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Trusted for decades by Physical Therapy students as well as experienced therapists who want to improve their knowledge, Tecklin’s Pediatric Physical Therapy provides a comprehensive and logical overview of some of the most common pediatric physical therapy diagnoses. This straightforward approach presents basic medical information regarding common clinical diagnostic categories followed by coverage of physical therapy examination, intervention and special considerations within each diagnostic group. Content in this 6th Edition has been thoroughly updated and reorganized to help prepare students for today’s clinical challenges, accompanied by case studies and interactive features that reinforce understanding and instill the clinical decision-making skills essential to successful practice.
This revised, updated, and substantially expanded third edition provides an accessible, practical overview of major areas of research, technical development and clinical application in the field of neurorehabilitation movement therapy. The initial section provides the basic framework and a rationale for technology application in movement therapy by summarizing recent findings in neuroplasticity and motor learning. The following section provides a detailed overview of the movement physiology of various neurologic conditions, illustrating how this knowledge has been used to design various neurorehabilitation technologies. The third section then explains the principles of human-machine interaction for movement rehabilitation. The fourth section provides an overview of assessment technology and predictive modeling in neurorehabilitation. The fifth section provides a survey of technological approaches to neurorehabilitation, including spinal cord stimulation, functional electrical stimulation, virtual reality, wearable sensing, brain computer interfaces, mobile technologies, and telerehabilitation. The final two sections examine in greater detail the ongoing revolution in robotic therapy for upper extremity movement and walking, respectively. The promises and limitations of these technologies in neurorehabilitation are discussed, including an Epilogue which debates the impact and utility of robotics for neurorehabilitation. Throughout the book the chapters provide detailed practical information on state-of-the-art clinical applications of these devices following stroke, spinal cord injury, and other neurologic disorders and future developments in the field. The text is illustrated throughout with photographs and schematic diagrams which serve to clarify the information for the reader. Neurorehabilitation Technology, Third Edition is a valuable resource for neurologists, biomedical engineers, roboticists, rehabilitation specialists, physiotherapists, occupational therapists and those training in these fields. Chapter “Spinal Cord Stimulation to Enable Leg Motor Control and Walking in People with Spinal Cord Injury is available open access under a Creative Commons Attribution 4.0 International License via link.springer.com.
Constraint-Induced Movement therapy (CI therapy) is a behavioral approach to neurorehabilitation based on a program of neuroscience experiments conducted with monkeys. Evidence has accumulated to support the efficacy of CI therapy for rehabilitating hemiparetic arm use in individuals with chronic stroke. This book addresses the related topics.
Cerebral palsy is the most common movement disorder encountered in pediatric physical therapy practice. Physical Therapy for Children With Cerebral Palsy: An Evidence-Based Approach is a unique, comprehensive reference that focuses on physical therapy management of children with cerebral palsy through the analysis and synthesis of published research, and it offers evidence-based teaching and learning opportunities to a wide reading audience. Inside, Dr. Mary Rahlin examines the current approach to the diagnosis and classification of cerebral palsy and explores the research evidence related to prognosis; medical management; and physical therapy examination, evaluation, and intervention for children with this condition. Physical Therapy for Children With Cerebral Palsy analyzes cerebral palsy as a lifespan condition and utilizes the framework of International Classification of Functioning, Disability and Health (ICF). Sections include: Typical and atypical development of movement and postural control Cerebral palsy as a development disorder Medical management of alterations of body structures and functions by body systems Physical therapy management, including theoretical foundation, research evidence, and practice Normal and abnormal gait patterns and current evidence for orthotic management and assistive technology Transition to adult life Unique topics discussed: Variability, complexity, and adaptability in motor development The interdisciplinary team and effective interprofessional collaboration Assessment and management of therapy-related behavior Complementary and alternative interventions Segmental kinematic approach to orthotic management via ankle-foot-orthosis/footwear combination Other unique features include “Questions to Ponder” and “Suggested Questions for Future Research” at the end of each chapter. These are intended to generate healthy professional debate on a variety of topics, both in the classroom and in the clinic, and challenge the readers to plan new studies in search for evidence that will continue moving the pediatric physical therapy practice forward. Bonus! Also included with Physical Therapy for Children With Cerebral Palsy is online access to video clips that accompany the text and highlight typical and atypical development, use of assistive technology, life span issues, and transition to adulthood. Physical Therapy for Children With Cerebral Palsy: An Evidence-Based Approach is intended for physical therapy students, educators, residents, and experienced clinicians, including physical therapists, other members of the interdisciplinary team, and researchers working with children with cerebral palsy.
Note to Readers: Publisher does not guarantee quality or access to any included digital components if book is purchased through a third-party seller. This revised and greatly expanded sixth edition of Pediatric Rehabilitation continues to set the standard of care for clinicians and remains the premier reference dedicated to education and training in the field of pediatric rehabilitation medicine. Under the direction of a new editorial team, this text brings together renowned specialists from all sectors of the pediatric rehabilitation community to provide the most current and comprehensive information with evidence-based discussions throughout. The sixth edition encompasses substantial updates from beginning to end and addresses emerging topics in the field with eight entirely new chapters devoted to brachial plexus palsy, oncology, robotics, genetics, spasticity management, rheumatology, burns, and advocacy. Major revisions to chapters on spinal cord injuries, acquired brain injury, cerebral palsy, neuromuscular diagnoses, and medical care of children reflect recent advances and expand coverage to include pediatric stroke, anoxic brain injury, bone health, pain management, and more. Chapter pearls, detailed summary tables, and over 250 figures emphasize major takeaways from the text for readers. With contributors chosen both for their academic and clinical expertise, chapters offer a real hands-on perspective and reference the most up to date literature available. Pediatric Rehabilitation covers all aspects of pediatric rehabilitation medicine from basic examination and testing to in-depth clinical management of the full range of childhood disabilities and injuries. As the foundational reference dedicated to the field of pediatric rehabilitation medicine over 6 editions, the book provides a thorough and contemporary review of clinical practice principles and serves as the primary resource for trainees and clinicians in this area. Key Features: Thoroughly revised and expanded new edition of the seminal reference for the field of pediatric rehabilitation medicine Contains eight entirely new chapters to address areas of growing importance Increased coverage of core topics including brain injury and concussion in children, integrated spasticity management, lifespan care for adults with childhood onset disability, pediatric stroke, and much more 13 high-quality gait videos review ambulation in children and adults with cerebral palsy New editorial team and many new contributors provide new perspectives and a modern evidence-based approach Clinical pearls and highly illustrative tables and lists underscore most essential information
This thesis focuses on interventional aspects of spasticity, but has a very holistic approach, grounded in the specialty of Rehabilitation medicine. This means capturing the effects of spasticity, on such a complex biological system as the human being, living in a psychosocial context affecting the situation. When evaluating spasticity there are a number of levels of evidence. The first of course, understanding what we mean with spasticity, where there unfortunately is no consensus. The second level is to study if our treatments affect spasticity in a positive direction. The third is to grasp if a decrease in spasticity improve or normalize patient’s movement patterns. The fourth level investigates if improvement in movement patterns improve patient’s ability to perform activities; and the fifth level, comprising whether this intervention improves life satisfaction. Finally, on a societal level, we wish to investigate whether the improvement in life satisfaction or health related quality of life would motivate society to fund the intervention. Paper I on Goal Attainment Scaling pointed out necessary aspects to consider when using this instrument. This relates, among other things, to the need of learning (“the art of”) goal setting and deciding the purpose of the measurements. Research and clinical use puts different demands on the instrument, for the latter time-efficiency and simplicity to use being most important. For research, it is important to be able to register deterioration, and this can be achieved using the 6-step version. In paper II, concerning validation of the portable motion system, we showed this system to be valid for short-term measurements and that the use of Exposure Variation Analysis (EVA) seems to be a valuable tool for graphically elucidating different movements. The equipment needs further development in handling long-term measurements (which is effectuated), and norms for normal movements in different activities has to be produced. The discriminative value of EVA needs confirmation in coming studies. For the future, there is the intriguing possibility of long-term measurements in patients’ every-day life, thereby getting objective measures on how our patients use their abilities, thus capturing the difference between what you can do and what you actually do. The results from paper III demonstrated a large inequality in Sweden regarding the accessibility of BoNT-A treatment for spasticity. We could also show that treatment with BoNT-A is sound from a health-economic perspective, accounting for the uncertainty of data via the sensitivity analysis. For the future, we need to explore if this inequality also exists for other modes of spasticity treatments, e.g. multidisciplinary spasticity treatment and ITB pumps, and in other countries. In paper IV evaluating multifocal TES, the results could not confirm efficacy with the treatment according to the protocol of the manufacturer. The results have to be interpreted with care, as low compliance and frequent adverse events made deduction not captured in the RCT study. Further studies are needed in a number of areas, e.g. what is the optimal stimulation frequency, what patients can gain from the treatment and how should adjunct treatment be organized. In this thesis, I have had the privilege to explore different methods of evaluating spasticity interventions from a multimodal perspective as a starting point in an effort to understand more of this intriguing phenomenon. Some of the research questions above are already in the “pipeline” for coming studies; others are to be planned by our research group and others.
Transcranial direct current stimulation (tDCS) is a non-invasive stimulation technique that modulates brain function by increasing or decreasing cortical excitability (Nitsche & Paulus, 2001). In chronic stroke patients tDCS has been shown to improve function of the affected arm when combined with rehabilitative motor training (e.g. Lindenberg et al., 2010) and thus has the potential to accelerate motor learning. Its potential as a treatment for upper limb function in hemiplegic cerebral palsy (CP) had not been explored, which was the principle aim of this doctorate. After literature reviews on CP and tDCS (Chapter 1) feasibility work in healthy subjects was conducted to develop and validate the experimental procedures (Chapters 2 to 5). Chapter 2 examined whether tDCS improved motor performance of the non-preferred hand in healthy right-handed adults. The sophisticated kinematic outcome measures detected changes in performance due to learning, but no effect of tDCS was found. In Chapter 3, a novel motor learning task was developed and validated in healthy children and adolescents. This task was added to the study protocol and using a revised study design tDCS was found again to have no benefit on either motor performance or motor learning in healthy adults (Chapter 4). Tolerability, perception and acceptance of electrical stimulation were explored in Chapters 5 and 6, with the former showing that tDCS was well tolerated by healthy adults. Using a qualitative research methodology Chapter 6 established that teenagers with CP and their parents had concerns over the application of electricity on the scalp and how little is currently known of tDCS effects in CP. In Chapter 7, tDCS was applied to a teenager with hemiplegic CP with no clear beneficial effects. Finally, the contribution of this doctoral work with regard to the use of tDCS for the rehabilitation of motor function in CP is discussed in Chapter 8.
When a child has a health problem, parents want answers. But when a child has cerebral palsy, the answers don't come quickly. A diagnosis of this complex group of chronic conditions affecting movement and coordination is difficult to make and is typically delayed until the child is eighteen months old. Although the condition may be mild or severe, even general predictions about long-term prognosis seldom come before the child's second birthday. Written by a team of experts associated with the Cerebral Palsy Program at the Alfred I. duPont Hospital for Children, this authoritative resource provides parents and families with vital information that can help them cope with uncertainty. Thoroughly updated and revised to incorporate the latest medical advances, the second edition is a comprehensive guide to cerebral palsy. The book is organized into three parts. In the first, the authors describe specific patterns of involvement (hemiplegia, diplegia, quadriplegia), explain the medical and psychosocial implications of these conditions, and tell parents how to be effective advocates for their child. In the second part, the authors provide a wealth of practical advice about caregiving from nutrition to mobility. Part three features an extensive alphabetically arranged encyclopedia that defines and describes medical terms and diagnoses, medical and surgical procedures, and orthopedic and other assistive devices. Also included are lists of resources and recommended reading.