteria. Peer-reviewed repo...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章,评审
doi：10.1016/j.apmr.2013.06.036
更新日期：2014-03-01 00:00:00
