Current Physical Medicine and Rehabilitation Reports最新文献

Purpose of review: Individuals with a history of traumatic brain injury (TBI) are at a much greater risk for developing cardiovascular disease (CVD) compared to the general population. This review discusses dietary patterns as a means of addressing modifiable risk factors following TBI exposure. Evidence-based resources for practicing Physiatrists and Brain Injury Medicine specialists pertaining to nutrition education and counseling are also provided.

Recent findings: We examined Mediterranean, Dietary Approaches to Stop Hypertension, plant-based, ketogenic, and intermittent fasting dietary patterns through publications of clinical trials and systematic reviews. While many reviews had significant positive findings, some were limited by generalizability.

Summary: While there is extensive literature on the immediate nutrition goals in the inpatient setting following an acute TBI exposure, there is limited literature discussing the nature of diet and nutrition in the post-acute setting. Fortunately, most individuals with TBI exposure survive their initial injury and continue into the recovery phase. The scientific literature supports increased morbidity and mortality with chronic TBI exposure compared to matched counterparts, most notably with CVD. A diet rich in fiber and nutrients but limited in added sugars, saturated fats, and excess calories would likely have the greatest cardiovascular and related neurologic protection. Future studies are needed to assess the specific impact of dietary interventions in the chronic phase of brain injury recovery.

Purpose of review: Spinal cord injury (SCI) creates unique needs that if not recognized and addressed timely can have detrimental effects on the health and quality of life (QOL) of people living with a SCI. Primary preventive health care is shown to decrease morbidity and mortality, yet the SCI population reportedly faces challenges getting access to this care. This area in SCI health care is still largely understudied with no consensus on the ideal way or which health care provider is best to provide primary care for this population.

Findings: Preventive care is generally provided by general primary care providers, but not all primary care providers are trained in recognizing and addressing spinal cord injury-specific needs. SCI providers generally are not trained in addressing all aspects of preventive care. Knowing the recommended preventive care screenings, recognizing and managing specific conditions seen after a SCI, and seamless coordination of care between general practitioners and SCI specialists are some of the interventions to help prevent health complications, decrease morbidity and mortality, improve health outcomes, and promote QOL in this patient population.

Summary: Prioritized focus on preventive care is necessary for a positive impact on the overall health and QOL in this population. Addressing the knowledge gap reported by primary care providers and SCI providers may help increase the probability of SCI patients getting their preventive and specialty care needs addressed. We present a "cheat sheet" of recommendations for the preventive care evaluation of a person living with a SCI.

Purpose of review: The increased use of musculoskeletal ultrasound (MSKUS) in clinical practice warrants achieving competency earlier in physiatrists' careers. Physical Medicine and Rehabilitation (PM&R) residency programs have started incorporating formal MSKUS training in their curricula; however, significant heterogeneity remains in MSKUS education.

Recent findings: Numerous barriers contribute to the lack of consensus for MSKUS training during residency, but the COVID-19 pandemic severely disrupted in-person learning. As an adjunct or alternative to in-person learning, teleguided technology is being utilized.

Summary: This curriculum demonstrates the role of a hybrid MSKUS training with interinstitutional collaboration. Twenty PM&R learners, from two institutions, were divided into a fundamental or advanced track. Virtual didactic sessions alternated weekly with hands-on ultrasonographic scanning sessions. Following a 12-month longitudinal curriculum, an end-of-year practical examination was used for competency assessment, in addition to a survey assessing resident perceptions and feedback. To our knowledge, this is the first collaborative and hybrid MSKUS curriculum for PM&R learners that can be easily reproduced at most training institutions and circumvent some of the barriers amplified by the COVID-19 pandemic.

Supplementary information: The online version contains supplementary material available at 10.1007/s40141-023-00380-z.