Additional Information
Book Details
Abstract
The most-trusted resource for physiatry knowledge and techniques, Braddom’s Physical Medicine and Rehabilitation remains an essential guide for the entire rehabilitation team. With proven science and comprehensive guidance, this medical reference book addresses a range of topics to offer every patient maximum pain relief and optimal return to function.
- In-depth coverage of the indications for and limitations of axial and peripheral joints through therapies enables mastery of these techniques.
- Optimize the use of ultrasound in diagnosis and treatment.
- A chapter covering PM&R in the international community serves to broaden your perspective in the field.
- Detailed illustrations allow you to gain a clear visual understanding of important concepts.
- New lead editor - Dr. David Cifu – was selected by Dr. Randall Braddom to retain a consistent and readable format. Additional new authors and editors provide a fresh perspective to this edition.
- Features comprehensive coverage of the treatment of concussions and military amputees.
- Includes brand-new information on rehabilitating wounded military personnel, the latest injection techniques, speech/swallowing disorders, head injury rehabilitation, and the rehabilitation of chronic diseases.
- New chapters on pelvic floor disorders and sensory impairments keep you at the forefront of the field.
- Reader-friendly design features an updated table of contents and improved chapter approach for an enhanced user experience.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Expert Consult page | IFC1 | ||
| Braddom's Physical Medicine and Rehabilitation | i | ||
| Copyright Page | iv | ||
| Dedication | v | ||
| Contributors | vii | ||
| Preface | xvii | ||
| Acknowledgments | xix | ||
| Table Of Contents | xxi | ||
| Video Contents | xxiii | ||
| 1 Evaluation | 1 | ||
| 1 The Physiatric History and Physical Examination | 3 | ||
| The Physiatric History | 3 | ||
| Chief Complaint | 4 | ||
| History of the Present Illness | 5 | ||
| Functional Status | 5 | ||
| Mobility | 5 | ||
| Activities of Daily Living and Instrumental Activities of Daily Living | 6 | ||
| Cognition | 6 | ||
| Communication | 6 | ||
| Past Medical and Surgical History | 7 | ||
| Cardiopulmonary | 7 | ||
| Musculoskeletal | 7 | ||
| Neurologic Disorders | 7 | ||
| Rheumatologic | 7 | ||
| Medications | 7 | ||
| Social History | 7 | ||
| Home Environment and Living Situation | 7 | ||
| Family and Friends Support | 7 | ||
| Substance Abuse | 7 | ||
| Sexual History | 8 | ||
| Vocational Activities | 8 | ||
| Finances and Income Maintenance | 8 | ||
| Recreation | 8 | ||
| Psychosocial History | 8 | ||
| Spirituality and Belief | 8 | ||
| Pending Litigation | 8 | ||
| Family History | 8 | ||
| Review of Systems | 8 | ||
| The Physiatric Physical Examination | 8 | ||
| Neurologic Examination | 8 | ||
| Mental Status Examination | 9 | ||
| Level of Consciousness. | 9 | ||
| Attention. | 10 | ||
| Orientation. | 10 | ||
| Memory. | 10 | ||
| General Fundamentals of Knowledge. | 10 | ||
| Abstract Thinking. | 10 | ||
| Insight and Judgment. | 11 | ||
| Mood and Affect. | 11 | ||
| General Mental Status Assessment. | 11 | ||
| Communication | 11 | ||
| Aphasia. | 11 | ||
| Dysarthria. | 11 | ||
| Dysphonia. | 11 | ||
| Verbal Apraxia. | 11 | ||
| Cognitive Linguistic Deficits. | 12 | ||
| Cranial Nerve Examination | 12 | ||
| Cranial Nerve I: Olfactory Nerve. | 12 | ||
| Cranial Nerve II: Optic Nerve. | 12 | ||
| Cranial Nerves III, IV, and VI: Oculomotor, Trochlear, and Abducens Nerves. | 12 | ||
| Cranial Nerve V: Trigeminal Nerve. | 12 | ||
| Cranial Nerve VII: Facial Nerve. | 12 | ||
| Cranial Nerve VIII: Vestibulocochlear Nerve. | 13 | ||
| Cranial Nerves IX and X: Glossopharyngeal Nerve and Vagus Nerve. | 13 | ||
| Cranial Nerve XI: Accessory Nerve. | 13 | ||
| Cranial Nerve XII: Hypoglossal Nerve. | 13 | ||
| Sensory Examination | 13 | ||
| Motor Control | 15 | ||
| Strength. | 15 | ||
| Coordination. | 15 | ||
| Apraxia. | 16 | ||
| Involuntary Movements. | 16 | ||
| Tone. | 16 | ||
| Reflexes | 17 | ||
| Superficial Reflexes. | 17 | ||
| Muscle Stretch Reflexes. | 17 | ||
| Primitive Reflexes. | 17 | ||
| Gait | 18 | ||
| Musculoskeletal Examination | 18 | ||
| Caveats | 18 | ||
| Inspection | 18 | ||
| Palpation | 19 | ||
| Assessment of Joint Stability. | 19 | ||
| Assessment of Range of Motion General Principles. | 26 | ||
| Assessment Techniques. | 26 | ||
| Assessment of Muscle Strength | 27 | ||
| General Principles. | 27 | ||
| Assessment Techniques. | 30 | ||
| Assessment, Summary, and Plan | 36 | ||
| Summary | 37 | ||
| Acknowledgment: | 38 | ||
| Key References | 38 | ||
| References | 39.e1 | ||
| 2 History and Examination of the Pediatric Patient* | 41 | ||
| History | 41 | ||
| Birth History | 41 | ||
| History of Presenting Problem | 41 | ||
| Developmental History | 41 | ||
| Family History | 42 | ||
| Social and Educational History | 42 | ||
| Physical Examination | 42 | ||
| Growth | 43 | ||
| Inspection | 43 | ||
| Musculoskeletal Assessment | 44 | ||
| Neurologic Assessment | 46 | ||
| Functional Assessment | 48 | ||
| Summary | 50 | ||
| References | 50 | ||
| 3 Adult Neurogenic Communication and Swallowing Disorders | 53 | ||
| Rehabilitation of Patients with Communication Disorders | 53 | ||
| Aphasia | 53 | ||
| Special Considerations: Handedness and Language Dominance | 54 | ||
| Cognitive Communication Disorders | 55 | ||
| Right Hemisphere Stroke | 55 | ||
| Traumatic and Nontraumatic Brain Injury | 55 | ||
| Mild Brain Injury. | 56 | ||
| Alzheimer Disease and Other Dementia | 56 | ||
| Motor Speech Disorders | 57 | ||
| Dysarthria | 57 | ||
| Apraxia | 58 | ||
| Rehabilitation of Patients with Swallowing Disorders | 58 | ||
| Physiology | 58 | ||
| Central “Cortical” Representation of Swallowing | 59 | ||
| Pathophysiology | 60 | ||
| Evaluation | 62 | ||
| Bedside/Clinical Swallow Assessments | 62 | ||
| Swallow Screenings. | 62 | ||
| Clinical Swallow Examination. | 62 | ||
| Blue Dye Clinical Swallow Examination. | 63 | ||
| Cervical Auscultation. | 63 | ||
| Instrumental Swallow Assessment | 63 | ||
| Videofluoroscopic Swallow Study. | 63 | ||
| FEES Procedure. | 64 | ||
| Comparison of VFSS and FEES. | 64 | ||
| High-Resolution Manometry. | 65 | ||
| Ultrasonography. | 65 | ||
| Electromyography. | 65 | ||
| Treatment of Dysphagia | 65 | ||
| Restorative: Exercise Training and Plasticity Considerations | 65 | ||
| Compensatory Strategies in Swallowing Rehabilitation | 66 | ||
| Surgery for Dysphagia | 67 | ||
| Pharyngeal Bypass | 67 | ||
| Prevention of Aspiration Pneumonia | 67 | ||
| Psychological Considerations | 68 | ||
| Acknowledgments: | 68 | ||
| Key References | 68 | ||
| References | 69.e1 | ||
| 4 Psychological Assessment and Intervention in Rehabilitation | 71 | ||
| Psychological Assessment in Rehabilitation | 71 | ||
| Assessment in the Acute Care Setting | 72 | ||
| Assessment in the Inpatient Rehabilitation Setting | 72 | ||
| Assessment in the Postacute Rehabilitation Setting | 73 | ||
| Psychological Management of Cognitive, Emotional, and Behavioral Problems | 76 | ||
| Interventions for Cognitive Problems | 76 | ||
| Impaired Awareness | 76 | ||
| Attention | 77 | ||
| Memory | 78 | ||
| Problem-Solving | 79 | ||
| Interventions for Emotional and Behavioral Problems | 79 | ||
| Emotional Problems | 79 | ||
| Behavioral Problems | 80 | ||
| Other Considerations | 81 | ||
| Acknowledgments: | 82 | ||
| Key References | 82 | ||
| References | 83.e1 | ||
| 5 Practical Aspects of Impairment Rating and Disability Determination | 85 | ||
| Terminology and Conceptualization of Disablement | 85 | ||
| From Classification of Causes of Death to International Classification of Functioning, Disability, and Health | 85 | ||
| Americans with Disabilities Act and Implications | 86 | ||
| Relating Impairment to Disability and Compensation Formulas | 87 | ||
| Major U.S. Disability Systems Compared with Attention to the Role of the Examining Physician | 88 | ||
| Social Security Disability Insurance and Supplemental Security Income | 88 | ||
| Federal Workers’ Compensation Systems | 89 | ||
| State Workers’ Compensation Systems | 89 | ||
| Compensation and Pensioning Under the Veterans Benefits Administration | 90 | ||
| Personal Injury Claims | 90 | ||
| Impairment Rating Guides for Physicians with Attention to Guides, Sixth Edition | 90 | ||
| Application of the AMA Guides, Sixth Edition, to Musculoskeletal Impairments | 91 | ||
| Qualitative Impairments | 91 | ||
| Quantitative Impairments | 91 | ||
| Diagnosis-Based Impairment Method | 92 | ||
| Spine and Extremities as Regional Units | 92 | ||
| Combining Impairments to Whole Person Impairment Ratings | 93 | ||
| Independent Medical Examination: Elements and Reporting Requirements | 93 | ||
| Diagnosis and Medical Necessity | 93 | ||
| Causation and Allowable Conditions | 93 | ||
| Maximum Medical Improvement Determination | 94 | ||
| Future Medical Needs | 95 | ||
| Disability as Return-To-Work Restrictions | 95 | ||
| Legal and Ethical Considerations | 95 | ||
| Expert Witness Testimony | 95 | ||
| Ethical Considerations | 99 | ||
| References | 100 | ||
| 6 Employment of People with Disabilities | 103 | ||
| Concept of Disability | 103 | ||
| Data: Impairment and Disability | 104 | ||
| Socioeconomic Effect of Disability | 105 | ||
| Treatment of the Injured Worker | 106 | ||
| Workers’ Compensation Medicine | 106 | ||
| Functional Capacity Evaluation | 106 | ||
| Work Hardening Program | 107 | ||
| Functional Restoration Program | 107 | ||
| Disability-Related Programs and Policies | 107 | ||
| Programs | 107 | ||
| Public Disability Policies | 108 | ||
| Vocational Rehabilitation | 108 | ||
| Traditional Approaches to Vocational Rehabilitation | 109 | ||
| Aptitude Matching Compared with Work Sample | 109 | ||
| Sheltered Workshops | 110 | ||
| Day Programs | 110 | ||
| Home-Based Programs | 110 | ||
| Other Programs for Employment | 110 | ||
| Projects with Industry | 110 | ||
| Transitional and Supported Employment | 110 | ||
| Independent Living Centers | 111 | ||
| Disincentives for Vocational Rehabilitation | 112 | ||
| Incentives for Vocational Rehabilitation | 112 | ||
| Incentives for the Individual | 112 | ||
| Incentives for Industry | 113 | ||
| Disability Prevention | 114 | ||
| Conclusion | 114 | ||
| References | 115 | ||
| 7 Quality and Outcome Measures for Medical Rehabilitation | 117 | ||
| Outcome Measures | 119 | ||
| Types of Outcome Measures | 119 | ||
| International Classification of Functioning, Disability, and Health | 120 | ||
| Functional Independence Measure | 121 | ||
| Patient-Reported Outcomes | 121 | ||
| Choosing Outcome Measures | 122 | ||
| Evidence and Guidelines | 122 | ||
| Definitions of Evidence-Based Medicine | 122 | ||
| Assessing, Evaluating, and Applying Evidence | 123 | ||
| Clinical Practice Guidelines | 124 | ||
| Performance Measures and Metrics | 125 | ||
| Measure Development | 125 | ||
| Challenges in Measure Development | 126 | ||
| Desirable Attributes of a Measure Are Complex | 126 | ||
| Measure Testing That Is Critical to the Process of Its Development Is Elaborate | 126 | ||
| Measures are Tested by Different Agencies Before They are Vetted | 126 | ||
| Measure Development Necessitates Extensive Costs Through the Intricate Life Cycle of the Measure | 126 | ||
| Risk Adjustment | 126 | ||
| Privacy, Security, and Databases | 126 | ||
| Strategically Improving Health Care Quality with Performance Measurement | 126 | ||
| Safety and Accreditation | 127 | ||
| Value Equation | 127 | ||
| Maintenance of Certification and Quality Improvement | 128 | ||
| Quality Improvement and Practice Improvement | 128 | ||
| Practice Improvement Project Options | 129 | ||
| Clinical Care Practice Improvement Project (Clinical Care PIP) | 129 | ||
| AAPMR Practice Improvement Project | 129 | ||
| AANEM Performance in Practice: Electrodiagnostic Report Writing | 129 | ||
| Summary | 129 | ||
| References | 130 | ||
| 8 Electrodiagnostic Medicine | 131 | ||
| Clinical Assessment: History and Physical Examination | 131 | ||
| History | 131 | ||
| Physical Examination | 131 | ||
| Purpose of Electrodiagnostic Testing | 132 | ||
| Nerve Injury Classification | 132 | ||
| Seddon Classification | 132 | ||
| Neurapraxia | 132 | ||
| Axonotmesis | 132 | ||
| Neurotmesis | 133 | ||
| Sunderland Classification | 133 | ||
| Clinical Testing of Motor and Sensory Nerves | 133 | ||
| H-Reflexes | 134 | ||
| F-Waves | 134 | ||
| Needle Electromyography | 134 | ||
| Needle Insertional Activity | 135 | ||
| Decreased Insertional Activity | 135 | ||
| Increased Insertional Activity | 135 | ||
| End-Plate Potentials | 136 | ||
| Miniature End-Plate Potentials | 136 | ||
| End-Plate Spikes | 136 | ||
| Single Muscle Fiber | 137 | ||
| Fibrillation Potentials: Spike Form and Positive Sharp Waves | 138 | ||
| Positive Sharp Waves | 138 | ||
| Complex Repetitive Discharge | 139 | ||
| Myotonic Discharges | 140 | ||
| Fasciculation Potentials | 140 | ||
| Myokymic Discharge | 141 | ||
| Cramp Potentials | 141 | ||
| Neuromyotonic Discharges | 142 | ||
| Motor Units | 142 | ||
| Extent of Electrodiagnostic Testing | 142 | ||
| Limitations of Electrodiagnosis | 142 | ||
| Standards of Practice for Electrodiagnostic Medicine | 144 | ||
| Pediatric Electrodiagnosis | 145 | ||
| Mononeuropathies and Entrapment Neuropathies | 146 | ||
| Brachial Plexopathies | 150 | ||
| Radiculopathies | 150 | ||
| How Many and Which Muscles to Study | 151 | ||
| Traumatic Nerve Injuries | 152 | ||
| Electrodiagnostic Assessment of Nerve Injuries | 153 | ||
| Generalized Disorders | 154 | ||
| Polyneuropathy | 155 | ||
| Myopathies | 158 | ||
| Neuromuscular Junction Disorders | 158 | ||
| Motor Neuron Disease | 160 | ||
| Final Electrodiagnostic Conclusions and Report | 161 | ||
| Summary | 161 | ||
| Appendix 8A Physiologic Basis for Electrodiagnostic Testing | 163.e1 | ||
| Action Potential Generation | 163.e1 | ||
| Physiologic Factors Affecting Action Potential Propagation | 163.e2 | ||
| Gender | 163.e2 | ||
| Aging | 163.e2 | ||
| Digit Circumference | 163.e2 | ||
| Height | 163.e2 | ||
| Temperature | 163.e2 | ||
| Physiology of Sensory and Motor Responses | 163.e3 | ||
| References | 163.e4 | ||
| Appendix 8B Motor Unit Recruitment and Morphology: Assessing Phases | 163.e5 | ||
| References | 163.e6 | ||
| Appendix 8C Instrumentation | 163.e7 | ||
| Electrodes | 163.e7 | ||
| Amplifier | 163.e8 | ||
| Filters | 163.e8 | ||
| Sound | 163.e9 | ||
| Stimulator | 163.e9 | ||
| References | 163.e10 | ||
| Key References | 161 | ||
| References | 163.e11 | ||
| 2 Treatment Techniques and Special Equipment | 165 | ||
| 9 Rehabilitation and Prosthetic Restoration in Upper Limb Amputation | 167 | ||
| Demographics, Incidence, and Prevalence | 167 | ||
| Nomenclature and Functional Levels of Amputations | 168 | ||
| Principles of Limb Salvage and Amputation Surgery | 169 | ||
| Limb Salvage | 169 | ||
| Hand Replantation | 170 | ||
| Hand Transplantation | 171 | ||
| Rehabilitation After Hand Replantation and Hand Transplantation | 172 | ||
| Outcomes | 172 | ||
| Amputation | 173 | ||
| Acute Management: Preamputation Through Early Rehabilitation | 174 | ||
| Preamputation | 174 | ||
| Acute Postamputation | 175 | ||
| Upper Limb Prostheses | 177 | ||
| Introduction to Upper Limb Prosthetic Systems | 177 | ||
| Socket and Suspension Choices | 177 | ||
| Power | 178 | ||
| Level-Specific Upper Limb Amputation Prostheses | 179 | ||
| Terminal Devices and Wrist Units | 181 | ||
| Bilateral Upper Limb Amputee | 184 | ||
| Advances in Prosthetic Technology | 185 | ||
| Surgical | 185 | ||
| Prosthetic Technology | 185 | ||
| Prosthetic Training | 186 | ||
| Follow-up | 187 | ||
| Acknowledgments: | 188 | ||
| References | 188 | ||
| 10 Lower Limb Amputation and Gait | 191 | ||
| Epidemiology | 191 | ||
| Amputation Terminology | 192 | ||
| Rehabilitation Implications of Amputation Level and Surgical Technique | 192 | ||
| Residual Limb and Skin Care | 193 | ||
| Pain Management | 195 | ||
| Psychological Support | 196 | ||
| Preprosthetic Phase Rehabilitation Considerations | 196 | ||
| Prosthetic Training Phase Considerations | 197 | ||
| Functional Classification | 198 | ||
| Prosthetic Restoration | 199 | ||
| Essential Elements of the Prosthetic Prescription | 199 | ||
| Socket Designs | 199 | ||
| Transtibial Socket Design | 199 | ||
| Patellar Tendon Bearing. | 199 | ||
| Patellar Tendon Bearing and Supracondylar/Suprapatellar. | 199 | ||
| Total Surface Bearing. | 200 | ||
| Transfemoral Socket Design | 200 | ||
| Quadrilateral Socket (Quad Socket). | 200 | ||
| Ischial Containment Socket. | 200 | ||
| Subischial Socket Design. | 200 | ||
| Prosthetic Limb Suspension | 200 | ||
| Suction Suspension | 201 | ||
| Elevated Vacuum Suspension | 201 | ||
| Pin Lock Suspension | 202 | ||
| Alternate Suspension Designs | 202 | ||
| Prosthetic Interface Options | 203 | ||
| Prosthetic Limb Frame Options (Endoskeletal or Exoskeletal) | 203 | ||
| Prosthetic Feet | 203 | ||
| Nonarticulated Prosthetic Feet | 203 | ||
| Solid Ankle Cushion Heel Foot. | 203 | ||
| Solid Ankle Flexible Endoskeletal Foot. | 203 | ||
| Articulated Prosthetic Feet | 204 | ||
| Single Axis Feet. | 204 | ||
| Multiaxial Feet. | 204 | ||
| Specialty Feet | 204 | ||
| Energy-Storing/Dynamic-Response Feet | 204 | ||
| Microprocessor Feet | 205 | ||
| Prosthetic Knees | 205 | ||
| Manual Locking Knee | 205 | ||
| Single Axis Knee | 206 | ||
| Weight-Activated Stance Control (Safety Knee) | 206 | ||
| Polycentric Knees | 206 | ||
| Hydraulic or Pneumatic Knees | 207 | ||
| Microprocessor Knee | 207 | ||
| Microprocessor Knees with Internal Power | 207 | ||
| Prosthetic Hip Joints | 208 | ||
| Additional Componentry Considerations | 208 | ||
| Prosthetic Prescription for Partial Foot Amputations | 208 | ||
| Prosthetic Prescription for Ankle Disarticulation (Syme) Amputations | 208 | ||
| Prosthetic Prescription Algorithms for Transtibial Amputees | 209 | ||
| Functional Level One (K1) | 209 | ||
| Functional Level Two (K2) | 209 | ||
| Functional Level Three (K3) | 209 | ||
| Functional Level Four (K4) | 209 | ||
| Knee Disarticulation | 209 | ||
| Prescription Criteria | 209 | ||
| Prosthetic Prescription Algorithms for Transfemoral Amputees | 210 | ||
| Functional Level One (K1) | 210 | ||
| Functional Level Two (K2) | 210 | ||
| Functional Level Three (K3) | 210 | ||
| Functional Level Four (K4) | 210 | ||
| Hip Disarticulation and Hemipelvectomy Levels of Amputation | 211 | ||
| Prescription Criteria | 211 | ||
| Prosthetic Limb Fitting and Replacement Considerations | 211 | ||
| Energy Consumption | 211 | ||
| Bilateral Amputee Considerations | 212 | ||
| Land Mine–Related Amputation Considerations | 212 | ||
| Pediatric Lower Limb Loss | 213 | ||
| Prevalence, Classification, and Epidemiology: Congenital Lower Limb Deficiencies | 213 | ||
| Classification and Etiology: Acquired Amputation | 214 | ||
| Fibular Deficiencies, Syme, and Transtibial Amputations | 215 | ||
| Tibial Deficiencies and Knee Disarticulation Amputation | 215 | ||
| Longitudinal Deficiency of the Femur, Partial | 215 | ||
| Amputation Level and Energy Expenditure in Congenital and Acquired Pediatric Lower Limb Deficiencies | 215 | ||
| Financial and Vocational Impacts of Pediatric Limb Loss | 216 | ||
| Future Considerations | 216 | ||
| Normal Human Gait | 216 | ||
| Introduction | 216 | ||
| Gait Terminology | 216 | ||
| Determinants of Gait | 217 | ||
| Kinematics | 218 | ||
| Sagittal Plane Kinematics. | 218 | ||
| Kinetics | 218 | ||
| Sagittal Plane Kinetics. | 218 | ||
| Muscle Activity | 219 | ||
| Muscle Activity during Gait. | 219 | ||
| Hip Extensors | 219 | ||
| Hip Flexors | 220 | ||
| Knee Extensors | 220 | ||
| Knee Flexors | 220 | ||
| Ankle Dorsiflexors | 220 | ||
| Ankle Plantar Flexors | 220 | ||
| Prosthetic Gait Deviations | 220 | ||
| Transtibial Gait Deviations | 220 | ||
| Uneven Stride Length | 220 | ||
| Abrupt Knee Flexion in Loading Response | 220 | ||
| Absent Knee Flexion in Loading Response | 220 | ||
| Visible “Pistoning” | 220 | ||
| Coronal Knee Instability | 220 | ||
| 3 Common Clinical Problems | 425 | ||
| 20 Bladder Dysfunction | 427 | ||
| Neuroanatomy and Physiology | 427 | ||
| Detrusor and Sphincter Muscle Characteristics | 427 | ||
| Lower Urinary Tract Pharmacology: Receptors and Neurotransmitters | 427 | ||
| Muscarinic Receptors and Transmitters | 427 | ||
| Adrenergic Receptors and Transmitters | 427 | ||
| Other Receptors and Transmitters | 427 | ||
| Estrogens | 428 | ||
| Transmitter Function Depends on Location | 428 | ||
| Lower Urinary Tract Innervation | 428 | ||
| Peripheral Innervation | 428 | ||
| Micturition Reflex | 429 | ||
| Other Lower Urinary Tract Reflexes | 429 | ||
| Lower Urinary Tract Function | 429 | ||
| Voiding Function in Infants and Young Children | 429 | ||
| Voiding Function in Adults | 430 | ||
| Voiding Function in Older Adults | 430 | ||
| Classification of Neurogenic Bladder Dysfunction | 431 | ||
| Evaluation of Neurogenic Bladder Dysfunction | 431 | ||
| History and Physical Examination | 431 | ||
| Diagnostic Testing for Neurogenic Bladder Dysfunction | 432 | ||
| Indications for Diagnostic Testing | 432 | ||
| Upper Tract Tests | 432 | ||
| Ultrasonography | 432 | ||
| Plain Radiography of the Urinary Tract: Kidneys, Ureter, and Bladder | 432 | ||
| Computed Tomography | 432 | ||
| Excretory Urography or Computed Tomography/Intravenous Pyelogram | 432 | ||
| Creatinine Clearance Time | 433 | ||
| Isotope Studies | 433 | ||
| Lower Tract Tests | 433 | ||
| Urinalysis, Culture, and Sensitivity Testing | 433 | ||
| Postvoid Residual | 433 | ||
| Cystography | 433 | ||
| Urodynamics | 433 | ||
| Urethral Pressure Profiles | 434 | ||
| Sphincter Electromyography | 434 | ||
| Videourodynamics/Fluorourodynamics | 434 | ||
| Cystoscopy | 434 | ||
| Nonpharmacologic Treatment of Neurogenic Bladder Dysfunction | 434 | ||
| General Principles | 434 | ||
| Behavioral Management | 434 | ||
| Timed Voiding | 434 | ||
| Bladder Stimulation | 435 | ||
| Valsalva and Credé Maneuvers | 435 | ||
| Anal Stretch Voiding | 436 | ||
| Pelvic Floor Exercises | 436 | ||
| Urine Collection Devices | 436 | ||
| External (“Condom” or “Texas”) Catheters. | 436 | ||
| Indwelling Catheters. | 436 | ||
| Adult Diapers and Other Protective Garments. | 436 | ||
| Clean Intermittent Catheterization. | 437 | ||
| Pharmacologic Treatment of Neurogenic Bladder Dysfunction | 437 | ||
| General Principles | 437 | ||
| Antimuscarinic Agents | 437 | ||
| Cholinergic Agonists | 438 | ||
| Bethanechol. | 438 | ||
| Adrenergic Antagonists | 438 | ||
| Adrenergic Agonists | 438 | ||
| Estrogens | 438 | ||
| Muscle Relaxants | 438 | ||
| Intravesical Therapy | 438 | ||
| Surgical Treatment of Neurogenic Bladder Dysfunction: To Increase Capacity | 438 | ||
| Bladder Augmentation | 438 | ||
| Bladder Augmentation with Continent Catheterizable Stoma | 439 | ||
| Urinary Diversion | 439 | ||
| Denervation Procedures | 439 | ||
| Surgical Treatments for Neurogenic Bladder Dysfunction: To Increase Contractility | 440 | ||
| Electrical Stimulation | 440 | ||
| Surgical Treatment of Neurogenic Bladder Dysfunction: To increase Outlet Resistance | 440 | ||
| Urethral Bulking Agents | 440 | ||
| External Compressive Procedures | 440 | ||
| Surgical Treatment of Neurogenic Bladder Dysfunction: To Decrease Outlet Resistance | 441 | ||
| Sphincterotomy | 441 | ||
| Urethral Stents | 441 | ||
| Other Methods of Decreasing Outflow Resistance | 441 | ||
| Differential Diagnosis of Neurogenic Bladder Dysfunction | 441 | ||
| Diseases of the Brain | 441 | ||
| Stroke. | 441 | ||
| Parkinson Disease. | 441 | ||
| Dementia, Brain Tumors, and Trauma. | 441 | ||
| Diseases of the Brain and Spinal Cord. | 441 | ||
| Diseases of the Spinal Cord. | 441 | ||
| Diseases of the Conus, Cauda Equina, and Peripheral Nerves. | 442 | ||
| Diseases of the Spinal Cord and Conus. | 443 | ||
| Complications of Neurogenic Voiding Dysfunction | 443 | ||
| Bacteriuria | 443 | ||
| Autonomic Dysreflexia | 443 | ||
| Hypercalciuria and Stones | 444 | ||
| Lower Urinary Tract Changes | 445 | ||
| Ureteral Reflux and Upper Tract Dilation | 445 | ||
| Summary | 445 | ||
| Key References | 445 | ||
| References | 447.e1 | ||
| 21 Neurogenic Bowel: | 449 | ||
| Epidemiology | 449 | ||
| Impact | 449 | ||
| Neuroanatomy and Physiology of the Gastrointestinal Tract | 450 | ||
| Enteric Nervous System | 450 | ||
| Enteric Nervous System Relationship to the Spinal Cord and Brain | 450 | ||
| Gastrointestinal Neuromotor System | 452 | ||
| Gastric Motility | 452 | ||
| Intestinal Motility | 452 | ||
| Motility of the Anus, Rectum, and Pelvic Floor | 453 | ||
| Physiology of Normal Defecation | 453 | ||
| Pathophysiology of Gastrointestinal Dysfunction | 454 | ||
| Nausea, Vomiting, Bloating, and Early Satiety | 454 | ||
| Abdominal Pain and Discomfort | 455 | ||
| Diarrhea | 455 | ||
| Defecation Dysfunction | 455 | ||
| Constipation | 455 | ||
| Fecal Incontinence | 455 | ||
| Upper Motor Neurogenic Bowel | 455 | ||
| Lower Motor Neurogenic Bowel | 456 | ||
| Gastrointestinal Dysfunction in Common Neurologic Disorders | 456 | ||
| Brain Disorders | 456 | ||
| Parkinson Disease and Parkinson Plus Diseases | 457 | ||
| Multiple Sclerosis | 458 | ||
| Spinal Cord Disorders | 458 | ||
| Peripheral Neuropathy | 458 | ||
| Comprehensive Evaluation | 458 | ||
| History | 458 | ||
| Physical Examination | 459 | ||
| Diagnostic Testing | 459 | ||
| Management | 459 | ||
| Management of Nausea, Vomiting, Bloating, and Early Satiety | 459 | ||
| Management of Diarrhea | 460 | ||
| Management of Defecation Dysfunction: Constipation and Fecal Incontinence | 461 | ||
| Goals of the Bowel Program | 461 | ||
| Dietary Considerations | 461 | ||
| Treatment Approaches and Rationale | 462 | ||
| Management of Upper Motor Neuron Defecatory Dysfunction | 462 | ||
| New Medications to Treat Constipation | 463 | ||
| Lubiprostone. | 463 | ||
| Linaclotide. | 463 | ||
| Prucalopride. | 463 | ||
| Methylnaltrexone and Alvimopan. | 463 | ||
| Management of Lower Motor Neuron Defecatory Dysfunction | 463 | ||
| Physical Interventions | 463 | ||
| Bowel Irrigation | 463 | ||
| Abdominal Massage | 464 | ||
| Functional Electrical Stimulation/Functional Magnetic Stimulation | 464 | ||
| Surgical Options | 465 | ||
| Gastric Electrical Stimulation | 465 | ||
| Gastrostomies and Enterostomies | 465 | ||
| Surgeries for Chronic Intestinal or Colonic Pseudoobstruction | 465 | ||
| Pelvic Floor Sling | 465 | ||
| Electroprosthesis | 465 | ||
| Antegrade Continence Enema | 466 | ||
| Colostomy | 466 | ||
| Complications | 466 | ||
| Treatment Outcomes | 467 | ||
| Key References | 467 | ||
| References | 468.e1 | ||
| Resources | 468.e3 | ||
| 22 Sexual Dysfunction and Disability | 469 | ||
| Sexual Response and Behavior | 469 | ||
| Human Sexual Response | 469 | ||
| Sexual Behavior and Aging | 469 | ||
| Types of Sexual Dysfunction | 470 | ||
| Classification | 470 | ||
| Male Sexual Dysfunction | 471 | ||
| Female Sexual Dysfunction | 472 | ||
| Sexual Dysfunction in Disability and Chronic Disease | 473 | ||
| Spinal Cord Injury | 473 | ||
| Stroke | 474 | ||
| Traumatic Brain Injury | 474 | ||
| Multiple Sclerosis | 475 | ||
| Other Neurologic Disorders | 475 | ||
| Chronic Pain | 475 | ||
| Rheumatologic Disease | 475 | ||
| Amputation | 475 | ||
| Diabetes Mellitus | 476 | ||
| Cardiac Disease | 476 | ||
| Depression | 476 | ||
| Sexual Dysfunction Related to Medication Use in Individuals with Disability | 476 | ||
| Evaluation of Sexual Dysfunction | 477 | ||
| Sexual History Taking | 477 | ||
| Physical Examination | 478 | ||
| Diagnostic Evaluation | 478 | ||
| Treatment of Sexual Dysfunction | 480 | ||
| Male Hypoactive Sexual Desire Disorder | 480 | ||
| Erectile Dysfunction | 480 | ||
| Premature Ejaculation | 481 | ||
| Delayed Ejaculation, Anejaculation, and Anorgasmia in Men | 482 | ||
| Female Sexual Interest/Arousal Disorder | 483 | ||
| Female Orgasmic Dysfunction | 484 | ||
| Genito-Pelvic Pain/Penetration Disorder | 484 | ||
| Conclusion | 484 | ||
| Key References | 484 | ||
| References | 485.e1 | ||
| 23 Spasticity | 487 | ||
| Pathophysiology | 487 | ||
| Stretch Reflex and Its Regulation | 487 | ||
| Abnormal Regulation of the Stretch Reflex | 488 | ||
| Does Spasticity Result from Maladaptive Plasticity? | 490 | ||
| Peripheral Contribution | 491 | ||
| Clinical Presentation, Goal Setting, and Assessment | 491 | ||
| Problem Identification | 491 | ||
| Postural Abnormalities | 491 | ||
| Impaired Movement | 491 | ||
| Functional Limitation | 491 | ||
| Goal Setting | 495 | ||
| Clinical Assessment | 495 | ||
| Biomechanical and Electrophysiologic Assessment | 495 | ||
| Biomechanical Assessment: Spasticity or Contracture? | 495 | ||
| Electrophysiologic Measurement | 497 | ||
| Management | 498 | ||
| Nonpharmacologic | 498 | ||
| Pharmacologic | 498 | ||
| Oral Spasmolytics | 498 | ||
| Focal Treatment: Botulinum Toxin Chemodenervation | 501 | ||
| Clinical Issues Related to Botulinum Toxin Chemodenervation | 502 | ||
| Dosing. | 502 | ||
| Dilution. | 502 | ||
| Techniques to Enhance Toxin Effectiveness. | 502 | ||
| Reasons for Poor Response to Botulinum Toxin Chemodenervation. | 503 | ||
| Immunoresistance. | 503 | ||
| Repeated Injections: When Is “Enough” Enough? | 503 | ||
| Early Treatment. | 503 | ||
| Recovery of Function. | 503 | ||
| “Therapeutic Weakness.” | 504 | ||
| Focal Pharmacologic Treatment: Nerve Block (Neurolysis) | 506 | ||
| Intrathecal Therapies | 506 | ||
| Surgical Intervention | 508 | ||
| Emerging Therapies | 508 | ||
| Key References | 509 | ||
| References | 510.e1 | ||
| 24 Chronic Wounds | 511 | ||
| Scope of the Problem | 511 | ||
| Definitions | 511 | ||
| Epidemiology of Chronic Wounds | 512 | ||
| Pressure Ulcers | 512 | ||
| Diabetic, Ischemic, and Neuropathic Ulcers | 513 | ||
| Chronic Venous Leg Ulcers | 513 | ||
| Wound Physiology and Pathophysiology | 513 | ||
| Definitions | 513 | ||
| Process of Normal Healing | 513 | ||
| Biochemistry of Normal Healing | 514 | ||
| Pathophysiology of Chronic Wounds | 514 | ||
| Pathomechanics | 514 | ||
| Chronic Hypoxia | 515 | ||
| Reperfusion Injury | 515 | ||
| Edema, Impaired Oxygen, and Nutrient Exchange | 515 | ||
| Growth Factor Abnormalities | 515 | ||
| Chronic Inflammation | 515 | ||
| Comorbidities | 515 | ||
| Clinical Wound Assessment | 515 | ||
| Wound Area and Volume Assessment | 515 | ||
| Wound Area | 515 | ||
| Wound Volume | 516 | ||
| Wound Appearance | 516 | ||
| Computerized Assessment of Wound Geometry | 516 | ||
| Perfusion Assessment | 516 | ||
| Macrocirculation | 516 | ||
| Ankle-Brachial Index and Pulse Volume Recording. | 518 | ||
| Angiography. | 518 | ||
| Microcirculation | 518 | ||
| Pressure and Shear Stress Assessment | 518 | ||
| Skin Biopsy | 519 | ||
| General Principles of Treatment | 519 | ||
| Wound Bed Preparation | 519 | ||
| Débridement | 519 | ||
| Surgical Débridement | 519 | ||
| Sharps Débridement | 519 | ||
| Mechanical Débridement | 519 | ||
| Enzymatic Débridement | 519 | ||
| Autolytic Débridement | 520 | ||
| Dressings | 520 | ||
| Hyperbaric Oxygen Therapy | 520 | ||
| Gene Therapy and Exogenous Application of Growth Factors | 522 | ||
| Stem Cell Therapy | 522 | ||
| Platelet-Rich Plasma | 522 | ||
| Therapeutic Ultrasound | 523 | ||
| Electrical Stimulation and Electromagnetic Therapy | 524 | ||
| Negative Pressure Wound Therapy | 524 | ||
| Skin Substitutes | 524 | ||
| Diagnosis and Treatment of Specific Ulcer Types | 524 | ||
| Pressure Ulcers | 524 | ||
| Presentation | 524 | ||
| Deep Tissue Injury | 525 | ||
| Treatment | 526 | ||
| Prevention | 527 | ||
| Screening of Pressure Ulcers | 527 | ||
| Uncomplicated Chronic Venous Ulcers | 528 | ||
| Presentation | 528 | ||
| Diagnostic Tests | 529 | ||
| Treatment | 529 | ||
| Prevention: Compression Stockings | 530 | ||
| Uncomplicated Neuropathic Ulcers | 530 | ||
| Presentation | 530 | ||
| Diagnostic Tests | 531 | ||
| Treatment | 531 | ||
| Prevention | 531 | ||
| Ischemic Ulcers | 532 | ||
| Presentation | 532 | ||
| Diagnostic Tests | 533 | ||
| Treatment | 533 | ||
| Prevention | 533 | ||
| Infection, Surgical Repair, and the Transition from Outpatient to Acute Inpatient Management | 533 | ||
| Presentation | 533 | ||
| Soft Tissue Infections: Wound Culture, Microbiology, and Antibiotic Therapy | 534 | ||
| Osteomyelitis | 535 | ||
| Imaging Studies | 535 | ||
| Adjunctive Treatment for Osteomyelitis | 535 | ||
| Surgical Management | 535 | ||
| Surgical Management of Infection | 536 | ||
| Soft Tissue Reconstruction | 536 | ||
| Bone Repair and Reconstruction | 536 | ||
| Revascularization | 536 | ||
| Amputation | 536 | ||
| Nutrition | 537 | ||
| Management of Wound Pain | 537 | ||
| Wound Care Centers | 537 | ||
| Team Form and Function | 538 | ||
| Limb Preservation and the Diabetic Foot Ulcer | 538 | ||
| Hyperbaric Oxygen and Limb at Risk | 538 | ||
| Quality in Wound Care | 539 | ||
| Background | 539 | ||
| Quality Measures | 540 | ||
| Summary | 541 | ||
| Acknowledgments: | 541 | ||
| Key References | 541 | ||
| References | 542.e1 | ||
| 25 Vascular Diseases | 543 | ||
| Arterial Diseases | 543 | ||
| Arteriosclerosis Obliterans | 543 | ||
| Vasculitic Syndrome | 543 | ||
| Rheumatoid Vasculitis | 543 | ||
| Cryoglobulinemia | 544 | ||
| Polyarteritis | 544 | ||
| Other Vasculitides | 544 | ||
| Thromboangiitis Obliterans (Buerger Disease) | 544 | ||
| Raynaud Syndrome | 544 | ||
| Vibration Syndrome | 544 | ||
| Hypothenar Hammer Syndrome | 545 | ||
| External Iliac Syndrome in Cyclists | 545 | ||
| Arterial Evaluation | 545 | ||
| Noninvasive Arterial Studies | 545 | ||
| Ankle-Brachial Index | 545 | ||
| Segmental Pressure Measurements | 545 | ||
| Continuous Wave Doppler (See Videos 25-1 to 25-3) | 545 | ||
| Transcutaneous Oximetry | 546 | ||
| Photoplethysmography | 546 | ||
| Duplex Scanning | 546 | ||
| Imaging Techniques | 546 | ||
| Computed Tomography Angiography | 546 | ||
| Magnetic Resonance Angiography | 546 | ||
| Contrast Arteriography | 546 | ||
| Management | 547 | ||
| Risk Factor Management | 547 | ||
| Lipid Management | 548 | ||
| Angiotensin-Converting Enzyme Inhibitors | 548 | ||
| Antiplatelet Therapy | 548 | ||
| Agents for Intermittent Claudication | 548 | ||
| Rehabilitation | 548 | ||
| Gene Therapy | 549 | ||
| Revascularization | 549 | ||
| Intermittent Pneumatic Compression | 549 | ||
| Venous Disease | 549 | ||
| Venous Thromboembolism | 550 | ||
| Phlegmasia Cerulea Dolens | 550 | ||
| May-Thurner Syndrome | 550 | ||
| Chronic Venous Insufficiency | 550 | ||
| Venous Evaluation | 551 | ||
| Continuous Wave Doppler | 551 | ||
| Duplex Ultrasound | 551 | ||
| Computed Tomography and Magnetic Resonance Venography | 551 | ||
| Contrast Venography | 551 | ||
| D-Dimer | 551 | ||
| Management | 552 | ||
| Compression | 552 | ||
| Elevation | 552 | ||
| Intermittent Pneumatic Compression | 552 | ||
| Exercise | 552 | ||
| Lymphatic Disease | 553 | ||
| Lymphatic System | 553 | ||
| Lymphedema | 553 | ||
| Classification of Lymphedema | 553 | ||
| Evaluation | 553 | ||
| Imaging Techniques | 554 | ||
| Lymphoscintigraphy | 554 | ||
| Lymphangiography | 554 | ||
| Treatment of Lymphedema | 554 | ||
| Compression | 554 | ||
| Elevation | 555 | ||
| Exercise | 555 | ||
| Vasopneumatic Compression Therapy | 555 | ||
| Conclusion | 555 | ||
| References | 555 | ||
| 26 Burns | 557 | ||
| Epidemiology of Burn Injury | 557 | ||
| Acute Physiatric Assessment of the Burned Individual | 557 | ||
| Acute Wound Care | 559 | ||
| Acute Pain Management | 559 | ||
| Acute Surgical Procedures in Burn Injuries | 560 | ||
| Other Acute Conditions Treated in the Burn Center | 560 | ||
| Presence of Inhalation Injury | 561 | ||
| Polytrauma and Burns | 561 | ||
| Catabolism and Metabolic Abnormalities | 561 | ||
| Nutrition and Swallowing in Burns | 561 | ||
| Peripheral Neuropathies | 562 | ||
| Heterotopic Ossification | 562 | ||
| Hypertrophic Scarring | 563 | ||
| Contractures | 564 | ||
| Burn Scar Pruritus | 565 | ||
| Scar Measurement | 565 | ||
| Inpatient Rehabilitation Admission for Burned Individuals | 565 | ||
| Psychosocial Adjustment | 566 | ||
| Community Reintegration | 567 | ||
| Key References | 568 | ||
| References | 569.e1 | ||
| 27 Acute Medical Conditions | 571 | ||
| Cardiopulmonary Rehabilitation | 571 | ||
| Assessment of Cardiopulmonary Function | 571 | ||
| History and Physical Examination | 571 | ||
| History | 571 | ||
| Dyspnea. | 571 | ||
| Chest Pain. | 571 | ||
| Palpitations. | 572 | ||
| Syncope. | 572 | ||
| Edema. | 572 | ||
| Fatigue. | 572 | ||
| Cough. | 572 | ||
| Physical Examination | 572 | ||
| Cardiac Anatomy and Physiology | 573 | ||
| Cardiac Anatomy | 573 | ||
| Variation of Arteries | 573 | ||
| Cardiac Physiology | 573 | ||
| Pulmonary Anatomy and Physiology | 573 | ||
| Pulmonary Anatomy | 573 | ||
| Pulmonary Physiology | 574 | ||
| Basic Terminology for Exercise | 574 | ||
| Aerobic Capacity | 574 | ||
| Heart Rate | 574 | ||
| Stroke Volume | 574 | ||
| Cardiac Output | 574 | ||
| Myocardial Oxygen Consumption | 574 | ||
| Interventions for Cardiopulmonary Disease | 575 | ||
| Aerobic Training | 575 | ||
| Intensity. | 575 | ||
| Duration. | 576 | ||
| Frequency. | 576 | ||
| Specificity. | 576 | ||
| Pulmonary Rehabilitation | 576 | ||
| Abnormal Physiology: Lung | 576 | ||
| Cardiac Rehabilitation | 577 | ||
| Abnormal Physiology: Heart | 577 | ||
| Pulmonary Rehabilitation Programs | 579 | ||
| Cardiac Rehabilitation of the Patient After Myocardial Infarction | 579 | ||
| Acute Phase (Phase 1) | 580 | ||
| Inpatient Rehabilitation Phase (Phase 1B) | 580 | ||
| Training Phase (Phase 2) | 580 | ||
| Maintenance Phase (Phase 3) | 580 | ||
| Cardiac Rehabilitation Programs in Specific Conditions | 580 | ||
| Angina Pectoris | 580 | ||
| Cardiac Rehabilitation After Revascularization Procedures | 580 | ||
| Postcoronary Artery Bypass Grafting | 580 | ||
| Cardiac Rehabilitation for Patients After Cardiac Transplantation | 581 | ||
| Cardiomyopathy | 581 | ||
| Valvular Heart Disease | 581 | ||
| Cardiac Arrhythmias | 582 | ||
| Pulmonary Rehabilitation Programs in Specific Conditions | 582 | ||
| Emphysema | 582 | ||
| Interstitial Lung Disease | 582 | ||
| Pulmonary Hypertension | 582 | ||
| Ventilatory Failure | 582 | ||
| Cardiopulmonary Rehabilitation in the Physically Disabled | 583 | ||
| Conclusion | 584 | ||
| Frailty | 584 | ||
| Movement and Function | 584 | ||
| Physiology and Consequences of Inactivity | 584 | ||
| Metabolic Syndrome | 584 | ||
| Deep Vein Thrombosis | 585 | ||
| Obesity | 585 | ||
| Insulin | 585 | ||
| Frailty Syndrome | 585 | ||
| Fried Frailty Phenotype | 585 | ||
| Weight Loss | 585 | ||
| Exhaustion | 585 | ||
| Low Physical Activity | 585 | ||
| Slow Walking Speed | 585 | ||
| Reduced Grip Strength | 586 | ||
| Canadian Study of Health and Aging Measurement Tools | 586 | ||
| Frailty: A Complex Syndrome | 586 | ||
| Zero Physical Activity: Hospital Immobility | 587 | ||
| Traditional Hospital Practices (Bed Rest, Sedation, and Immobilization). | 587 | ||
| Iatrogenic Immobilization and Deconditioning. | 587 | ||
| Early Mobilization | 588 | ||
| Rationale. | 588 | ||
| Culture of Immobility. | 588 | ||
| Culture of Mobility. | 588 | ||
| Physiatric Involvement. | 588 | ||
| Ambulatory Devices. | 588 | ||
| Training. | 588 | ||
| Treatment Considerations in the Critical Care Setting | 589 | ||
| Hemodynamic Instability/Orthostatic Hypotension | 589 | ||
| Ventilatory Dependence | 589 | ||
| Postparalytic/Intensive Care Unit–Acquired Weakness | 589 | ||
| Psychology of the Patient in the Intensive Care Unit | 589 | ||
| Posttraumatic Stress Disorder | 589 | ||
| Delirium | 589 | ||
| Transition of Care | 590 | ||
| Application to Patients Not in the Intensive Care Unit | 590 | ||
| Community Mobilization | 590 | ||
| Healthy People 2020. | 590 | ||
| Wellness Centers. | 590 | ||
| Renal Failure | 591 | ||
| Physiology of Renal Failure | 591 | ||
| Hyperkalemia | 592 | ||
| Hyponatremia | 592 | ||
| Uremia | 592 | ||
| Metabolic Issues | 592 | ||
| Bone Issues | 592 | ||
| Hypocalcemia. | 592 | ||
| Hypophosphatemia. | 592 | ||
| Weakness | 592 | ||
| Debility | 592 | ||
| Issues of Dialysis: “Residual Syndrome” | 593 | ||
| Sarcopenia/Uremia | 593 | ||
| Rehabilitation for Patients Before Transplantation | 593 | ||
| Early Mobilization After Renal Transplantation | 593 | ||
| Key References | 593 | ||
| References | 595.e1 | ||
| 28 Chronic Medical Conditions | 597 | ||
| Pulmonary Rehabilitation | 597 | ||
| Definition | 597 | ||
| Classification of Pulmonary Disease | 597 | ||
| Epidemiology | 597 | ||
| Treatment Options in Pulmonary Rehabilitation | 597 | ||
| General Medical Management | 598 | ||
| Oxygen Therapy | 598 | ||
| Chest Physical Therapy | 598 | ||
| Exercise Conditioning: General Considerations | 600 | ||
| Exercise Prescription for Pulmonary Rehabilitation | 600 | ||
| Exercise in Chronic Obstructive Pulmonary Disease | 600 | ||
| Exercise in Asthma | 601 | ||
| Exercise in Cystic Fibrosis | 602 | ||
| Exercise in Disorders of Chest Wall Function | 602 | ||
| Exercise in Paradoxical Vocal Fold Dysfunction | 603 | ||
| Nutritional Issues | 603 | ||
| Psychosocial Support | 603 | ||
| Management Options for Individuals with Severe Lung Disease and Long-Term Outcomes | 603 | ||
| Mechanical Ventilation | 603 | ||
| Long-Term Outcomes of Mechanical Ventilation | 607 | ||
| Lung Volume Reduction Surgery | 607 | ||
| Long-Term Results for Lung Volume Reduction Surgery | 607 | ||
| Lung Transplant | 608 | ||
| Long-Term Results in Lung Transplant | 608 | ||
| Special Considerations | 608 | ||
| Obesity-Related Pulmonary Dysfunction | 608 | ||
| Spinal Cord Injury and Pulmonary Dysfunction | 608 | ||
| Summary | 608 | ||
| Rehabilitation in Solid Organ Transplant Recipients | 609 | ||
| Physiatric Interventions in Enhancing Outcomes | 609 | ||
| Hypertension | 610 | ||
| Hyperlipidemia | 610 | ||
| Steroid-Induced Hyperglycemia and Posttransplant Diabetes | 610 | ||
| Renal Insufficiency | 610 | ||
| Infections | 610 | ||
| Immunosuppression | 610 | ||
| Renal Transplantation Rehabilitation | 612 | ||
| Exercise After Kidney Transplantation | 612 | ||
| Rehabilitation in Cardiac Transplantation | 613 | ||
| Heart Transplant Epidemiology | 613 | ||
| Rehabilitation Before Heart Transplantation | 613 | ||
| Complications After Cardiac Transplantation | 614 | ||
| Physiology of the Transplanted Heart | 614 | ||
| Therapeutic Exercise After Cardiac Transplantation | 615 | ||
| Rehabilitation in Lung Transplantation | 616 | ||
| Lung Transplants and Patient Outcomes | 616 | ||
| Pretransplant Rehabilitation: Assessment, Education, and Conditioning | 617 | ||
| Medical Complications | 618 | ||
| Postoperative Exercise Considerations | 619 | ||
| Rehabilitation in Liver Transplantation | 619 | ||
| Rehabilitation Following Liver Transplant | 620 | ||
| Return to Work Posttransplantation | 620 | ||
| Summary | 620 | ||
| Rehabilitation Management of Diabetes Mellitus | 620 | ||
| Epidemiology | 620 | ||
| Pathophysiology and Diagnosis | 621 | ||
| Prevention Guidelines | 621 | ||
| Lifestyle Modifications | 621 | ||
| Treatment Guidelines | 621 | ||
| Exercise and Diabetes Mellitus | 621 | ||
| Assessment of Physical Activity | 621 | ||
| Physiologic Effects of Exercise in Type 2 Diabetes Mellitus | 622 | ||
| Preexercise Assessment | 622 | ||
| Exercise Prescription in Type 2 Diabetes Mellitus | 622 | ||
| Oral Pharmacologic Treatment | 623 | ||
| Diabetes Mellitus Treatment with Insulin | 624 | ||
| The Inpatient Rehabilitation Diabetes Consult Team | 624 | ||
| Treatment of Diabetic Peripheral Neuropathy | 624 | ||
| Treatment of Diabetic Gastroparesis | 624 | ||
| Conclusion | 625 | ||
| Key References | 625 | ||
| References | 626.e1 | ||
| 29 Cancer Rehabilitation | 627 | ||
| Epidemiology | 627 | ||
| Demographic Disparities in Cancer | 627 | ||
| Disease Considerations | 627 | ||
| Staging | 627 | ||
| Prognosis and Metastatic Spread | 628 | ||
| Phases of Cancer | 628 | ||
| Constitutional Symptoms | 629 | ||
| Fatigue | 629 | ||
| Pain | 630 | ||
| Acute Pain | 630 | ||
| Chronic Pain | 630 | ||
| Nonsteroidal Antiinflammatory Drugs for Bone Pain | 631 | ||
| Adjuvant for Bone Pain | 631 | ||
| Opioids for General Cancer Pain | 631 | ||
| Opioid Conversion | 631 | ||
| Invasive and Intraspinal Analgesic Approaches | 631 | ||
| Impairments in Cancer | 632 | ||
| Impairments Caused by Tumor Effects | 632 | ||
| Bone Metastases | 632 | ||
| Brain Tumors: Primary and Metastases | 633 | ||
| 4 Issues in Specific Diagnoses | 685 | ||
| 32 Common Neck Problems | 687 | ||
| Pathophysiology and the Significance of Pain Referral Patterns | 687 | ||
| Common Clinical Disorders | 692 | ||
| Cervical Strain and Sprains | 692 | ||
| Epidemiology | 692 | ||
| Pathophysiology | 693 | ||
| Diagnosis | 694 | ||
| Treatment | 695 | ||
| Cervical Radiculopathy and Radicular Pain | 696 | ||
| Epidemiology | 696 | ||
| Pathophysiology | 696 | ||
| Diagnosis | 696 | ||
| History and Physical Examination. | 696 | ||
| Imaging Studies. | 697 | ||
| Electrodiagnostic Evaluation. | 697 | ||
| Treatment | 698 | ||
| Physical Medicine and Rehabilitation. | 698 | ||
| Modalities. | 698 | ||
| Medications. | 699 | ||
| Stabilization and Functional Restoration. | 699 | ||
| Interventional Spine Care. | 700 | ||
| Diagnostic Selective Nerve Root Block. | 700 | ||
| Therapeutic Selective Nerve Root Injection. | 700 | ||
| Percutaneous Diskectomy/Disk Decompression. | 701 | ||
| Surgery. | 701 | ||
| Cervical Joint Pain | 701 | ||
| Epidemiology | 701 | ||
| Diagnosis | 702 | ||
| History and Physical Examination. | 702 | ||
| Imaging Studies. | 702 | ||
| Treatment | 702 | ||
| Physical Medicine and Rehabilitation. | 702 | ||
| Interventional Spine Care. | 702 | ||
| Diagnostic Zygapophyseal Joint Blocks. | 702 | ||
| Therapeutic Zygapophyseal Joint Injections. | 703 | ||
| Percutaneous Radiofrequency Ablation Medial Branch Neurotomy. | 703 | ||
| Cervical Internal Disk Disruption | 704 | ||
| Epidemiology | 704 | ||
| Diagnosis | 704 | ||
| History and Physical Examination. | 704 | ||
| Imaging Studies. | 704 | ||
| Treatment | 704 | ||
| Physical Medicine and Rehabilitation. | 704 | ||
| Interventional Spine Care | 705 | ||
| Provocation Diskography. | 705 | ||
| Transforaminal Epidural Steroid Injections. | 705 | ||
| Surgery | 705 | ||
| Cervical Myelopathy and Myeloradiculopathy | 705 | ||
| Epidemiology | 705 | ||
| Diagnosis | 706 | ||
| History and Physical Examination. | 706 | ||
| Imaging Studies. | 706 | ||
| Electrodiagnostic Evaluation. | 706 | ||
| Treatment | 706 | ||
| Nonoperative Care. | 706 | ||
| Surgery. | 707 | ||
| Cervicogenic Headaches | 707 | ||
| Epidemiology and Pathophysiology | 707 | ||
| Diagnosis | 708 | ||
| History and Physical Examination. | 708 | ||
| Imaging Studies. | 708 | ||
| Functional Diagnostic Tests and Treatment. | 708 | ||
| Whiplash Syndrome | 709 | ||
| Conclusion | 709 | ||
| Key References | 709 | ||
| References | 710.e1 | ||
| 33 Low Back Pain | 711 | ||
| Epidemiology | 711 | ||
| Public Health Perspective | 711 | ||
| Anatomy and Biomechanics of the Lumbar Spine | 711 | ||
| General Concepts | 711 | ||
| Vertebrae | 712 | ||
| Intervertebral Disk | 712 | ||
| Zygapophyseal Joints | 713 | ||
| Ligaments | 713 | ||
| Muscles | 714 | ||
| Muscles with Origins on the Lumbar Spine | 714 | ||
| Abdominal Musculature | 714 | ||
| Thoracolumbar Fascia | 714 | ||
| Pelvic Stabilizers | 714 | ||
| Nerves | 715 | ||
| Pain Generators of the Lumbar Spine | 715 | ||
| Aging Spine: A Degenerative Cascade | 716 | ||
| Centralization and Pain | 718 | ||
| Psychosocial Factors and Low Back Pain | 718 | ||
| Depression, Anxiety, and Anger | 718 | ||
| Patient Beliefs About Pain and Pain Cognition | 718 | ||
| History and Physical Examination of the Low Back | 718 | ||
| History | 718 | ||
| Physical Examination | 720 | ||
| Observation | 720 | ||
| Palpation | 720 | ||
| Range of Motion | 720 | ||
| Quantity of Range of Motion. | 720 | ||
| Quality of Range of Motion. | 721 | ||
| Neurologic Examination | 721 | ||
| Orthopedic Special Tests to Assess for Relative Strength and Flexibility | 721 | ||
| Orthopedic Special Tests for Lumbar Segmental Instability | 721 | ||
| Passive Intervertebral Motion Testing. | 722 | ||
| Prone Instability Test. | 722 | ||
| Examining the Area Above and Below the Lumbar Spine | 722 | ||
| Illness Behavior and Nonorganic Signs Seen on Physical Examination | 723 | ||
| Clinical Evaluation: Diagnostics | 724 | ||
| Imaging Studies | 724 | ||
| Plain Radiography | 724 | ||
| Magnetic Resonance Imaging | 724 | ||
| Computed Tomography | 725 | ||
| Myelography | 725 | ||
| Scintigraphy | 725 | ||
| Electromyography | 725 | ||
| Laboratory Studies | 726 | ||
| Differential Diagnosis and Treatment: Back Pain Greater Than Leg Pain | 726 | ||
| Nonspecific Low Back Pain | 726 | ||
| Lumbar Spondylosis | 726 | ||
| Lumbar Disk Disease | 727 | ||
| Internal Disk Disruption | 727 | ||
| Disk Herniation | 727 | ||
| Treatment of Low Back Pain | 728 | ||
| Reassurance and Patient Education | 728 | ||
| Back Schools | 728 | ||
| Exercise | 729 | ||
| Aquatic Exercises | 730 | ||
| Exercise After Spine Surgery | 730 | ||
| Medication | 730 | ||
| Nonsteroidal Antiinflammatory Drugs. | 730 | ||
| Muscle Relaxants. | 730 | ||
| Antidepressants. | 730 | ||
| Opioids. | 731 | ||
| Anticonvulsants. | 731 | ||
| Tramadol. | 731 | ||
| Systemic Steroids. | 731 | ||
| Herbal Medicines. | 731 | ||
| Antibiotics. | 731 | ||
| Topical Treatments. | 731 | ||
| Injections and Needle Therapy for Low Back Pain | 731 | ||
| Myofascial Pain and Trigger Point Injections. | 731 | ||
| Acupuncture. | 732 | ||
| Experimental Injection Procedures. | 732 | ||
| Steroid Injections and Other Spinal Procedures. | 732 | ||
| Manual Mobilization or Manipulation | 732 | ||
| Traction | 732 | ||
| Lumbar Supports | 732 | ||
| Transcutaneous Electrical Nerve Stimulation | 733 | ||
| Massage | 733 | ||
| Complementary Movement Therapies | 733 | ||
| Interdisciplinary Pain Treatment Programs | 733 | ||
| Treatment of Comorbidities | 733 | ||
| Prognosis of Low Back Pain | 734 | ||
| Spinal Fractures | 734 | ||
| Spondylolysis | 734 | ||
| Spondylolisthesis | 735 | ||
| Other Spinal Fractures | 736 | ||
| Posterior Column Fractures | 736 | ||
| Anterior Column Fractures | 736 | ||
| Anterior and Middle Column Fractures | 736 | ||
| Anterior and Posterior Column Fractures | 736 | ||
| Osteoporotic Compression Fractures | 736 | ||
| Treatment. | 736 | ||
| Cancer and Low Back Pain | 737 | ||
| Spinal Infections | 737 | ||
| Spondyloarthropathies | 738 | ||
| Ankylosing Spondylitis | 738 | ||
| Other Spondyloarthropathies | 738 | ||
| Differential Diagnosis and Treatment: Leg Pain Greater Than Back Pain | 738 | ||
| Lumbosacral Radiculopathy | 738 | ||
| Lumbar Spinal Stenosis | 740 | ||
| Nonlumbar Spine Causes of “Radicular” Leg Symptoms | 741 | ||
| Joint Disorders | 741 | ||
| Soft Tissue Disorders | 742 | ||
| Vascular Disorders | 742 | ||
| Peripheral Nerve Disorders | 742 | ||
| Low Back Pain in Special Populations | 742 | ||
| Low Back Pain in Pregnancy | 742 | ||
| Pediatric Low Back Pain | 743 | ||
| Acknowledgment: | 744 | ||
| Key References | 744 | ||
| References | 745.e1 | ||
| 34 Osteoporosis | 747 | ||
| Bone Function and Structure | 747 | ||
| Bone Remodeling | 747 | ||
| Pathogenesis | 748 | ||
| Classification of Osteoporosis | 748 | ||
| Hormones and Physiology of Bone | 748 | ||
| Role of Sex Steroids | 749 | ||
| Other Factors Affecting Bone Mass | 749 | ||
| Effect of Aging on Bone Mass | 749 | ||
| Clinical Manifestations of Osteoporosis | 750 | ||
| Fractures and Management | 750 | ||
| Vertebral Fracture | 751 | ||
| New Hypothesis on the Most Effective Exercise to Reduce the Risk for Vertebral Fracture | 752 | ||
| Vertebroplasty and Kyphoplasty | 752 | ||
| Hip Fracture | 752 | ||
| Hip Pads for Fracture Prophylaxis | 754 | ||
| Sacral Insufficiency Fracture | 754 | ||
| Diagnostic Studies in Osteoporosis | 754 | ||
| Treatment | 756 | ||
| Exercise | 757 | ||
| Posture Training Program and the Osteoporotic Skeletal Frame | 759 | ||
| Orthoses and the Osteoporotic Spine | 762 | ||
| Pharmacologic Interventions | 765 | ||
| Key References | 767 | ||
| References | 768.e1 | ||
| 35 Upper Limb Pain and Dysfunction | 769 | ||
| Upper Limb Physical Examination | 769 | ||
| Shoulder Special Tests | 769 | ||
| Anterior Apprehension and Relocation Tests | 769 | ||
| Posterior Apprehension Test | 769 | ||
| Sulcus Sign | 769 | ||
| O’Brien Test | 769 | ||
| Horizontal Adduction Test | 769 | ||
| Speed Test | 769 | ||
| Yergason Test | 769 | ||
| Neer-Walsh Impingement Test | 769 | ||
| Hawkins-Kennedy Impingement Test | 770 | ||
| Drop Arm Test | 770 | ||
| Elbow Special Tests | 770 | ||
| Cozen Test | 770 | ||
| Ligamentous Instability Test | 770 | ||
| Wrist and Hand Special Tests | 770 | ||
| Finkelstein Test | 770 | ||
| Watson Test | 770 | ||
| Rehabilitation Principles of Upper Limb Injury | 770 | ||
| Musculoskeletal Problems of the Upper Limb | 771 | ||
| Conditions of the Shoulder | 771 | ||
| Acromioclavicular Joint Sprains | 771 | ||
| Rotator Cuff Tendonitis and Impingement | 771 | ||
| Glenohumeral Joint Instability | 773 | ||
| Adhesive Capsulitis | 774 | ||
| Conditions of the Elbow | 775 | ||
| Lateral Epicondylitis | 775 | ||
| Medial Epicondylitis | 776 | ||
| Olecranon Bursitis | 776 | ||
| Ulnar Collateral Ligament Sprain | 776 | ||
| Conditions of the Forearm, Wrist, and Hand | 777 | ||
| De Quervain Syndrome | 777 | ||
| Scapholunate Instability | 777 | ||
| Triangular Fibrocartilage Complex Injuries | 778 | ||
| First Metacarpophalangeal Joint Ulnar Collateral Ligament Sprain | 779 | ||
| Conclusion | 779 | ||
| Key References | 779 | ||
| References | 780.e1 | ||
| 36 Musculoskeletal Disorders of the Lower Limb | 781 | ||
| Disorders of Muscle-Tendon Groups of the Lower Limb | 781 | ||
| Disorders of the Iliotibial Band, Including Trochanteric Bursitis | 781 | ||
| Disorders of the Hamstring Muscle Group | 783 | ||
| Disorders of the Adductor Muscle Group | 784 | ||
| Combined Muscle Group Injuries | 785 | ||
| Pes Anserine Tendonitis or Bursitis | 785 | ||
| Athletic Pubalgia and Sportsman’s Hernia | 785 | ||
| Injuries to the Quadriceps Muscle Group | 786 | ||
| Patellar Tendinopathy | 786 | ||
| Osgood-Schlatter Disease and Sinding-Larsen-Johansson Disease | 786 | ||
| Quadriceps Strain, and Quadriceps and Patella Tendon Rupture | 787 | ||
| Rectus Femoris Avulsion from the Anterior Inferior Iliac Spine | 788 | ||
| Quadriceps Contusions and Myositis Ossificans | 788 | ||
| Patellofemoral Arthralgia | 789 | ||
| Injuries to the Anterior Leg Muscle Group | 789 | ||
| Tibialis Anterior, Extensor Hallucis Longus, and Extensor Digitorum Longus | 789 | ||
| Injuries to the Posterior Leg Muscle Group and Associated Soft Tissue Structures | 789 | ||
| Gastrocnemius, Soleus, Tibialis Posterior, Flexor Hallucis Longus, and Flexor Digitorum Longus | 789 | ||
| Sever Disease | 790 | ||
| Flexor Hallucis Longus Overload | 790 | ||
| Tibialis Posterior Overload or Medial Tibial Stress Syndrome | 791 | ||
| Injuries to the Lateral Leg Muscle Group | 791 | ||
| Fibularis Longus and Brevis | 791 | ||
| Compartment Syndrome | 792 | ||
| Injury to the Plantar Foot Muscles and Plantar Fascia; Plantar Fasciitis | 792 | ||
| Disorders of the Joints of the Lower Limb | 793 | ||
| Osteoarthritis | 793 | ||
| Disorders of the Hip Joint | 794 | ||
| Avascular Necrosis | 794 | ||
| Legg-Calvé-Perthes Disease | 795 | ||
| Slipped Capital Femoral Epiphysis | 795 | ||
| Hip Dislocation | 796 | ||
| Labral Injuries | 796 | ||
| Impingement Syndromes | 796 | ||
| Disorders of the Knee Joint | 797 | ||
| Knee Ligament Injuries | 797 | ||
| Posterolateral Corner Injuries | 799 | ||
| Meniscal Injuries | 799 | ||
| Osteochondral Lesions (Osteochondritis Dissecans) | 799 | ||
| Prepatellar Bursitis | 800 | ||
| Disorders of the Ankle and Subtalar Joints | 800 | ||
| Sprains | 800 | ||
| Osteochondral Lesions of the Ankle | 801 | ||
| Miscellaneous Disorders of the Ankle and Foot | 801 | ||
| Morton Interdigital Neuroma, Metatarsalgia, and Sesamoiditis | 801 | ||
| Turf Toe | 802 | ||
| Bone Injuries of the Lower Limb | 802 | ||
| Stress Reactions and Stress Fractures | 802 | ||
| Summary | 805 | ||
| References | 806 | ||
| 37 Chronic Pain | 809 | ||
| Historical Overview | 809 | ||
| Pain Defined | 809 | ||
| Prevalence | 809 | ||
| Cost of Chronic Pain | 810 | ||
| Early History of Pain Theory: A Peripheral Perspective | 810 | ||
| Central Theories of Pain | 811 | ||
| History of Contemporary Advancements in Psychological Aspects of Pain | 812 | ||
| Physiology and Pathophysiology of Pain | 813 | ||
| Transduction | 813 | ||
| Transmission | 814 | ||
| Peripheral Sensitization | 814 | ||
| Modulation | 814 | ||
| Central Sensitization | 815 | ||
| Ascending and Descending Modulation | 815 | ||
| Psychological Issues Related to Chronic Pain | 816 | ||
| Affective Factors | 816 | ||
| Depression | 816 | ||
| Anxiety | 816 | ||
| Anger | 816 | ||
| Cognitive Factors | 817 | ||
| Learning Factors | 817 | ||
| Operant Learning | 817 | ||
| Fear of Movement | 817 | ||
| Behavioral Treatment Approaches | 817 | ||
| Operant Behavioral Techniques | 817 | ||
| Cognitive Behavioral Techniques | 818 | ||
| Sleep and Chronic Pain | 818 | ||
| Assessment | 818 | ||
| Treatment | 820 | ||
| Pain Treatment Programs | 820 | ||
| Interdisciplinary and Multidisciplinary Approaches | 821 | ||
| Interdisciplinary Treatment | 821 | ||
| Multidisciplinary Team | 821 | ||
| Physical Therapy and Occupational Therapy. | 821 | ||
| Psychology. | 822 | ||
| Vocational Rehabilitation. | 822 | ||
| Nurse Facilitator. | 823 | ||
| Medications | 823 | ||
| Nonsteroidal Antiinflammatory Drugs and Cyclooxygenase-2 Inhibitors | 823 | ||
| Opioid Analgesics | 825 | ||
| Anticonvulsant Medications as a Treatment for Neuropathic Pain Conditions | 825 | ||
| Antidepressants | 828 | ||
| Tricyclic Antidepressants and Selective Serotonin Reuptake Inhibitors. | 828 | ||
| Serotonin-Norepinephrine Reuptake Inhibitors. | 830 | ||
| Medication for Insomnia | 830 | ||
| Topical Analgesics | 831 | ||
| Mind-Body Medicine | 831 | ||
| Relaxation Training | 831 | ||
| Biofeedback | 831 | ||
| Summary | 832 | ||
| Key References | 832 | ||
| References | 833.e1 | ||
| 38 Pelvic Floor Disorders | 835 | ||
| Pelvic Floor Neuromusculoskeletal Anatomy | 835 | ||
| Overview of Terminology | 837 | ||
| Pelvic Floor Physical Examination | 838 | ||
| Types of Pelvic Floor Dysfunction | 839 | ||
| Urinary Incontinence | 839 | ||
| Definitions and Etiology | 839 | ||
| Epidemiology | 839 | ||
| Diagnosis and Physical Examination | 839 | ||
| Treatment | 839 | ||
| Urinary Urgency and Frequency | 840 | ||
| Definitions and Etiology | 840 | ||
| Diagnosis and Physical Examination | 840 | ||
| Index | 1163 | ||
| A | 1163 | ||
| B | 1166 | ||
| C | 1167 | ||
| D | 1172 | ||
| E | 1174 | ||
| F | 1175 | ||
| G | 1177 | ||
| H | 1178 | ||
| I | 1179 | ||
| J | 1181 | ||
| K | 1181 | ||
| L | 1181 | ||
| M | 1183 | ||
| N | 1187 | ||
| O | 1188 | ||
| P | 1189 | ||
| Q | 1193 | ||
| R | 1193 | ||
| S | 1195 | ||
| T | 1199 | ||
| U | 1201 | ||
| V | 1202 | ||
| W | 1203 | ||
| X | 1204 | ||
| Y | 1204 | ||
| Z | 1204 | ||
| Clinical Key ad | IBC2 |