Journal of Back and Musculoskeletal Rehabilitation - Volume 8, issue 1
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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: Determination of a fair and consistent permanent impairment rating is a very important part of the injured worker's care. This rating is a medical determination and is based on objective and consistent physical findings. Conversion of these findings into a percent of impairment is greatly facilitated by the use of guidelines which enable different examiners to be consistent in their determinations. The most widely used guide is the Guides to the Evaluation of Permanent Impairment, published by the American Medical Association. Disability is a legal determination which attempts to quantitate how the impairment will affect the injured person. Disability takes…into account the worker's age, education, experience, and other social and economic factors. In the United States, disability is usually determined by the courts, while in other parts of the English-speaking world, the physician who does the impairment rating may be expected to estimate the disability as well as the impairment. This article will discuss some aspects of determination of impairment of the upper extremity, using the AMA Guides as the primary guideline.
Keywords: Disability evaluation, Extremity, upper, Amputation, Range of motion, articular, Neurologic evaluation
Abstract: Treating industrial injuries/dysfunctions present greater challenges for the treating physician and rehabilitation team. The treatment and documentation needs of injured workers require a coordinated effort of the entire rehabilitation team in order to bring the disability evaluating process to an efficient and final conclusion. This manuscript presents the authors' personal clinical approaches to industrial injuries, focusing on the rehabilitation process: what to do, when to do it, and when to stop and proceed along a different plan. This paper will also address issues of completing the disability evaluating process while meeting the needs of the patient, employer, case manager, and…payor source. The importance of the multi-disciplinary rehabilitation team and communication with the employer through the case manager, patient and family will be described. The use of Functional Capacity Evaluation, Job Analysis and other return to work and disability assessment modalities will be discussed as related to coordination with other rehabilitation efforts.
Abstract: Lower back pain (LBP) is a common condition with profound economic and social consequences. A conservative, symptomatic, goal-oriented management program is advocated by most, emphasizing pain relief and restoration of functional capacity. Still, LBP is recurrent in approximately 50% of patients and up to 5–10% experience chronic intractable pain. This article describes how to evaluate and rehabilitate the patient with spinal impairment (SI). All is summarized in a diagnostic/treatment algorithm as used in the spine rehabilitation center. Causes of LBP, components of the patient history and physical, diagnostic test usage and management options are summarized in tables for future reference.…Lastly, preventative measures are discussed which, when implemented within a treatment program, may prevent future reoccurrences.
Keywords: Disability, Low-back pain, Peripheral nervous system
Abstract: The foot and ankle have been an important part in the development of human gait and the erect posture of man. This paper presents several important evolutionary and biomechanical insights to the function of the midfoot and rearfoot. The bony architecture of the foot and ankle has enhanced the ability of man to walk in an upright posture. The complex movements of supination and pronation was established as a result of positional changes of the talus and calcaneus. The human foot has adapted to a bipedal striding gait by forming a compact structure that can absorb high ground reaction forces…and provide a lever for push-off. Certain mechanical disorders of the foot and ankle may result from alterations of several evolutionary features. Excessive pronation and supination are the two major categories of mechanical disorders of the foot and ankle. The restoration of normal foot mechanics offers an important treatment approach to mechanical dysfunction of the foot and ankle.
Keywords: Pronation, Supination, Pes cavus, Pes planus