Journal of Back and Musculoskeletal Rehabilitation - Volume 12, issue 2
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Journal of Back and Musculoskeletal Rehabilitation is a journal whose main focus is to present relevant information about the interdisciplinary approach to musculoskeletal rehabilitation for clinicians who treat patients with back and musculoskeletal pain complaints. It will provide readers with both 1) a general fund of knowledge on the assessment and management of specific problems and 2) new information considered to be state-of-the-art in the field. The intended audience is multidisciplinary as well as multi-specialty.
In each issue clinicians can find information which they can use in their patient setting the very next day. Manuscripts are provided from a range of health care providers including those in physical medicine, orthopedic surgery, rheumatology, neurosurgery, physical therapy, radiology, osteopathy, chiropractic and nursing on topics ranging from chronic pain to sports medicine. Diagnostic decision trees and treatment algorithms are encouraged in each manuscript. Controversial topics are discussed in commentaries and rebuttals. Associated areas such as medical-legal, worker's compensation and practice guidelines are included.
The journal publishes original research papers, review articles, programme descriptions and cast studies. Letters to the editors, commentaries, and editorials are also welcomed. Manuscripts are peer reviewed. Constructive critiques are given to each author. Suggestions for thematic issues and proposed manuscripts are welcomed.
Abstract: Athletes are susceptible to peripheral nerve injuries because of the extreme physical challenges to which they are exposed. These injuries are often associated with subtle abnormalities and can be difficult to diagnose. They may be overlooked because the well motivated and conditioned athlete often compensates for or is not aware of mild weakness and sensory deficits. Electrodiagnostic studies play an important role in diagnosing peripheral injuries, objectifying neurologic damage and prognosticating outcome. They are also being used to study muscle kinesiology and fatigue. This article will review some of the basic neurophysiologic and electrophysiologic principles relevant to peripheral nerve injuries,…and introduce the clinician treating athletes to the role of electrodiagnostics in sports medicine and some of the common peripheral nerves injured.
Abstract: Cancer has a profound impact upon public health throughout the world due to its prevalence and devastating morbidity and mortality (A.K. Jacox, et al. (1994) and F.M. Ferrante, et al. (1996)). For this reason, in 1980 the World Health Organization began an effort to codify prevailing approaches to cancer pain relief and to encourage implementation of these methods as health policy throughout the world. This review will summarize subsequent progress in assessing cancer pain and treating it by means of systemic and intraspinal pharmacologic management as well as nonpharmacologic interventions. Important elements of the initial pain evaluation include…a detailed history, physical examination, psychosocial assessment and, when appropriate, a diagnostic plan to detect the cause of new or escalating pain. Moreover, clinicians treating cancer patients should recognize common cancer pain syndromes. Systemic pharmacologic management, the cornerstone of cancer pain management, must be individualized. The three major classes of drugs used today in the treatment of cancer pain, non-steroidal anti-inflammatory drugs (NSAIDs), opioids, and adjuvants will be discussed. The WHO three-step ladder to guide cancer pain treatment will be reviewed. The discussion will then turn to neuroaxial pharmacologic management in the treatment of refractory pain resistant to systemic drugs. Factors to consider in deciding whether to begin spinal opioid therapy will be described. Finally, nonpharmacologic management of cancer pain will be surveyed, ranging from physical and psychosocial modalities to more invasive therapies.
Abstract: The vestibular system registers changes in head position, gravity, vibration, acceleration and deceleration. This information is then transmitted to the central nervous system, where additional information from the visual and auditory systems, muscles, tendons, joints and skin, serve to regulate and maintain the equilibrium and orientation of the system. Vision plays the most obvious part in continual monitoring of the environment. Distances, speeds of linear and angular movement, and changes of direction, can all be estimated with experience and be integrated in the central nervous system with those received by other sensory systems. Light touch and pressure receptors in…the skin detect bodily contact with the environment and are an essential source of data in walking, cycling, motoring, flying and other activities. Proprioception provides data regarding the instantaneous mechanical disposition of the musculoskeletal system as it relates to the force of gravity acting upon it. The functional recovery that occurs after unilateral vestibular lesions is referred to as “vestibular compensation” and consists of all the processes of neurological reorganization that allow recovering balance after a unilateral vestibular lesion. Exercises are particularly useful in helping patients to overcome disturbances, associated with balance disorders. The purpose of these selected exercises is to build up a tolerance mechanism in the brain, which will compensate for the unequal balance of the two ears.