Phys Med Rehabil Clin N Am
· 2025 May · PMID 40210365
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Pelvic pain is a complex diagnosis that can be related to numerous etiologies across several specialties. This chapter aims to explore diagnosis and management of common neuromusculoskeletal causes of pelvic pain includi...Pelvic pain is a complex diagnosis that can be related to numerous etiologies across several specialties. This chapter aims to explore diagnosis and management of common neuromusculoskeletal causes of pelvic pain including pelvic floor myofascial pain, vulvodynia, nerve injuries, pelvic girdle pain, and coccydynia. Pelvic floor physical therapy is often the first-line treatment of many musculoskeletal causes of pelvic pain. Depending on examination findings, diagnosis, and response to physical therapy, additional medical management may include neuromodulation in oral or topical form, vaginal muscle relaxants, or pelvic floor botulinum toxin or trigger point injections.
Phys Med Rehabil Clin N Am
· 2025 May · PMID 40210364
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Chronic pelvic pain is a complex diagnosis that has a significant impact on quality of life and function in women of all ages. Symptoms often span across numerous organ systems and involve several types of pain including...Chronic pelvic pain is a complex diagnosis that has a significant impact on quality of life and function in women of all ages. Symptoms often span across numerous organ systems and involve several types of pain including visceral, neuropathic, musculoskeletal, and psychological, making management and treatment difficult. To adequately assess and recognize etiologies of pelvic pain, it is critical to first understand the specialized skills required for history taking and physical examination. This article aims to serve as a guide to understanding the physiatrist's approach to history taking and examination of pelvic pain.
Phys Med Rehabil Clin N Am
· 2025 May · PMID 40210363
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Publisher ↗
There is well-established epidemiologic evidence demonstrating variance in the pain disorders affecting women compared with men, although limited conclusive evidence exists regarding the pathophysiologic mechanisms to ac...There is well-established epidemiologic evidence demonstrating variance in the pain disorders affecting women compared with men, although limited conclusive evidence exists regarding the pathophysiologic mechanisms to account for this difference. Six of the most common pain disorders affecting women include migraine headache, fibromyalgia, endometriosis, interstitial cystitis, temporomandibular disorders, and osteoarthritis. The sex-specific prevalence, risk factors, triggers, presentations, and treatments of these disorders are critical for physicians to appreciate and understand to provide the highest standard of care when treating these common pain conditions.
Phys Med Rehabil Clin N Am
· 2025 May · PMID 40210362
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Publisher ↗
This article discussed the anatomic, physiologic, hormonal, and psychosocial factors unique to the female athelte that can affect a female athlete's injury risk and rehabilitation trajectory. A review of considerations u...This article discussed the anatomic, physiologic, hormonal, and psychosocial factors unique to the female athelte that can affect a female athlete's injury risk and rehabilitation trajectory. A review of considerations unique to different stages of life in the female athlete and a discussion of the prevalence of certain injuries in female athletes are discussed. The purpose of this narrative review is to highlight how understanding the unique characteristics of the female athlete can allow for optimization of rehabilitation protocols.
Phys Med Rehabil Clin N Am
· 2025 May · PMID 40210361
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Publisher ↗
Although men are more commonly affected than women with spinal cord injuries (SCIs), women comprise a growing portion of the population of individuals with SCIs. Guidelines for primary care and SCI issues are generally n...Although men are more commonly affected than women with spinal cord injuries (SCIs), women comprise a growing portion of the population of individuals with SCIs. Guidelines for primary care and SCI issues are generally non-sex specific, and there are differences in the medical and rehabilitation needs of women compared with men. Consideration of these differences can optimize function and health for women with SCI and improve quality of life.
Raj VS, Patel BD, Mullan S
… +3 more, Hine R, Mack PP, Pugh T
Phys Med Rehabil Clin N Am
· 2025 May · PMID 40210360
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As the prevalence of female cancer survivors increases, their quality of life (QOL) and function have become key areas of focus in the context of survivorship and rehabilitation needs. Although behavioral modifications m...As the prevalence of female cancer survivors increases, their quality of life (QOL) and function have become key areas of focus in the context of survivorship and rehabilitation needs. Although behavioral modifications may help to decrease the development of malignancy, women are still at increased risk of developing a cancer diagnosis in their lifetime. Cancer and its treatment can lead to significant functional impairments and symptomatic challenges. However, rehabilitation interventions and medical management provide options to address these issues throughout the oncological continuum of care. With appropriate treatment, women are enabled to experience improved QOL and performance status.
Greiss C, Berkowitz A, Chan JP
… +1 more, Ferber A
Phys Med Rehabil Clin N Am
· 2025 May · PMID 40210359
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This review highlights the physiological, hormonal, and hematological changes following traumatic brain injury (TBI) in women. Younger women may experience worse outcomes due to higher cerebral pressures, while hormonal...This review highlights the physiological, hormonal, and hematological changes following traumatic brain injury (TBI) in women. Younger women may experience worse outcomes due to higher cerebral pressures, while hormonal changes during menstruation, pregnancy, and menopause further influence TBI recovery. Postmenopausal women face higher risks of osteoporosis and fall-related TBIs. Psychological impacts include higher rates of depression, anxiety, and posttraumatic stress disorder. Social challenges and sexual dysfunction are prevalent, impacting community and vocational reintegration. Tailored rehabilitation addressing these gender-specific factors is crucial for improving outcomes for female patients with TBI across their lifespan.
Phys Med Rehabil Clin N Am
· 2025 May · PMID 40210358
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Publisher ↗
Cardiovascular disease is the leading cause of morbidity and mortality in women globally. Cardiac rehabilitation (CR)-a comprehensive program including supervised progressive exercise, education, support, behavior modifi...Cardiovascular disease is the leading cause of morbidity and mortality in women globally. Cardiac rehabilitation (CR)-a comprehensive program including supervised progressive exercise, education, support, behavior modification, and nutritional guidance over 36 individual sessions-positively impacts morbidity, mortality, function, and quality of life. Overall, less than 30% of those who qualify are referred and participate in CR-referral and completion rates are significantly less in women compared with men despite evidence supporting equal benefit. Barriers contributing to these disparities have been identified, and CR programs can be modified to enhance the participation of women.
Phys Med Rehabil Clin N Am
· 2025 May · PMID 40210357
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Publisher ↗
Stroke is the third leading cause of death of women in the United States, and women have a higher lifetime risk of stroke than men. Studies show that women live longer but with poorer functional outcomes and higher rates...Stroke is the third leading cause of death of women in the United States, and women have a higher lifetime risk of stroke than men. Studies show that women live longer but with poorer functional outcomes and higher rates of disability compared with men. Sex-specific disparities exist between clinical symptoms, medical evaluation, and management after stroke. Stroke rehabilitation strategies specific to women should take into consideration both physiologic and psychosocial demands more common in women to improve functional outcomes. Additional resources for education, clinical research, and implementation of best practices are needed to eliminate gender-related disparities in poststroke care.
Phys Med Rehabil Clin N Am
· 2025 Feb · PMID 39567041
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A marked decrease in bone mineral density is a well recognized, if not always fully addressed, spinal cord injury-related comorbidity. The bone loss starts shortly after paralysis onset, and the loss rate is steep. The d...A marked decrease in bone mineral density is a well recognized, if not always fully addressed, spinal cord injury-related comorbidity. The bone loss starts shortly after paralysis onset, and the loss rate is steep. The diverse etiology includes mechanical, neurologic, endocrine, vascular, and pharmacologic factors. Dual x-ray absorptiometry is available and affordable to quantify the degree of bone loss and follow changes related to treatment. Fragility/low impact fractures occur frequently and can induce significant morbidity. Physical modalities and pharmacologic interventions can be employed to stave off and/or reverse bone loss with variable success rates.
Phys Med Rehabil Clin N Am
· 2025 Feb · PMID 39567040
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Publisher ↗
The majority of individuals with neurogenic lower urinary tract dysfunction will have complicated urinary tract infections (UTIs) that will qualify as recurrent. Existing inconsistencies and challenges contribute to its...The majority of individuals with neurogenic lower urinary tract dysfunction will have complicated urinary tract infections (UTIs) that will qualify as recurrent. Existing inconsistencies and challenges contribute to its subjective diagnosis. Thus, there is a pressing need for a reconceptualization of our understanding of UTI, accompanied by a paradigm shift in diagnosis and treatment approaches.
Phys Med Rehabil Clin N Am
· 2025 Feb · PMID 39567039
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Publisher ↗
Neurogenic bowel is often overshadowed by other medical complications of spinal cord injury (SCI) but can significantly impact one's quality of life. This article aims to illustrate the intricacies of anatomy and physiol...Neurogenic bowel is often overshadowed by other medical complications of spinal cord injury (SCI) but can significantly impact one's quality of life. This article aims to illustrate the intricacies of anatomy and physiology within the gastrointestinal (GI) tract as it pertains to SCI and how to navigate neurogenic bowel management-from the acute postinjury phase through the lifelong journey of adaptation and care in outpatient settings.
Phys Med Rehabil Clin N Am
· 2025 Feb · PMID 39567038
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Publisher ↗
Spinal cord injuries (SCI) affect the anatomy and physiology of the spinal cord and result in characteristic changes. Identifying the impairments resulting from SCI is vital for the health care provider. Specifically, th...Spinal cord injuries (SCI) affect the anatomy and physiology of the spinal cord and result in characteristic changes. Identifying the impairments resulting from SCI is vital for the health care provider. Specifically, this article focuses on neurologic decline after SCI in the subacute to chronic stages. This includes changes in spasticity and its management over time, management of neuropathic pain after SCI, the development of spine complications (posttraumatic syrinx, spinal cord tethering, and so forth), management of dual-diagnosis traumatic brain injury and SCI, and other neurologic complications in chronic SCI management, such as upper-extremity entrapment mononeuropathies.
Phys Med Rehabil Clin N Am
· 2025 Feb · PMID 39567037
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Publisher ↗
Musculoskeletal pain occurs in 50% to 81% of people living with spinal cord injury. Pain can have a significantly limiting impact. Pain can lead to decreased mobility, endurance, social participation, and depression. Add...Musculoskeletal pain occurs in 50% to 81% of people living with spinal cord injury. Pain can have a significantly limiting impact. Pain can lead to decreased mobility, endurance, social participation, and depression. Additionally, many people living with spinal cord injury (SCI) rely on their upper body for ADLs (activities of daily living) which may result in decreased independence in cases of severe pain. Musculoskeletal impairments associated with spinal cord injury include decreased muscle mass and bone density, spasticity, contractures, as well as overuse injuries in muscles, tendons, and joints. These issues can contribute to pain and morbidity in patients with SCI. However, there is a lack of research on the risk of developing these conditions in the SCI population. This article aims to investigate and outline the common MSK conditions after SCI. Other musculoskeletal impairments that can often be found in patients with SCI include but are not limited to muscle atrophy, osteoporosis, fractures, spasticity, heterotopic ossification, tendinopathies, and mononeuropathies.
Phys Med Rehabil Clin N Am
· 2025 Feb · PMID 39567036
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Publisher ↗
The transition to adulthood is a complex and dynamic process for youth with spinal cord injury (SCI). A key goal of SCI rehabilitation is to develop the skillsets necessary to successfully transition to adulthood, lead a...The transition to adulthood is a complex and dynamic process for youth with spinal cord injury (SCI). A key goal of SCI rehabilitation is to develop the skillsets necessary to successfully transition to adulthood, lead a meaningful life, engage in one's community, and maintain a good quality of life. This article provides an overview of transition outcomes and interventions within a biopsychosocial framework, with regard to physiologic functioning, participation in education and employment, emotional and social well-being, and the health care system.
Bohn AS, Porter G, Penniman R
… +1 more, Leonard S
Phys Med Rehabil Clin N Am
· 2025 Feb · PMID 39567035
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This article focuses on identifying how health care providers can support a person with spinal cord injury to pursue and maintain involvement in adaptive sports. Benefits and barriers of sport participation, equipment co...This article focuses on identifying how health care providers can support a person with spinal cord injury to pursue and maintain involvement in adaptive sports. Benefits and barriers of sport participation, equipment considerations, and recommendations on how to determine sport appropriateness for a person with spinal cord injury will be provided. The authors emphasize through appropriate medical management and consideration of level of disability, functional performance, psychological readiness, and individual preference, a health care provider can play a valuable role in connecting individuals with spinal cord injury to adaptive sports and recreation.
Phys Med Rehabil Clin N Am
· 2025 Feb · PMID 39567034
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Publisher ↗
Autonomic dysfunctions are a major challenge to individuals following spinal cord injury. Despite this, these consequences receive far less attention compared with motor recovery. This review will highlight the major aut...Autonomic dysfunctions are a major challenge to individuals following spinal cord injury. Despite this, these consequences receive far less attention compared with motor recovery. This review will highlight the major autonomic dysfunctions following SCI predominantly based on our present understanding of the anatomy and physiology of autonomic control and available clinical data.
Tamayo NCR, Quinzaños-Fresnedo J, Loyola-Sanchez A
… +4 more, Velasquez-Cano M, Aceves MA, Reyes EL, Abramoff BA
Phys Med Rehabil Clin N Am
· 2025 Feb · PMID 39567033
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This article describes the differences and similarities in post-acute care for patients with spinal cord injuries in Canada, the United States, and Mexico. It provides a comprehensive description of the current state of...This article describes the differences and similarities in post-acute care for patients with spinal cord injuries in Canada, the United States, and Mexico. It provides a comprehensive description of the current state of spinal cord injury post-acute care in each country, including the prevalent practices, rehabilitation continuum of care, as well as challenges and opportunities related to clinical services, psychosocial factors, economic considerations, and cultural influences.