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West Orange, NJ, United States

Wendel I.,The New School | Cole J.,Kessler Institute for Rehabilitation
PM and R

Extensor digitorum brevis manus (EDBM) muscles are accessory dorsal hand muscles that are present in 1%-3% of the population. These muscles are not commonly symptomatic, but they can occasionally cause pain and discomfort and may be misdiagnosed as tenosynovitis or a ganglion cyst. In this case, we describe an appropriate workup of dorsal hand masses and myalgia that are suspected to be related to EDBM muscles. The patient's symptoms were controlled with injections of botulinum toxin into the EDMB muscle belly, which allowed thepatient to be relatively pain free for a considerable amount of time and avoid surgery. © 2014 American Academy of Physical Medicine and Rehabilitation. Source

Cohen E.E.W.,University of California at San Diego | Lamonte S.J.,Louisiana State University Health Sciences Center | Erb N.L.,American Cancer Society Inc | Beckman K.L.,American Cancer Society | And 8 more authors.
CA Cancer Journal for Clinicians

Answer questions and earn CME/CNE The American Cancer Society Head and Neck Cancer Survivorship Care Guideline was developed to assist primary care clinicians and other health practitioners with the care of head and neck cancer survivors, including monitoring for recurrence, screening for second primary cancers, assessment and management of long-term and late effects, health promotion, and care coordination. A systematic review of the literature was conducted using PubMed through April 2015, and a multidisciplinary expert workgroup with expertise in primary care, dentistry, surgical oncology, medical oncology, radiation oncology, clinical psychology, speech-language pathology, physical medicine and rehabilitation, the patient perspective, and nursing was assembled. While the guideline is based on a systematic review of the current literature, most evidence is not sufficient to warrant a strong recommendation. Therefore, recommendations should be viewed as consensus-based management strategies for assisting patients with physical and psychosocial effects of head and neck cancer and its treatment. CA Cancer J Clin 2016;66:203-239. © 2016 American Cancer Society. Source

Kisala P.A.,University of Delaware | Tulsky D.S.,University of Delaware | Choi S.W.,CTB McGraw Hill | Kirshblum S.C.,Kessler Institute for Rehabilitation | Kirshblum S.C.,The New School
Journal of Spinal Cord Medicine

Objective: To develop a self-reported measure of the subjective impact of pressure ulcers on health-related quality of life (HRQOL) in individuals with spinal cord injury (SCI) as part of the SCI quality of life (SCI-QOL) measurement system. Design: Grounded-theory based qualitative item development methods, large-scale item calibration testing, confirmatory factor analysis (CFA), and item response theory-based psychometric analysis. Setting: Five SCI Model System centers and one Department of Veterans Affairs medical center in the United States. Participants: Adults with traumatic SCI. Main Outcome Measures: SCI-QOL Pressure Ulcers scale. Results: 189 individuals with traumatic SCI who experienced a pressure ulcer within the past 7 days completed 30 items related to pressure ulcers. CFA confirmed a unidimensional pool of items. IRT analyses were conducted. A constrained Graded Response Model with a constant slope parameter was used to estimate item thresholds for the 12 retained items. Conclusions: The 12-item SCI-QOL Pressure Ulcers scale is unique in that it is specifically targeted to individuals with spinal cord injury and at every stage of development has included input from individuals with SCI. Furthermore, use of CFA and IRT methods provide flexibility and precision of measurement. The scale may be administered in its entirety or as a 7-item "short form" and is available for both research and clinical practice. © The Academy of Spinal Cord Injury Professionals, Inc. 2015. Source

Frisina P.G.,Kessler Institute for Rehabilitation | Kutlik A.M.,Kessler Institute for Rehabilitation | Barrett A.M.,Kessler Institute for Rehabilitation | Barrett A.M.,Kessler Foundation Research Center | Barrett A.M.,The New School
Archives of Physical Medicine and Rehabilitation

Objective: To test the hypothesis that a left-dominant brain immune network (LD-BIN) might affect the occurrence of infection during inpatient rehabilitation of stroke and traumatic brain injury (TBI). Design: A retrospective analysis was performed on electronic medical records between January 2009 and December 2010. All patients with left- or right-sided stroke or TBI were included into the study. The LD-BIN hypothesis was tested by comparing HAI rates depending on whether patients had left- or right-sided brain lesions. Setting: A large inpatient rehabilitation hospital. Participants: Among the patients (N=2236) with stroke or TBI who had either a left- or right-sided brain lesion, 163 patients were identified with HAIs. Intervention: Not applicable. Main Outcome Measure: Frequency of HAIs. Results: In the 163 patients identified with HAIs with a diagnosis of stroke or TBI, chi-square analysis revealed a significantly higher proportion of HAIs among patients with left-sided (n=98; 60.1%) relative to right-sided (n=65; 39.9%) brain injuries (χ2= 6.68, P<.01). These effects could not be attributed to either clinical or demographic factors. Conclusions: Our findings are consistent with the hypothesis that an LD-BIN may mediate vulnerability to infection during rehabilitation of patients with stroke or TBI. Further translational research investigating novel means of managing patients based on brain lesion location, and modulating the LD-BIN via behavioral and physiologic interventions, may result in neuroscience-based methods to improve infection resistance in brain-injured patients. © 2013 American Congress of Rehabilitation Medicine. Source

Goedert K.M.,Seton Hall University | Chen P.,Kessler Foundation | Chen P.,The New School | Boston R.C.,University of Pennsylvania | And 4 more authors.
Neurorehabilitation and Neural Repair

Background. Spatial neglect is a debilitating disorder for which there is no agreed on course of rehabilitation. The lack of consensus on treatment may result from systematic differences in the syndrome's characteristics, with spatial cognitive deficits potentially affecting perceptual-attentional "Where" or motor-intentional "Aiming" spatial processing. Heterogeneity of response to treatment might be explained by different treatment impacts on these dissociated deficits: prism adaptation, for example, might reduce Aiming deficits without affecting Where spatial deficits. Objective. Here, we tested the hypothesis that classifying patients by their profile of Where-versus-Aiming spatial deficit would predict response to prism adaptation and specifically that patients with Aiming bias would have better recovery than those with isolated Where bias. Methods. We classified the spatial errors of 24 subacute right stroke survivors with left spatial neglect as (1) isolated Where bias, (2) isolated Aiming bias, or (3) both. Participants then completed 2 weeks of prism adaptation treatment. They also completed the Behavioral Inattention Test and Catherine Bergego Scale (CBS) tests of neglect recovery weekly for 6 weeks. Results. As hypothesized, participants with only Aiming deficits improved on the CBS, whereas those with only Where deficits did not improve. Participants with both deficits demonstrated intermediate improvement. Conclusion. These results support behavioral classification of spatial neglect patients as a potential valuable tool for assigning targeted, effective early rehabilitation. © The Author(s) 2013. Source

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