Shoulder Pain in the Throwing Athlete

Disease/Disorder Definition Pain and/or discomfort within the shoulder, proximal arm or shoulder girdle of the throwing arm, with associated symptoms that may include: “dead arm” sensation, loss of throwing velocity and/or control, and snapping or catching about the shoulder. Etiology

Dystonias (except torticollis)

[…] Counseling to help patients understand the diagnosis, available treatments, set realistic expectations, and to provide additional resources for support Adjunctive services with physical, occupational, and speech therapies Adequate psychological support as living with dystonia can impact emotional and psychological well-being […]

Blount’s Disease

Disease/ Disorder Definition Blount disease, also known as tibia vara, is an acquired disorder affecting the medial proximal tibial growth plates (metaphysis) which results in a multidimensional lower extremity deformity most prominently defined by tibial varus.1 Etiology While the exact

Professionalism in Rehabilitation: Peer, Student, Resident and Fellow Recommendations/Assessment

[…] of knowledge that its physician members must teach and expand upon, 2) a code of ethics and a duty of service which puts patient care above self-interest, and 3) the privilege of self-regulation granted by society.1,2,3 The American Academy of […]

Legg-Calve-Perthes Disease

[…] involved then the prognosis is good, whereas if more than 50% is involved, a potentially poor prognosis is indicated 6 (i.e., early degenerative arthritis). Herring: is based on the height of the lateral pillar of the FH epiphysis in the […]

Cardiac Rehabilitation Before and After Cardiac Transplantation

[…] of Cardiology. Eur J Heart Fail. 2009;11:433-443. (2022). OPTN/SRTR 2020 Annual Data Report: Heart. U.S. Department of Health and Human Services. https://srtr.transplant.hrsa.gov/annual_reports/2020/Heart.aspx Eisen HJ, Hunt SA, Yeon SB. Patient education (beyond the basics). https://www.uptodate.com/contents/heart-transplantation-beyond-the-basics. July 2019. Browsed on August 4, […]

Congenital Upper Limb Deficiency

[…] favor body-powered devices, as would deserts, beaches, or places with inconsistent power sources. Myoelectric devices require geographic access to repair services. Social role and social support system The psychosocial effects of this population directly influence quality of life. In a […]

Functional Assessment

[…] from these instruments and its application on real life situations. In addition to this, third-party payers have been shaping how services are provided and what outcomes are to be expected. Gaps in Knowledge/ Evidence Base Gaps have been observed in […]

Pediatric Anoxic Brain Injury

[…] recovery of continuous background Late appearance of epileptiform activity Poor outcome predictors: Low Voltage or isoelectric EEG High voltage, rhythmic delta waves, biphasic sharp waves, “burst suppression” pattern (Use with caution as burst suppression can be induced by midazolam or propofol), absence of beta rhythms, generalized suppression, status epilepticus, nonreactivity Persistently abnormal EEG at 48 hours or more associated with adverse neurodevelopmental outcome Epileptiform Features (sharp waves, polyspikes, spikes, wave patterns) 32 Somatosensory Evoked Potential (SSEP) Monitoring Somatosensory Evoked Potentials (SSEPs) assess afferent thalamocortical integrity. 32 SSEP is used as a neurophysiologic test for assessing integrity of neuronal pathways from the peripheral nerves, spinal cord, brainstem and cerebral cortex. Most reliable evoked potential waveform as median N20 component of SSEP Median N20 SSEP: first cortical response of SSEP with median nerve stimulation Bilateral absence of median N20 response on days 1 and 3 or later following CPR accurately predicts poor outcome (reflects widespread cortical necrosis) Bilateral absence of N20 potentials is a reliable/strong predictor of poor outcome after cardiac arrest yet may be impacted by hypothermia.32 Advantage: less susceptible to effects of sedative drugs, metabolic changes and artifact interference compared to EEG monitoring. Disadvantage: require advanced neurologic training, interpretation limited to specialized centers, low sensitivity Serum Biomarkers for ABI Prognostication Serum NSE (neuron-specific enolase) Isomer of intracytoplasmic glycolytic enzyme enolase found in neuronal bodies, axons, neuroendocrine cells and tumors NSE peaks in serum and CSF at ours after injury Serum NSE > 33 microgram/L at days 1 and 3 associated with poor outcome Use limited by lack of laboratory standardization, long turn-around […]

Metabolic Encephalopathies

[…] to detect global cerebral dysfunction. ME may show diffuse bilateral slowing of background rhythm, triphasic waves, and frontally predominant rhythmic delta activity. In extreme cases, burst-suppression pattern may be seen.3,4,12 Practitioners should have low threshold for EEG monitoring as seizures […]