A New Jersey team of researchers has reported the successful, long-term relief of chronic refractory shoulder pain in a wheelchair user with spinal cord injury (SCI) following a single injection of autologous, micro-fragmented adipose tissue into the affected shoulder joint. The article, “Autologous micro-fragmented adipose tissue as a treatment for chronic shoulder pain in a wheelchair using individual with spinal cord injury: a case report” (doi: 10.1038/s41394-019-0186-8) was epublished ahead of print on May 13, 2019 by Spinal Cord Series and Cases. This is the first reported use of this intervention for shoulder pain in an individual with spinal cord injury who has failed to improve with conservative care, such as physical therapy and pharmacological agents.
The authors are Chris Cherian, MD, of Rutgers New Jersey Medical School, Gerard Malanga, MD, of the New Jersey Regenerative Institute and Kessler Institute for Rehabilitation, Trevor Dyson-Hudson, MD, and Nathan Hogaboom, PhD, of Kessler Foundation, and Michael A. Pollack, MD, of Montclair Radiology.
Researchers continue to dig for molecular clues to better understand how gene-environment interactions influence neuropsychiatric disease risk and resilience. An increasing number of studies point to a strong association between the FKBP5 gene and increased susceptibility to depression, anxiety, post-traumatic stress disorder and other mental health disorders.
Adding to the growing evidence, a new preclinical study by University of South Florida neuroscientists finds that anxiety-like behavior increases when early life adversity combines with high levels of FKBP5 – a protein capable of modifying hormonal stress response. Moreover, the researchers demonstrate this genetic-early life stress interaction amplifies anxiety by selectively altering signaling of the enzyme AKT in the dorsal hippocampus, a portion of the brain primarily responsible for cognitive functions like learning and memory.
The plan was set: on May 21, APTA would hold a congressional briefing on the importance of increasing patient access to nonpharmacological approaches to pain treatment. The event would be highlighted by the story of Cindy Whyde and her son Elliott, who became addicted to prescription opioids, and eventually heroin, after receiving an opioid prescription to treat a high school football injury 9 years ago. Elliott’s road to recovery has not been easy.
But the briefing didn’t go as planned. Days before the Whydes were to travel to Washington, DC, Elliott relapsed into addiction and disappeared. Cindy came to the event alone, determined to do whatever she could to effect change. At the time of the event Elliott had been missing for 3 days.
“That is one of the worst fears any parent should have to go through, not knowing where their child is and what’s going on with them,” Whyde said.
An in-home exercise program reduced subsequent falls in high-risk seniors by 36 per cent, according the results of a 12-month clinical trial published today in the Journal of the American Medical Association.
The study, conducted by UBC faculty of medicine researchers in partnership with the clinical team at the Falls Prevention Clinic at Vancouver General Hospital, found a reduction in fall rate and a small improvement in cognitive function in seniors who received strength and balance training through the clinical trial.
Falls increase risk of injury and loss of independence for older adults. Exercise is a widely recommended fall prevention strategy, but whether it can reduce subsequent falls in those who have previously fallen is not well established.
Scoliosis causes the spine to curve sideways, causing pain, weakness, and changes in the way a person walks. Exercise and stretching are vital components of treatment.
In mild cases, people can treat scoliosis with specific exercises and stretches alone, eliminating the need for surgery.
While some medical conditions can cause scoliosis, the most typical form of scoliosis is adolescent idiopathic scoliosis. This form of scoliosis develops while a person is still growing and affects 2–3%of the population.
While research has found evidence supporting specific exercises for scoliosis, it is a good idea for a person with scoliosis to speak to a doctor or physical therapist about the best stretches and exercises for them.
When it comes to technology, virtual reality is a hot trend making its way into the medical field.
It’s like a high-tech game, with patients “playing” rehab programs that specifically challenge 24 different deficits.
For example, a stroke patient stretches out a weak arm and maneuvers objects on the screen while at the same time focusing on improving visual neglect. And to improve sequencing and planning of movement, computer-generated prompts and sounds can initiate the activity.
“When you compare yesterday’s rehab to today’s technology, it’s evident that patients are more engaged in their outcomes,” says Brain Rosenberg, physical therapist at Bioness.
Researchers at Karolinska Institutet in Sweden have developed a stem cell based model in order to study the resilience and vulnerability of neurons in the neurodegenerative disease ALS.
The results, published in the journal Stem Cell Reports, may help aid in the identification of new genetic targets for treatments protecting sensitive neurons, they suggest, in a media release from Karolinska Institutet.
“This cell culture system can help identify new genes contributing to the resilience in oculomotor neurons that could be used in gene therapy to strengthen sensitive motor neurons,” explains Eva Hedlund, docent at the Department of Neuroscience at Karolinska Institutet, who led the study.
The road to recovery after a moderate-to-severe traumatic injury can be daunting for anyone, but a new study suggests that individuals who are African American may face an even more challenging path. Researchers found that in groups matched for age, injury type, and injury severity, African Americans were on average 36% less likely to use rehabilitation services and 40% less likely to have outpatient visits postdischarge.
The presence of the apparent difference echoes APTA’s characterization of racial and ethnic disparities as existing “across a range of illnesses and health care services.”
The study’s conclusions are based on an analysis of 2.5 years’ worth of patient-reported data linked to trauma treatment records from 3 Boston-area level 1 trauma centers participating in the Functional Outcomes and Recovery after Trauma (FORTE) project. Patients included in the study experienced moderate-to-severe trauma, defined as an Injury Severity Score (ISS) of 9 or greater, and participated in phone interviews conducted 6 to 12 months after trauma center discharge. Results were published in the American Journal of Surgery.
A multidisciplinary group of researchers, including physical therapists (PTs), has identified a core set of 11 clinical practice guideline (CPG) recommendations for treating adult musculoskeletal (MSK) pain, according to a new article in British Journal of Sports Medicine (BJSM). Authors hope the recommendations will assist emergency and primary care clinicians in providing evidence-based care, as well as help consumers make informed health care decisions.
Authors write that while “care that is more concordant with CPG recommendations results in better patient outcomes and lower costs,” providers across disciplines too often do not practice according to guidelines, resulting in overuse of imaging, surgery, and opioids, and a failure to provide patient education and advice. There are many reasons for this, according to authors: CPGs often are not “user-friendly”; they often lack guidance on how to implement recommendations in practice; and different guidelines for a single condition may include conflicting recommendations.