Phys Med Rehabil Clin N Am
· 2026 Feb · PMID 41207720
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Female Para and adaptive athletes face health disparities affecting sport performance, clinical health, and well-being unique to the intersection between sex and disability. A guideline to comprehensive clinical care for...Female Para and adaptive athletes face health disparities affecting sport performance, clinical health, and well-being unique to the intersection between sex and disability. A guideline to comprehensive clinical care for female Para and adaptive athletes, including discussion regarding concussion, mental health, cardiorespiratory, body composition/nutrition, endocrinologic, gynecologic/urologic, and musculoskeletal factors, are summarized in this article. Data from large epidemiologic studies investigating the role of gender in injury/illness outcomes are additionally summarized, thus providing context on trends disproportionately facing this population.
Heasley V, Dubon ME, Rabatin A
… +1 more, Timmerman M
Phys Med Rehabil Clin N Am
· 2026 Feb · PMID 41207719
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Adaptive sports offer significant physical and psychological benefits, reducing the risk of chronic illnesses like cardiovascular disease and diabetes while enhancing life satisfaction and independence. However, only 46%...Adaptive sports offer significant physical and psychological benefits, reducing the risk of chronic illnesses like cardiovascular disease and diabetes while enhancing life satisfaction and independence. However, only 46% to 49% of people with disabilities engage in physical activity, compared to 62% to 68% of those without disabilities, partly due to barriers such as limited access, social stigma, high costs of specialized equipment, and inadequate policies. This article explores ways to address these challenges through methods and models that promote inclusive practices and improve access.
Phys Med Rehabil Clin N Am
· 2025 Nov · PMID 41167861
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This article reviews interventional treatments for headache and facial pain. Procedures, such as botulinum toxin injections, occipital and peripheral nerve blocks, trigger point injections, and sphenopalatine ganglion bl...This article reviews interventional treatments for headache and facial pain. Procedures, such as botulinum toxin injections, occipital and peripheral nerve blocks, trigger point injections, and sphenopalatine ganglion blocks, are discussed with protocols and evidence supporting their efficacy. These approaches serve both therapeutic and diagnostic purposes, particularly in cases refractory to medication or conservative management. Emphasis is placed on anatomic knowledge and careful pre-procedural considerations to enhance precision and safety, with procedural guidance provided for reducing risks and improving patient outcomes.
Phys Med Rehabil Clin N Am
· 2025 Nov · PMID 41167860
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Headaches are one of the most common disabling pain conditions worldwide across a number of diagnostic categories. Behavioral treatments have received significant research and clinical attention for headache management,...Headaches are one of the most common disabling pain conditions worldwide across a number of diagnostic categories. Behavioral treatments have received significant research and clinical attention for headache management, but the diverse range of headache mechanisms and diagnostic categories makes it difficult to identify a single behavioral treatment modality that is ideal for all headaches. This article will review some of the most common behavioral treatments for headache pain and disability and will explore differences in evidence base, treatment outcomes, and suitability of these treatments for some of the most common headache diagnoses.
Phys Med Rehabil Clin N Am
· 2025 Nov · PMID 41167859
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Patients with headache disorders may benefit from a collaborative, interdisciplinary and/or multidisciplinary approach with involvement from multiple physician specialties, therapists, psychologists, and pharmacists. Eac...Patients with headache disorders may benefit from a collaborative, interdisciplinary and/or multidisciplinary approach with involvement from multiple physician specialties, therapists, psychologists, and pharmacists. Each member of the team plays a role in headache diagnosis and management, from medication management to patient education to procedural or surgical intervention. Initiation of an interdisciplinary approach for the patient with headache is crucial, especially if the patient fails initial conservative treatment or suffers from other chronic pain states so as to adequately address all aspects of the headache pain. The successful headache management team benefits from understanding each team member's role within the team.
Phys Med Rehabil Clin N Am
· 2025 Nov · PMID 41167858
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This article provides a comprehensive overview of high-pressure and low-pressure headaches, focusing on their pathophysiology, clinical presentation, diagnosis, and management. High-pressure headaches, often linked to id...This article provides a comprehensive overview of high-pressure and low-pressure headaches, focusing on their pathophysiology, clinical presentation, diagnosis, and management. High-pressure headaches, often linked to idiopathic intracranial hypertension, primarily affect young women and can lead to vision loss if untreated. Low-pressure headaches, commonly caused by spontaneous or iatrogenic cerebral spinal fluid leaks, are a significant cause of refractory headaches. The article emphasizes the importance of timely diagnosis using advanced imaging and multidisciplinary management, including pharmacologic therapies, procedural interventions, and surgical options. By addressing these challenging headache syndromes, clinicians can achieve better outcomes and improve patients' quality of life.
Phys Med Rehabil Clin N Am
· 2025 Nov · PMID 41167857
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Medication overuse headache (MOH) is defined as a new or worsening headache occurring more than 15 days a month in people with a pre-existing primary headache that develops as a result of regular overuse of acute headach...Medication overuse headache (MOH) is defined as a new or worsening headache occurring more than 15 days a month in people with a pre-existing primary headache that develops as a result of regular overuse of acute headache treatments. MOH is a common secondary headache disorder with an estimated prevalence of 1% to 5%. The presence of a pre-existing primary headache disorder is the main risk factor for MOH.
Phys Med Rehabil Clin N Am
· 2025 Nov · PMID 41167856
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There are various cranial nerve lesions that cause complex presentations of headache and facial pain, including trigeminal neuralgia, occipital neuralgia, glossopharyngeal neuralgia, and other rarer syndromes. Each prese...There are various cranial nerve lesions that cause complex presentations of headache and facial pain, including trigeminal neuralgia, occipital neuralgia, glossopharyngeal neuralgia, and other rarer syndromes. Each present with their distinct patterns and diagnosis is reliant on a thorough history and physical examination. Diagnostic workup often involves neuroimaging modalities to rule out more common diseases. Treatment is aimed at symptomatic management, with conservative and pharmacologic therapies (e.g. tricyclic antidepressants, serotonin norepinephrine reuptake inhibitors, and anticonvulsants) as primary treatment. Advanced procedures and surgical intervention are typically reserved for refractory cases.
Phys Med Rehabil Clin N Am
· 2025 Nov · PMID 41167855
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Cervicogenic headache (CGH) has proven to be an elusive diagnosis without the aid of diagnostic interventional procedures. This article highlights the key components of the clinical presentation and workup to aid the cli...Cervicogenic headache (CGH) has proven to be an elusive diagnosis without the aid of diagnostic interventional procedures. This article highlights the key components of the clinical presentation and workup to aid the clinician in distinguishing CGH from its differential diagnoses. It also discusses the evidence and outcomes behind the treatment options to guide physicians when establishing a plan for patients. Fortunately, most cases will resolve with conservative care and physical therapy, but severe or chronic cases will likely require the expertise of an interventional spine physician or surgeon.
Phys Med Rehabil Clin N Am
· 2025 Nov · PMID 41167854
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Posttraumatic headache (PTH) is the most common symptom seen in mild traumatic brain injury (mTBI). PTH most commonly resembles migraine or tension-type headache, but it is a unique entity that is challenging to treat. C...Posttraumatic headache (PTH) is the most common symptom seen in mild traumatic brain injury (mTBI). PTH most commonly resembles migraine or tension-type headache, but it is a unique entity that is challenging to treat. Co-occurring symptoms of mTBI or persistent postconcussive symptoms and comorbidities can increase the risk for persistent PTH. At this time, the pharmacologic management of PTH is largely based on PTH phenotype, but there is no high-quality research to support this practice. This review explores the current evidence for pharmacologic and nonpharmacologic treatment of PTH and proposes a multidisciplinary approach rooted in the principles of mTBI treatment.
Phys Med Rehabil Clin N Am
· 2025 Nov · PMID 41167853
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Trigeminal autonomic cephalalgias (TACs) are a distinct group of primary headache disorders characterized by unilateral pain and autonomic symptoms such as tearing, nasal congestion, and ptosis. This article provides an...Trigeminal autonomic cephalalgias (TACs) are a distinct group of primary headache disorders characterized by unilateral pain and autonomic symptoms such as tearing, nasal congestion, and ptosis. This article provides an in-depth review of the different TAC subtypes, including cluster headache, short-lasting unilateral neuralgiform headache with conjunctival injection and tearing, short-lasting unilateral neuralgiform headache with cranial autonomic features, paroxysmal hemicrania, and hemicrania continua, highlighting their unique clinical features and treatment responses. Early recognition is essential for prompt intervention, as proper diagnosis leads to targeted therapies that significantly improve patient outcomes and quality of life.
Phys Med Rehabil Clin N Am
· 2025 Nov · PMID 41167852
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Tension-type headache (TTH) is a bilateral, nonthrobbing, band-like headache considered the most common headache disorder and prevalent neurologic disorder worldwide. Despite the widespread prevalence of TTH, the pathoph...Tension-type headache (TTH) is a bilateral, nonthrobbing, band-like headache considered the most common headache disorder and prevalent neurologic disorder worldwide. Despite the widespread prevalence of TTH, the pathophysiology remains elusive, with current research indicating a complex mix of physiologic, psychological, and environmental systems that contribute to the initiation and perpetuation of TTH. The mainstay treatment for acute episodes includes simple analgesics, while more chronic and frequent episodes require preventative therapy with lifestyle and behavioral modification, psychobehavioral treatments, integrative health, and pharmacologic therapy such as tricyclic agents or antidepressants.
Phys Med Rehabil Clin N Am
· 2025 Nov · PMID 41167851
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Migraine, a common primary headache disorder, ranks second only to low back pain as a leading cause of disability. Proposed mechanisms include vasodilation, trigeminovascular activation, and neurogenic inflammation. Diag...Migraine, a common primary headache disorder, ranks second only to low back pain as a leading cause of disability. Proposed mechanisms include vasodilation, trigeminovascular activation, and neurogenic inflammation. Diagnosis is clinical, as no biomarker exists, and the International Classification of Headache Disorders-3 has clinical criteria for diagnosis. Differentiating migraine from other conditions can be challenging, with "red" and "green flags" guiding assessment. Treatment includes acute and preventive options, with calcitonin gene-related peptide inhibitors and neuromodulation as newer strategies. Complementary therapies and botulinum toxin injections may also benefit those with chronic migraine.
Phys Med Rehabil Clin N Am
· 2025 Nov · PMID 41167850
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Neuroimaging can play a vital role in headache evaluation, though its utilization must be judicious and evidence-based. While a comprehensive clinical assessment is always fundamental, imaging is essential for the diagno...Neuroimaging can play a vital role in headache evaluation, though its utilization must be judicious and evidence-based. While a comprehensive clinical assessment is always fundamental, imaging is essential for the diagnosis of many headache disorders. There exist several guidelines for headache imaging, but overutilization of imaging and missed diagnoses due to inappropriate imaging selection remain a significant challenge. This article examines the role of neuroimaging in primary and secondary headache disorders, discusses the strengths and limitations of different imaging modalities, and provides a practical framework for optimizing imaging utilization while maintaining resource efficiency.
Phys Med Rehabil Clin N Am
· 2025 Nov · PMID 41167849
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Clinicians are advised to identify headache types by assessing symptoms, triggers, severity, and red flags, utilizing the "SOCRATES" mnemonic for structured history-taking. A background knowledge of primary and secondary...Clinicians are advised to identify headache types by assessing symptoms, triggers, severity, and red flags, utilizing the "SOCRATES" mnemonic for structured history-taking. A background knowledge of primary and secondary headache characteristics can then be applied. A thorough physical examination protocol focuses on neuroanatomy, extending the neurologic examination to include the cervical spine, myofascial trigger points, and temporomandibular joint. Effective headache diagnosis and management depend on accurate history-taking, detailed physical examinations, and a solid understanding of headache physiology, underscoring the importance of skilled clinicians in improving patient outcomes.
Rogers SC, Osterwald A, Walecka E
… +1 more, Tikkanen AU
Phys Med Rehabil Clin N Am
· 2025 Aug · PMID 40581444
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Hospitalized pediatric heart transplant (PHT) recipients face unique and multifaceted challenges that impact their functional outcomes, including motor skills, activities of daily living, feeding, and communication. Peri...Hospitalized pediatric heart transplant (PHT) recipients face unique and multifaceted challenges that impact their functional outcomes, including motor skills, activities of daily living, feeding, and communication. Perioperative complications, lengthy hospitalizations, physical deconditioning, and comorbidities associated with complex congenital heart disease are important considerations as they can have a profound impact on their functional abilities and progress of individuals toward achieving independence. This article explores the role of rehabilitation providers in addressing these functional challenges through performance-based outcome measures and aims to support the development of tailored rehabilitation programs to achieve improved quality of life and long-term independence for PHT recipients.