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Journals Physical Medicine and Rehabili...

Physical Medicine and Rehabilitation Clinics of North America

https://read.qxmd.com/read/37993198/disorders-of-consciousness
#1
EDITORIAL
Sunil Kothari, Bei Zhang
No abstract text is available yet for this article.
February 2024: Physical Medicine and Rehabilitation Clinics of North America
https://read.qxmd.com/read/37993197/rehabilitation-management-of-disorders-of-consciousness
#2
EDITORIAL
Blessen C Eapen
No abstract text is available yet for this article.
February 2024: Physical Medicine and Rehabilitation Clinics of North America
https://read.qxmd.com/read/37993196/special-considerations-in-behavioral-assessments-for-disorders-of-consciousness
#3
REVIEW
Katherine O'Brien, Bei Zhang, Elizabeth Anderl, Sunil Kothari
Behavioral assessment remains the cornerstone of the clinical evaluation of disorders of consciousness (DoC). Because the basic approach to these evaluations has been extensively reviewed elsewhere, this article focuses on special considerations in the behavioral assessment of patients with a DoC. All therapy disciplines (physical therapy/occupational therapy/speech language pathologist) have a significant role to play and other staff and family members should also be encouraged to share their observations...
February 2024: Physical Medicine and Rehabilitation Clinics of North America
https://read.qxmd.com/read/37993195/evaluation-and-management-of-disorders-of-consciousness-in-the-acute-care-setting
#4
REVIEW
Ruth Tangonan, Christos Lazaridis
Acute disorders of consciousness (DOC) are impairments in arousal and awareness that occur within 28 days of an initial injury and can result from a variety of insults. These states range from coma, unresponsive wakefulness, covert consciousness, minimal consciousness, to confusional state. It is important to perform thorough, serial examinations with particular emphasis on the level of consciousness, brainstem reflexes, and motor responses. Evaluation of acute DOC includes laboratory tests, imaging, and electrophysiology testing...
February 2024: Physical Medicine and Rehabilitation Clinics of North America
https://read.qxmd.com/read/37993194/disorders-of-consciousness-programs-components-organization-and-implementation
#5
REVIEW
Kristen A Harris, Yi Zhou, Stacey Jou, Brian D Greenwald
Rehabilitation of patients with disorders of consciousness (DoC) presents unique challenges requiring comprehensive and specialized care. This article reviews the components, organization, and implementation of an inpatient DoC program under the framework of recent evidence-based practice guidelines and minimum competency recommendations. The evidence and clinical applications of these recommendations are elaborated upon with the goal of offering providers a reference to translate guidelines into clinical practice...
February 2024: Physical Medicine and Rehabilitation Clinics of North America
https://read.qxmd.com/read/37993193/neuroimaging-in-disorders-of-consciousness-and-recovery
#6
REVIEW
Linda B Xu, Stephen Hampton, David Fischer
There is a clinical need for more accurate diagnosis and prognostication in patients with disorders of consciousness (DoC). There are several neuroimaging modalities that enable detailed, quantitative assessment of structural and functional brain injury, with demonstrated diagnostic and prognostic value. Additionally, longitudinal neuroimaging studies have hinted at quantifiable structural and functional neuroimaging biomarkers of recovery, with potential implications for the management of DoC.
February 2024: Physical Medicine and Rehabilitation Clinics of North America
https://read.qxmd.com/read/37993192/structural-and-functional-neuroanatomy-of-core-consciousness-a-primer-for-disorders-of-consciousness-clinicians
#7
REVIEW
David B Arciniegas, Lindsey J Gurin, Bei Zhang
Understanding the structural and functional neuroanatomy of core consciousness (ie, wakefulness and awareness) is an asset to clinicians caring for persons with disorders of consciousness. This article provides a primer on the structural and functional neuroanatomy of wakefulness and awareness. The neuroanatomical structures supporting these elements of core consciousness functions are reviewed first, after which brief description of the clinically evaluable relationships between disruption of these structures and disorders of consciousness (ie, brain-behavior relationships) are outlined...
February 2024: Physical Medicine and Rehabilitation Clinics of North America
https://read.qxmd.com/read/37993191/disorders-of-consciousness-in-children-assessment-treatment-and-prognosis
#8
REVIEW
Beth S Slomine, Stacy J Suskauer
Children with acquired brain injury may experience prolonged disorders of consciousness (DoC); research on children with DoC lags behind adult literature. Rigorous evaluation of assessment tools used in children with DoC is lacking, though recent developments may contribute to improvements in care, particularly for assessment of young children and those without overt command following. Literature on prognosis continues to grow, reinforcing that early signs of consciousness suggest better long-term outcome. Although large clinical trials for children with DoC are lacking, single-site and multisite programmatic data inform standards of care and treatment options for children with DoC...
February 2024: Physical Medicine and Rehabilitation Clinics of North America
https://read.qxmd.com/read/37993190/disorders-of-consciousness-rehabilitation-ethical-dimensions-and-epistemic-dilemmas
#9
REVIEW
Michael J Young
Patients with disorders of consciousness who survive to discharge following severe acute brain injury may face profoundly complex medical, ethical, and psychosocial challenges during their courses of recovery and rehabilitation. Although issues encountered in caring for such patients during acute hospitalization have received substantial attention, ethical challenges that may arise in subacute and chronic phases have been underexplored. Shedding light on these issues, this article explores the landscape of normative issues in the course of treating and facilitating access to care for persons with disorders of consciousness during rehabilitation and examines potential implications for patients, clinicians, family members, and society...
February 2024: Physical Medicine and Rehabilitation Clinics of North America
https://read.qxmd.com/read/37993189/education-training-and-support-across-the-continuum-of-recovery-for-caregivers-of-persons-with-disorders-of-consciousness
#10
REVIEW
Amy Shapiro-Rosenbaum, Michelle P Jaffe
Evolving knowledge highlights the deleterious effects of caregiving on the emotional, psychosocial, and financial well-being of caregivers of persons with disorders of consciousness (DoC). Current practice guidelines and minimal competency recommendations emphasize the importance of identifying and addressing DoC caregiver needs. This article serves as a dissemination tool to enhance communication between providers and caregivers. Essential components of education and training are outlined for each level of care...
February 2024: Physical Medicine and Rehabilitation Clinics of North America
https://read.qxmd.com/read/37993188/emergence-from-disorders-of-consciousness-optimizing-self-agency-through-communication
#11
REVIEW
Brooke Murtaugh, Susan Fager, Tabatha Sorenson
Language and communication deficits are intrinsic to disorders of consciousness. This article will provide an overview of language and communication deficits that can significantly confound the accuracy of diagnostic assessment in these patients. Authors will also discuss interventions to promote early communication using assistive technology and augmentative communication rehabilitation strategies. Finally, this article will discuss the importance of family education as well as ethical considerations connected to the recovery of communication and adaptive strategies to support patient autonomy and enhance self-agency...
February 2024: Physical Medicine and Rehabilitation Clinics of North America
https://read.qxmd.com/read/37993187/prognostication-and-trajectories-of-recovery-in-disorders-of-consciousness
#12
REVIEW
Mary E Russell, Cindy B Ivanhoe, Eboni A Reed
Historically, there has been a pessimistic view regarding outcomes for patients with disorders of consciousness (DoC). There is a paucity of clinical diagnostic tools and prognostic protocols. Guidelines for the care of patients with DoC require behavioral observation, time, resources, and knowledge of the population. Many nonclinical factors such as patient wishes, family perception, and personal finances can indirectly influence long-term outcomes. Prognostic expectations need to be considered but we health-care professional cannot fully appreciate the decisions and influence of those decisions on the person served or on the care providers involved...
February 2024: Physical Medicine and Rehabilitation Clinics of North America
https://read.qxmd.com/read/37993186/pharmacology-in-treatment-of-patients-with-disorders-of-consciousness
#13
REVIEW
Michael H Marino
Pharmacologic treatment of disorders of consciousness remains a critical but challenging task for clinicians. Amantadine has been shown to promote the rate of neurologic recovery for patients with traumatic disorders of consciousness when administered between 4 and 16 weeks, as demonstrated by a well-designed randomized control trial. While there are no large, randomized controlled trials to support the use of other dopaminergic medicines (bromocriptine, levodopa, apomorphine), there is a large body of literature implicating their role in improving alertness and responsiveness in disorders of consciousness...
February 2024: Physical Medicine and Rehabilitation Clinics of North America
https://read.qxmd.com/read/37993185/disorders-of-consciousness-classification-and-taxonomy
#14
REVIEW
Katherine Golden, Yelena G Bodien, Joseph T Giacino
In this article, we discuss the taxonomy associated with the four major disorders of consciousness (DoC): coma, vegetative state or unresponsive wakefulness syndrome, minimally conscious state, and post-traumatic confusional state. We briefly review the history of each disorder and then provide operational definitions and diagnostic criteria for each one. We rely heavily on recently released practice guidelines and, where appropriate, identify knowledge gaps and discuss future directions to advance DoC research and practice...
February 2024: Physical Medicine and Rehabilitation Clinics of North America
https://read.qxmd.com/read/37993184/strategy-and-philosophy-for-treating-pain-and-sleep-in-disorders-of-consciousness
#15
REVIEW
Amanda Appel, Eric Spier
Despite the evolving practice of brain injury medicine, consciousness remains enigmatic. Most patients with disorders of consciousness have disordered sleep and return of normal sleep architecture is essential to the emergence of consciousness and the healing brain. In this article we lay a framework for understanding the emergence of consciousness in brain-injured patients. We then explore ways to use that framework to evaluate and tailor treatment of sleep and pain in patients with disorders of consciousness...
February 2024: Physical Medicine and Rehabilitation Clinics of North America
https://read.qxmd.com/read/37993183/medical-neurologic-and-neuromusculoskeletal-complications
#16
REVIEW
Jean E Woo, Abana Azariah, Eboni A Reed, Nicholas Gut
For patients with disorders of consciousness (DoC), treating the medical, neurologic, and neuromuscular complications not only stabilizes their medical disturbances, but minimizes confounding factors that may obscure the ability to accurately identify the level of consciousness and increase the chance of patients' neurologic and functional recovery. Lack of reliable communication and low-level function of patients with DoC make it challenging to diagnose some of the complications. Skilled clinical observation will be imperative to appropriately care for the patients...
February 2024: Physical Medicine and Rehabilitation Clinics of North America
https://read.qxmd.com/read/37993182/technological-modalities-in-the-assessment-and-treatment-of-disorders-of-consciousness
#17
REVIEW
Gang Liu, Bradley Chi
Over the last 10 years, there have been rapid advances made in technologies that can be utilized in the diagnosis and treatment of patients with a disorder of consciousness (DoC). This article provides a comprehensive review of these modalities including the evidence supporting their potential use in DoC. This review specifically addresses diagnostic, non-invasive therapeutic, and invasive therapeutic technological modalities except for neuroimaging, which is discussed in another article. While technologic advances appear promising for both assessment and treatment of patients with a DoC, high-quality evidence supporting widespread clinical adoption remains limited...
February 2024: Physical Medicine and Rehabilitation Clinics of North America
https://read.qxmd.com/read/37993181/conceptualizing-consciousness-a-change-in-perspective-the-elephant-still-surprises-those-only-touching-its-trunk
#18
REVIEW
Mariel Kalkach Aparicio, Christos Lazaridis
Providers of patients with disorders of consciousness (DoC) face clinical and ethical challenges that could be lessened by becoming acquainted with the subjective and objective aspects of consciousness. A first step to improving DoC taxonomies, management, and outcomes might be to recognize the shortcomings of the medical concept of consciousness and to improve the terminology used for the clinical parameters assessed. The authors critically review the medical perspective of consciousness represented by three sub-concepts that do not necessarily correlate with one another and discuss how none of them reflects fully the personal subjective nature of consciousness...
February 2024: Physical Medicine and Rehabilitation Clinics of North America
https://read.qxmd.com/read/37806706/evolution-of-burn-rehabilitation
#19
EDITORIAL
Karen Kowalske
No abstract text is available yet for this article.
November 2023: Physical Medicine and Rehabilitation Clinics of North America
https://read.qxmd.com/read/37806705/burn-rehabilitation
#20
EDITORIAL
Blessen C Eapen
No abstract text is available yet for this article.
November 2023: Physical Medicine and Rehabilitation Clinics of North America
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