Phys Med Rehabil Clin N Am
· 2025 Feb · PMID 39567032
·
Publisher ↗
The individual with spinal cord injury is the most important member of the interdisciplinary team of health care professionals who provide care and researchers who progress treatments. The consumer voice is critical to u...The individual with spinal cord injury is the most important member of the interdisciplinary team of health care professionals who provide care and researchers who progress treatments. The consumer voice is critical to understanding priorities and preferences. A literature search was conducted to identify consumer-level contribution, yielding 68 articles. Functional recovery priorities of motor and bladder/bowel function were universal. Priorities of secondary complications mirrored functional recovery, highlighting the impact that mitigating secondary complications can have on functional recovery. Imbedded within interventional preferences are those priorities, balanced between risks and benefits. Improving independence was consistently weighed against fear of functional decline.
Moturu S, Adkins EL, Delgado-Lebron JM
… +1 more, Castillo Diaz CM
Phys Med Rehabil Clin N Am
· 2025 Feb · PMID 39567031
·
Publisher ↗
Women encompass about 20% of all the traumatic spinal cord injury (SCI) population and there is increased incidence and prevalence of women with SCIs. The most recent data estimate that approximately 40,000-45,000 women...Women encompass about 20% of all the traumatic spinal cord injury (SCI) population and there is increased incidence and prevalence of women with SCIs. The most recent data estimate that approximately 40,000-45,000 women with SCI are living in the United States, increasing from previous years, with the most common cause still being motor vehicle collisions. Throughout their lifespan, women with SCI present with unique healthcare needs compare to the male population. Therefore we present a comprehensive summary to empower and equip all providers with awareness of these needs and recommendations of care.
Longoni M, Degano M, Sampogna G
… +1 more, Castillo Diaz CM
Phys Med Rehabil Clin N Am
· 2025 Feb · PMID 39567030
·
Publisher ↗
Numerous aspects of spinal cord injury have undergone extensive research over the years. However, amid this comprehensive exploration, one crucial aspect remains insufficiently emphasized: sexuality. Despite its paramoun...Numerous aspects of spinal cord injury have undergone extensive research over the years. However, amid this comprehensive exploration, one crucial aspect remains insufficiently emphasized: sexuality. Despite its paramount importance to individuals' holistic well-being, sexuality often receives inadequate attention within rehabilitation programs. In this article, we aim to underscore the significance of addressing this dimension comprehensively, especially given its increasing recognition and exploration in recent years.
Hublikar I, Ortiz LS, Castillo Diaz CM
… +1 more, Jimenez IH
Phys Med Rehabil Clin N Am
· 2025 Feb · PMID 39567029
·
Publisher ↗
PM&R plays an essential role in managing the individual with a spinal cord injury (SCI). Receiving care at an acute hospital and a rehabilitation center familiar with SCIs is critical. PM&R can guide the health care team...PM&R plays an essential role in managing the individual with a spinal cord injury (SCI). Receiving care at an acute hospital and a rehabilitation center familiar with SCIs is critical. PM&R can guide the health care team and the patient/family through such a potentially life-changing event. Early consultation can help prevent complications and decrease stay length and mortality. A life-long relationship with the rehabilitation team is often recommended; team members such as navigators and multiple inpatient rehabilitation stays can help enhance care and opportunities for individuals with SCI.
Phys Med Rehabil Clin N Am
· 2024 Nov · PMID 39389643
·
Publisher ↗
Much of the burden of living with a disability is concentrated among those populations least financially able to bear the burden. As the price of 3 dimensional (3D) printing decreases, individual access to this technolog...Much of the burden of living with a disability is concentrated among those populations least financially able to bear the burden. As the price of 3 dimensional (3D) printing decreases, individual access to this technology increases. 3D-printed prostheses can be designed specifically for use in resource-poor settings, including developing countries, to minimize the cost of consumable parts while optimizing durability in harsh environmental conditions.
Phys Med Rehabil Clin N Am
· 2024 Nov · PMID 39389642
·
Publisher ↗
This article reviews emerging surgical techniques and prosthetic innovations related to amputation rehabilitation. Osseointegration is discussed from conception to modern implant designs. Motor and sensory reinnervation...This article reviews emerging surgical techniques and prosthetic innovations related to amputation rehabilitation. Osseointegration is discussed from conception to modern implant designs. Motor and sensory reinnervation techniques are reviewed and compared. Prosthetic socket casting, interface, and design innovations are discussed, including direct molded sockets, water casting, adjustable sockets, and magnetic suspension. Advanced components with hydraulic and microprocessor control, power and crossover prosthetic feet are described.
Carnahan N, Holbrook L, Brunk E
… +2 more, Viola J, González-Fernández M
Phys Med Rehabil Clin N Am
· 2024 Nov · PMID 39389641
·
Publisher ↗
Reintegration back into one's life following limb loss is heavily influenced by the interaction among the individual's mental health, environment, and physical factors (eg, pain and prostheses). While many patients exper...Reintegration back into one's life following limb loss is heavily influenced by the interaction among the individual's mental health, environment, and physical factors (eg, pain and prostheses). While many patients experience posttraumatic growth and successfully reintegrate back into their lives, others have a more difficult adjustment. Interdisciplinary teams can best facilitate reintegration through early screening for barriers to reintegration such as depression, pain, body image, and inaccessible environments, to intervene early after amputation. With these barriers addressed, amputees may be able to return to driving and other valued activities more quickly, resulting in improved reintegration across life domains.
Phys Med Rehabil Clin N Am
· 2024 Nov · PMID 39389640
·
Publisher ↗
Limb loss is a common and disabling experience for patients, frequently caused by critical limb ischemia or deterioration of chronic wounds. Disparities in outcomes for prevention of amputation, level of amputation, and...Limb loss is a common and disabling experience for patients, frequently caused by critical limb ischemia or deterioration of chronic wounds. Disparities in outcomes for prevention of amputation, level of amputation, and postamputation outcomes have been described. Understanding the nature of these disparities and the populations most affected can help clinicians and policymakers target interventions and programs. This article reviews existing literature regarding disparities in amputation care, including prevention methods, surgical outcomes, and postamputation outcomes. The authors identified several potential racial, socioeconomic, and gender disparities, particularly affecting Black, Native American, and Latino/a/x patients, female gender, and those in rural settings.
Phys Med Rehabil Clin N Am
· 2024 Nov · PMID 39389639
·
Full text
Most research on people undergoing lower limb amputations for dysvascular disease summarizes average patient outcome risks and average associations between patient factors and these outcomes. More recently, the importanc...Most research on people undergoing lower limb amputations for dysvascular disease summarizes average patient outcome risks and average associations between patient factors and these outcomes. More recently, the importance of predicting patient-specific outcomes based on individual factors (ie, personalized rehabilitation) has become evident. This article reviews the evidence and discusses the importance of the following: (1) predicting outcomes to facilitate amputation-level and prosthesis prescription decisions and (2) how prediction models can be leveraged to develop decision support tools to facilitate provider/patient shared decision-making to ensure decisions considering each individual patient's priorities and preferences. Examples of these tools are discussed and referenced.
Phys Med Rehabil Clin N Am
· 2024 Nov · PMID 39389638
·
Publisher ↗
This article provides an overview of fundamental upper limb prosthesis concepts and componentry, including control systems (body-powered, externally powered, passive, and hybrid), sockets and suspension, and terminal dev...This article provides an overview of fundamental upper limb prosthesis concepts and componentry, including control systems (body-powered, externally powered, passive, and hybrid), sockets and suspension, and terminal devices.
Phys Med Rehabil Clin N Am
· 2024 Nov · PMID 39389637
·
Publisher ↗
This article describes fundamental lower limb prosthesis concepts and componentry, including skeletal structure (endoskeletal vs exoskeletal), transtibial and transfemoral sockets, prosthetic suspension and interfaces, p...This article describes fundamental lower limb prosthesis concepts and componentry, including skeletal structure (endoskeletal vs exoskeletal), transtibial and transfemoral sockets, prosthetic suspension and interfaces, prosthetic knees, and prosthetic foot and ankle systems.
Phys Med Rehabil Clin N Am
· 2024 Nov · PMID 39389636
·
Publisher ↗
Adaptive sports are a vital component in the continuum of rehabilitation for people with limb loss/limb deficiency (LL/LD), across the lifespan. Identifying the barriers and understanding health care disparities inform w...Adaptive sports are a vital component in the continuum of rehabilitation for people with limb loss/limb deficiency (LL/LD), across the lifespan. Identifying the barriers and understanding health care disparities inform ways to help people with LL/LD stay active and reach their health and wellness goals. Building knowledge in adaptive sports helps facilitate having a person go beyond activities of daily living and basic locomotion. Considering the participant, requirements of the sport, and the activity-specific prosthesis/equipment required leads to successful participation in adaptive sports.
Byl M, Tram J, Kalasho B
… +2 more, Pangarkar S, Pham QG
Phys Med Rehabil Clin N Am
· 2024 Nov · PMID 39389635
·
Publisher ↗
Postamputation pain is one of the most common and challenging pain conditions to treat and includes residual limb pain and phantom limb pain. Residual limb pain is present at the amputation site or proximal to the amputa...Postamputation pain is one of the most common and challenging pain conditions to treat and includes residual limb pain and phantom limb pain. Residual limb pain is present at the amputation site or proximal to the amputation site and may be caused by poor wound healing, poor prosthetic fitting, or neuropathic pain. Phantom limb pain is experienced distal to the amputation site and may be caused by maladaptive supraspinal reorganization. Treatment for post amputation pain should be multimodal and multidisciplinary, including pharmacologic agents, rehabilitation, psychosocial support, and integrative therapies. Surgical interventions including neuromodulation may be considered for refractory cases.
Aflatooni S, Beekman K, Hennessy K
… +5 more, Highsmith MJ, Heckman JT, Shumaker PR, Hivnor CM, Beachkofsky TM
Phys Med Rehabil Clin N Am
· 2024 Nov · PMID 39389634
·
Publisher ↗
The use of prostheses in individuals with limb loss increases the risk of maceration, friction, and pressure-induced skin injuries due to the vulnerability of the residual limb and the close contact with the socket. Poor...The use of prostheses in individuals with limb loss increases the risk of maceration, friction, and pressure-induced skin injuries due to the vulnerability of the residual limb and the close contact with the socket. Poorly fitting prostheses exacerbate these issues, especially for those with immunosuppression or vascular conditions. Skin pathologies disrupt daily prosthetic limb use and impact the independence of those with limb loss. Preventive measures, including proper prosthesis socket fitting and meticulous skin care, are crucial. This review explores residual limb-site skin pathologies and details current mitigation and management strategies.
Hooper RC, Kelly B, Cederna PS
… +1 more, Siegel G
Phys Med Rehabil Clin N Am
· 2024 Nov · PMID 39389633
·
Publisher ↗
Major upper and lower extremity amputations are increasingly being performed for peripheral vascular disease, infectious etiologies, trauma, and oncologic purposes. Attention to technique and emerging treatments for the...Major upper and lower extremity amputations are increasingly being performed for peripheral vascular disease, infectious etiologies, trauma, and oncologic purposes. Attention to technique and emerging treatments for the residual peripheral nerve is critical to prosthetic wear and quality of life following these life changing events. Here, we detail advancements in amputation surgery including targeted muscle reinnervation, regenerative peripheral nerve interface, and the use of osseointegrated implants.
Phys Med Rehabil Clin N Am
· 2024 Nov · PMID 39389632
·
Publisher ↗
Pediatric limb loss or limb deficiency is uncommon in the United Sates occurring 1 per 1943 live births per year, with a ratio of 2:1 upper to lower extremity. Causes include congenital limb deficiency, and less frequent...Pediatric limb loss or limb deficiency is uncommon in the United Sates occurring 1 per 1943 live births per year, with a ratio of 2:1 upper to lower extremity. Causes include congenital limb deficiency, and less frequently, limb loss secondary to trauma, cancer, or other illnesses. Vascular disruption, particularly as seen in amniotic band syndrome, stands as the leading suspect in the multifaceted and intricate causes of congenital limb loss. Children with limb difference and deficiency present unique medical and rehabilitation challenges. Physical Medicine and Rehabilitation (PM&R) physicians are uniquely equipped to navigate these complexities. Prosthetic prescription and fabrication for children require balancing scientific principles with individual needs. A "one-size-fits-all" approach is ineffective. Many diverse factors impact prosthetic prescription and fabrication, including amputation level, residual limb characteristics, cognitive/developmental age, family goals, financial resources, and medical literacy.
Phys Med Rehabil Clin N Am
· 2024 Nov · PMID 39389631
·
Publisher ↗
Limb-loss is a significant medical event with lifelong consequences, impacting various aspects of a patient's well-being. Care for these often-complex patients involves providers from many different specialties working t...Limb-loss is a significant medical event with lifelong consequences, impacting various aspects of a patient's well-being. Care for these often-complex patients involves providers from many different specialties working toward a set of patient-centered goals. This article aims to highlight the important role of physiatrists in directing the interdisciplinary care for these patients. Through evidence-based concepts, the authors aim to lay a roadmap for comprehensive, longitudinal management of these patients from pre-amputation assessment through lifelong care.
Xu J, Haider A, Sheikh A
… +1 more, González-Fernández M
Phys Med Rehabil Clin N Am
· 2024 Nov · PMID 39389630
·
Publisher ↗
The main causes of limb loss include trauma, complications from diabetes and peripheral arterial disease, malignancy, and congenital limb deficiency. There are significant geographic variations in the incidence of upper...The main causes of limb loss include trauma, complications from diabetes and peripheral arterial disease, malignancy, and congenital limb deficiency. There are significant geographic variations in the incidence of upper and lower, and major and minor limb loss worldwide. Limb loss is costly for patients and the health care system. The availability of orthotic and prosthetic services, along with cost of services, represents barrier to care and contributes to morbidity and mortality. More research is needed, especially in low-income and middle-income countries to describe the extent of limb loss.