Biomedical subjects
Publications and source records attributed to Karen P Barr.
Foot and ankle injuries are common in runners. Treatment is becoming more evidence-based for the most common of these conditions; however, further research is needed to determine the best treatments for injuries that are encountered less commonly.
The factors that affect lumbar stability have been an area of extensive research. The clinical application of this research in the form of lumbar stabilization exercise programs has become a common treatment of low back pain and is also increasingly used by athletes to improve performance and by the general public for health and the prevention of injury. This article includes a review of the key concepts behind lumbar stabilization. The literature regarding how those with low back pain differ in their ability to stabilize the spine from those without low back pain is discussed, and an overview of current research that assesses the benefits of a lumbar stabilization program to treat low back pain is provided.
We have reviewed the literature relevant to pathophysiology, diagnosis, treatment, and prognosis of whiplash-associated disorder (WAD) since 1995 and provided a brief summary of literature pertaining to forces action on the head and neck during a motor vehicle accident. The scope of the current review is confined to the Quebec guidelines for WAD grades 1-3 but excludes grade 4 (neck complaints and fracture or dislocation). After excluding papers without scientific data and single case reports or case series with fewer than 20 patients, articles were reviewed for methodological quality. The diagnosis remains clinical. No imaging, physiological, or psychological study provides specific diagnostic criteria. In the acute period up to 2 weeks, soft collars or rest and work-leave do not shorten the duration of neck pain. Sick leave is reduced by high-dose methylprednisolone given within 8 h of injury, but confirmatory studies examining the cost-benefit relationship are needed. In the first 6 months, active as opposed to passive treatment results in improved outcomes. Specific exercise strategies have not been studied. For those with symptoms lasting more than 6 months, percutaneous radio-frequency neurotomy can provide pain relief for many months in those responding to blind local anesthetic facet blocks. Intra-articular corticosteroids are ineffective. Uncontrolled trials suggest that multimodal rehabilitation programs result in improved overall function. The overall prognosis for recovery has varied considerably across studies. Such variability is likely due to differences in case identification methods and whether outcome is assessed in terms of symptoms or the receipt of financial compensation for injury. The impact on prognosis of both collision- and patient-related factors is also reviewed.
Rotator cuff disease is a complex condition. It includes a variety of pathologies, ranging from tendinosis to complete tear. The cause seems to be multifactorial and is most likely a combination of major trauma, microtrauma from daily wear and tear, and age related degeneration. When establishing a program for the patient with rotator cuff dysfunction, the rehabilitation specialist should consider biomechanical factors, the patient's functional goals, and issues beyond the shoulder that may affect the course of the disease.