Selections From This Month in the Archives

Article Outline

• Does Treadmill Exercise Improve Performance of Cognitive or Upper-Extremity Tasks in People With Chronic Stroke? A Randomized Cross-Over Trial
• Sources of Sacroiliac Region Pain: Insights Gained From a Study Comparing Standard Intra-Articular Injection With a Technique Combining Intra- and Peri-Articular Injection
• Control of a Six Degree of Freedom Prosthetic Arm After Targeted Muscle Reinnervation Surgery
• Trends in the Supply of Inpatient Rehabilitation Facilities Services: 1996 to 2004

Michelle Ploughman, PhD, PT

Jason McCarthy, MD

Melissa Bossé, BSc

Heather J. Sullivan, BKin

Dale Corbett, PhD

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Does Treadmill Exercise Improve Performance of Cognitive or Upper-Extremity Tasks in People With Chronic Stroke? A Randomized Cross-Over Trial 

Research suggests that exercise may be associated with improvements in cognition. Ploughman and colleagues examined whether a single session of moderate intensity treadmill exercise could produce similar improvements following stroke. The study involved 21 adults with stroke who underwent cognitive (eg, Trail Making Test Parts A and B) and motor skill (Action Research Arm Test) testing after participating in either a session of body-weight supported treadmill training (BWSTT) or a similar period of sedentary therapy. Analysis revealed that while the BWSTT did not appear to alter the subjects' cognitive testing scores that it was associated with improvements in the function of their impaired upper extremity. The authors conclude that BWSTT may improve a paretic arm's movement but that these improvements are not associated with changes in attention, visuomotor processing, or strength. • SEE PAGE 2041

Claude D. Borowsky, MD, MPhil

Glenn Fagen, PhD

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Sources of Sacroiliac Region Pain: Insights Gained From a Study Comparing Standard Intra-Articular Injection With a Technique Combining Intra- and Peri-Articular Injection 

Borowsky and Fagen examine the benefits of 2 injection techniques in a retrospective study of 120 patients with sacroiliac (SI) pain. All subjects received the same amount of steroid injectionate. However, 40 underwent only a conventional fluoroscopically guided intra-articular SI injection. The remaining 80 underwent a similar intra-articular injection but also received half of the steroidal injectionate in their peri-articular tissues. The investigators found that the 12% success rate (defined as a 50% reduction in visual analog scale pain scores) for the isolated intra-articular injections at the end of 3 months was significantly less than that of the 31% rate of the combined intra- and peri-articular injections (P=0.025). The authors also noted that anesthetic effects were poorly predictive of outcome and concluded that intra-articular diagnostic blocks underestimate the prevalence of SI region pain. • SEE PAGE 2048

Laura A. Miller, PhD, CP

Robert D. Lipschutz, CP

Kathy A. Stubblefield, OT

Blair A. Lock, MS

He Huang, PhD

T. Walley Williams, III, MA

Richard F. Weir, PhD

Todd A. Kuiken, MD, PhD

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Control of a Six Degree of Freedom Prosthetic Arm After Targeted Muscle Reinnervation Surgery 

Miller and colleagues address the dexterity limitations of current upper-extremity prostheses with a proof of concept investigation of a new prosthetic limb in a man with bilateral shoulder disarticulations who had undergone muscle reinnervation surgery and 2 years later was fit with a 6 degree of freedom (DOF) prosthesis. Limb movement and task performance were assessed with the subject using the new device as well as his conventional prosthesis. The findings indicated that use of the new prosthesis was associated with improvements in his ability to perform a number of 2 DOF movements but that more complex activities were marked by a deterioration in control. The authors conclude that their new prosthesis can improve prosthetic movement but that more advanced control systems are needed. • SEE PAGE 2057

Trudy R. Mallinson, PhD

Larry M. Manheim, PhD

Orit Almagor, MA

Holly M. DeMark, BA

Allen W. Heinemann, PhD

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Trends in the Supply of Inpatient Rehabilitation Facilities Services: 1996 to 2004 

Mallinson and colleagues performed a retrospective study to assess the impact reimbursement changes, particularly the introduction of the prospective payment system (PPS) in 2002, on 1424 inpatient rehabilitation facilities (IRFs). The investigators utilized the Healthcare Cost Report Information System database and found that the number of IRFs grew both before (by 146 between 1996 and 2001) and after (by a further 52) the introduction of the PPS. They also noted that the total number of inpatient IRF days increased in the period prior to the PPS but decreased after its introduction. The authors conclude that the impact of the PPS on IRF openings and closings was modest but that policies such as the “75% rule,” designed to limit IRF admissions, would likely have a significant impact on IRF utilization. • SEE PAGE 2066