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Background: There is a limited evidence base to inform patient management following lightning-induced injuries. Case report: A 36-year-old right-handed Caucasian male struck by lightning while outdoors suffered an out-of-hospital ...
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Background: There is a limited evidence base to inform patient management following lightning-induced injuries. Case report: A 36-year-old right-handed Caucasian male struck by lightning while outdoors suffered an out-of-hospital cardiac arrest with a recorded 50-min interval before the restoration of spontaneous circulation. Multiple life threatening injuries were sustained and a profound peripheral neuropathy developed. Cognitively, he was remarkably intact. We document his acute admission and his recovery during an inpatient stay in a UK-based Neurorehabilitation Unit. Conclusion: Intensive neurorehabilitation in this case improved functional independence and facilitated neuropsychological recovery, to the point that our patient was discharged to independent living. This case offers some support to the hypothesis that the electrical activity of a lightning strike can be both cardioprotective and neuroprotective, and that prolonged cardiopulmonary resuscitation is warranted in such cases.
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Heat illness remains a significant threat to health in the UK Armed Forces despite recent improvements in the prevention of cases. A small number of heat illness survivors develop long-term neurological sequelae. Here we briefly r...
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Heat illness remains a significant threat to health in the UK Armed Forces despite recent improvements in the prevention of cases. A small number of heat illness survivors develop long-term neurological sequelae. Here we briefly review the background literature and present our experience of treating UK Armed Forces patients with neurological consequences of heat illness. In our cohort of patients, we observed significant improvements in subjective symptoms and objective assessments following a period of neurological rehabilitation at the Defence Medical Rehabilitation Centre. We conclude with recommendations for further research and for the incorporation of screening for neurological disability following heat illness into service policy. ? 2022 Author(s). Published by BMJ.
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? 2021 American Congress of Rehabilitation MedicineObjective: A network meta-analysis (NMA) of current evidence was conducted to determine if physical exercise has a positive influence on multiple sclerosis (MS) fatigue and type o...
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? 2021 American Congress of Rehabilitation MedicineObjective: A network meta-analysis (NMA) of current evidence was conducted to determine if physical exercise has a positive influence on multiple sclerosis (MS) fatigue and type of exercise with the largest effect on fatigue also according to disease severity. Data Sources: MEDLINE, Embase, SPORTDiscus, Physiotherapy Evidence Database, Cochrane Library, and Web of Science. The search strategy combined relevant terms related to (1) MS; (2) clinical trials; (3) exercise; and (4) fatigue from inception to February 2021. Study Selection: Randomized controlled trials concerning the effectiveness of different types of exercise on total and physical fatigue in people with MS were included. Data Extraction: The data were extracted into predesigned data extraction tables. Risk of bias was evaluated with the Cochrane Risk of Bias tool (RoB 2.0), and the Grading of Recommendations, Assessment, Development, and Evaluation tool was used to evaluate the quality of the evidence. Data Synthesis: A total of 58 studies were examined. Data were pooled using a random-effects model. A ranking of 7 and 8 different exercise interventions for physical and total fatigue scores, respectively, was achieved. The highest effects for pairwise comparisons were for combined exercise and resistance training vs control (ranging between ?0.74 and ?1.24). In the NMA, combined exercise (?1.51; 95% confidence interval [CI], ?2.01 to ?1.01) and resistance training (?1.15; 95% CI, ?1.81 to ?0.49) compared with the control group achieved the highest effects for physical and total fatigue, respectively. Conclusions: Exercise should be considered an effective fatigue management strategy. Among the different exercise modalities, combined exercise is the most effective exercise modality for improving both physical and total fatigue. Resistance training is also an effective exercise for total fatigue among people diagnosed with MS.
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Objectives: To determine whether ballistic resistance training is feasible, safe, and effective in improving muscle strength, power generation, and mobility in adults with neurologic conditions.
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Robot-assisted therapy has been proved effective for dyskinesia, and has many unique advantages compared with traditional treatment, such as repeatability, accuracy, objectivity. But some studies show that the effect of the robot-...
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Robot-assisted therapy has been proved effective for dyskinesia, and has many unique advantages compared with traditional treatment, such as repeatability, accuracy, objectivity. But some studies show that the effect of the robot-assisted rehabilitation for improving patients' activities of daily life (ADLs) is not obvious. This study introduces a novel auxiliary method-vibration stimulation combined with robots which may improve patients' ADLs. In controlled trials, two kinds of feedback-vibration and visual feedback are applied to prompt subjects for rehabilitation, and electromyographic signals (EMGs) and motion parameters are recorded in real time. Experimental results show that subjects' EMGs using vibration feedback are similar to healthy people, and characteristics of motion are closer to the theoretical value compared with control group. Vibration stimulation may serve as a kind of efficient auxiliary means to improve the efficiency of neurological rehabilitation.
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Objective: To evaluate retrospectively the effect of robotic rehabilitation in a large group of children with motor impairment; an additional goal was to identify the effects in children with cerebral palsy (CP) and acquired brain...
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Objective: To evaluate retrospectively the effect of robotic rehabilitation in a large group of children with motor impairment; an additional goal was to identify the effects in children with cerebral palsy (CP) and acquired brain injury (ABI) and with different levels of motor impairment according to the Gross Motor Function Classification System. Finally, we examined the effect of time elapsed from injury on children's functions.
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Developments in this area are now moving faster than ever before. It is evident that recovery drugs and techniques promoting recovery after brain ischemia deserve separate consideration and special efforts. A large number of trial...
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Developments in this area are now moving faster than ever before. It is evident that recovery drugs and techniques promoting recovery after brain ischemia deserve separate consideration and special efforts. A large number of trials are ongoing, and several new methods are being tested in single or combination mode. We have decided to report Cochrane data, meta-analyses, or (when both not available) to select 1 or 2 major papers representative for each area to illustrate the achieved results and to point to the many promising experimental, clinical, and field trials currently underway.
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Objective: There is currently no published evidence from longitudinal or intervention studies of an association between lifestyle physical activity and walking impairment in persons with multiple sclerosis. This panel study tested...
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Objective: There is currently no published evidence from longitudinal or intervention studies of an association between lifestyle physical activity and walking impairment in persons with multiple sclerosis. This panel study tested the hypothesis that a change in lifestyle physical activity would be inversely associated with change in walking impairment over a 6-mo period in persons with relapsing-remitting multiple sclerosis. Design: Participants with a confirmed diagnosis of relapsing-remitting multiple sclerosis completed a battery of measures at baseline (n = 269) and at 6-mo follow-up (n = 263) in the absence of an intervention. The data were analyzed using linear panel analysis and covariance modeling in Mplus 3.0. Results: The panel model fit the data (chi~2 = 25.23; df = 12; P = 0.01; standardized root-mean-squared residual, 0.04; comparative fit index, 0.98) and, as expected, identified the direct effects between baseline physical activity and walking impairment (path coefficient, -0.31) and follow-up physical activity and walking impairment (path coefficient, -0.16). The second path coefficient indicated that a standard deviation unit change of 1 in physical activity was associated with a standard deviation unit residual change of 0.1 6 in walking impairment. Conclusions: The finding supports the possible importance of targeting free-living physical activity as a behavioral approach for forestalling walking impairments in adults with relapsing-remitting multiple sclerosis.
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Autonomic dysreflexia is a relatively common condition in people who have a spinal cord injury above the level of T6. It is a potentially life-threatening; without timely and effective treatment, it can have deleterious cardiophys...
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Autonomic dysreflexia is a relatively common condition in people who have a spinal cord injury above the level of T6. It is a potentially life-threatening; without timely and effective treatment, it can have deleterious cardiophysiological and systemic consequences. It is therefore imperative for medical professionals to have a clear understanding of its acute management, and be prepared to provide support and education to those caring for at-risk patients. In this paper we provide practical guidance and supporting evidence regarding the management of autonomic dysreflexia in adults with spinal cord injury.
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