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2020| January-March | Volume 3 | Issue 1
June 23, 2020
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A combined behavioral and pharmacological approach in nonparaneoplastic-related anti-N-methyl-D-aspartate receptor encephalitis: A case report with positive outcome in a male patient
Matthew Rong Jie Tay, Karen Sui Geok Chua
January-March 2020, 3(1):22-27
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a rare but potentially life-threatening and disabling autoimmune encephalitis mainly affecting young women. We report the case of a male in his early thirties who developed behavioral and neurocognitive manifestations of anti-NMDAR encephalitis. This case highlights the unique behavioral challenges in a male patient during the course of rehabilitation, including impulsivity, inappropriate sexual behavior, and hyperphagia, which has not been well-described in the literature. This presented complex problems for the rehabilitation team and amelioration of these clinical issues required a multidisciplinary approach. The behavioral and pharmacological strategies employed, which had a pronounced positive contribution in this patient, are described. A brief review of the epidemiology, course, and common complications of anti-NMDAR encephalitis is also presented.
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International society of physical and rehabilitation medicine/European society of physical and rehabilitation medicine guidelines on physical and rehabilitation medicine professional practice for adults with obesity and related comorbidities
Emanuele M Giusti, Chiara A M Spatola, Amelia Brunani, Dinesh Kumbhare, Aydan Oral, Elena Ilieva, Carlotte Kiekens, Giada Pietrabissa, Gian Mauro Manzoni, Marta Imamura, Gianluca Castelnuovo, Paolo Capodaglio
January-March 2020, 3(1):11-21
The World Health Organization (WHO) has declared obesity as the largest global chronic health problem in adults. In the last years, attention has been drawn to rehabilitative interventions for patients with obesity.
The aim of this manuscript is to provide physical and rehabilitation medicine (PRM) physicians with evidence-based recommendations for the rehabilitation of patients with obesity and related comorbidities.
Adults with overweight or obesity.
Guidelines were based on the Grading of Recommendations Assessment, Development and Evaluation and the WHO recommendations. A comprehensive search of the available evidence about rehabilitation treatments for obesity was performed, and 17 separate systematic literature reviews were conducted. For each outcome, estimates of the effects of rehabilitation treatments were computed and employed along with an assessment of quality of evidence, desirable and undesirable effects, values and preferences to formulate the recommendations. Recommendations were reviewed by a consensus expert panel using a modified Delphi process.
We strongly recommend providing comprehensive multiprofessional and multidisciplinary interventions including exercise, diet and behavioral or cognitive-behavioral therapy. The nutritional component of these treatments should include diets with either a high-protein or a low-fat content. It is strongly recommended to prescribe frequent moderate aerobic exercise. We strongly recommend providing cognitive-behavioral interventions as the behavioral component of rehabilitation programs.
PRM physicians should lead multidisciplinary teams providing comprehensive and individualized rehabilitation programs for patients with overweight or obesity. These guidelines were endorsed by the International Society of Physical and Rehabilitation Medicine and by the European Society of Physical and Rehabilitation Medicine.
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Preparedness among medical rehabilitation professionals for deployment to future disaster settings
Su Yi Lee, Bhasker Amatya, Mary P Galea, Fary Khan
January-March 2020, 3(1):5-10
To assess the preparedness among medical rehabilitation professionals for deployment to disaster settings and to establish a rehabilitation professional database for disaster training and deployment under the auspices of the International Society of Physical and Rehabilitation Medicine (ISPRM).
A survey tool for preparedness for deployment to disaster settings was developed by the authors following approval from the Rehabilitation Medicine Society of Australia and New Zealand (RMSANZ) and ISPRM. The link to the online survey was distributed by email to members through the RMSANZ and Central Office of ISPRM. Participants were registered rehabilitation professionals who were members of the RMSANZ and/or ISPRM. The survey was voluntary.
Of the 76 respondents, the majority (94%) were rehabilitation physicians, 72% had >10 years of experience in rehabilitation medicine, 63% expressed an interest in future deployment, and only 24% had some disaster management training in the past. Almost all who expressed an interest in deployment wanted to receive any relevant disaster management training and education before deployment; others were interested in potential opportunities and expectations in disaster management, mitigation, communication, team structure, and telemedicine utilization.
Surveying a larger cohort of rehabilitation professionals and documentation of context-specific rehabilitation skills relevant to disaster settings are needed. Establishment of a database of rehabilitation professionals, willing to be deployed, should be considered to assist with the integration of the rehabilitation workforce within the World Health Organization Emergency Medical Team Initiative.
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Pes Anserine Syndrome and Bursitis in a Stroke Patient without Prior Knee Pathology: Diagnostic and Treatment-Learning Points
Tan Yeow Leng
January-March 2020, 3(1):28-30
Snapping pes anserinus is a cause of extraarticular medial knee snapping. It results from the translation of the semitendinosis or gracilis tendon during active knee flexion and extension. A 60-year-old female with left medullary infarct and no prior left knee pathology presented with left painful knee snap on walking 3 years after the stroke onset. Clinical examination detected a medial knee snap on the left knee extension. Dynamic ultrasound identified the semitendinosis tendon causing the knee snap. Magnetic resonance imaging of the left knee excluded intraarticular causes of knee snap and confirms soft-tissue edema and bursitis near the pes anserine. The patient was treated with local anesthetic injection and physical therapy with immediate pain relief. This case describes pes anserine syndrome in a stroke patient without prior knee pathology. Poststroke gait deviation can possibly cause repetitive excessive knee loading, leading to secondary musculoskeletal complications such as snapping pes anserinus.
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Musculoskeletal ultrasound publications in rehabilitation journals: A EURO-MUSCULUS/USPRM update
Timur Ekiz, Ayşe Merve Ata, Murat Kara, Eda Gürçay, Ke-Vin Chang, Merve Sekizkardeş, Simão Serrano, Nikolaos Barotsis, Alessandro Picelli, Daniele Coraci, Kamal Mezian, Nuray Akkaya, Tülay Tiftik, Elem Yorulmaz, Gülümser Aydın, Wei-Ting Wu, Mario Giraldo-Prieto, Levent Özçakar, Franco Franchignoni
January-March 2020, 3(1):1-4
The utility of musculoskeletal ultrasound (US), both in the clinical settings and scientific arena, has significantly increased in recent years.
The aim of this study was to report and analyze the publications on musculoskeletal US in top rehabilitation journals (indexed by the 'Rehabilitation' category of Journal Citation Reports (JCR), Clarivate Analytics).
The search was carried out up to July 2018 through Web of Science (Science Citation Index-Expanded). The literature search comprised all 65 journals listed in the 2017 category “Rehabilitation” according to the JCR.
A total of 971 papers published in 39 different journals from 1989 to 2018 were analyzed. The top three publishing countries (in decreasing order) appeared as the United States of America (USA), Turkey and Taiwan. The American Journal of Physical Medicine and Rehabilitation, PM&R and the Archives of Physical Medicine and Rehabilitation were the top three journals (in decreasing order) publishing about topics on musculoskeletal US. The most commonly studied diseases in humans were musculoskeletal conditions, followed by neurological disorders. Physiatrists and PRM departments (46.9%) prevail as far as publishing specialties were concerned. Although the use of interventional US seems to have increased after 2000, diagnostic US is still ranked the first, when the purpose of the conducted study is taken into consideration.
Accordingly, we believe that this scientific output might help to raise awareness as regards the potential role of US in Physical and Rehabilitation Medicine.
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