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  • Online Resource  (5)
  • Ovid Technologies (Wolters Kluwer Health)  (5)
  • 2020-2024  (5)
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  • Online Resource  (5)
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  • Ovid Technologies (Wolters Kluwer Health)  (5)
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  • 2020-2024  (5)
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  • 1
    Online Resource
    Online Resource
    Validation of a Brief Cognitive Screening Examination in an Adult Acute Inpatient Rehabilitation Population
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Topics in Geriatric Rehabilitation Vol. 36, No. 2 ( 2020-04), p. 122-126
    Details
    In: Topics in Geriatric Rehabilitation, Ovid Technologies (Wolters Kluwer Health), Vol. 36, No. 2 ( 2020-04), p. 122-126
    Abstract: To establish validity of a Brief Cognitive Screening Examination (BCSE) to identify patients requiring further cognitive testing. Methods: A total of 100 adult inpatients at a university acute inpatient rehabilitation facility were given the Mini-Mental State Examination (MMSE), Clock Draw Test (CDT), and BCSE. The BCSE is a 2-minute test to assess registration, concentration, working memory, and calculation. Results: Univariate linear regression analysis demonstrated that BCSE scores of 16 predicted the MMSE score of 28 ( P 〈 .01) and BCSE of 12 or less predicted the MMSE less than 24 ( P 〈 .01). Conclusion: The BCSE is a valid, time-efficient, bedside cognitive screen that identifies patients who would benefit from further cognitive evaluation.
    Type of Medium: Online Resource
    ISSN: 0882-7524
    URL: Article
    DOI: 10.1097/TGR.0000000000000267
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 2093174-8
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    Online Resource
  • 2
    Online Resource
    Online Resource
    Abstract 76: Estimating The Impact Of Hospital-level Variation In The Use Of Inpatient Rehabilitation Facilities Versus Skilled Nursing Facilities On Individual Stroke Patients
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Stroke Vol. 54, No. Suppl_1 ( 2023-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 54, No. Suppl_1 ( 2023-02)
    Abstract: Introduction: Observational studies indicate that stroke rehabilitation at Inpatient Rehabilitation Facilities (IRFs) is superior to Skilled Nursing Facilities (SNFs). Nationally, IRF vs. SNF use varies widely at the hospital level, but the impact on individual patients is unclear. Our objective was to quantify the effect of the admitting hospital on the probability of receiving IRF or SNF care for individual stroke patients. Methods: Medicare claims data (2011-2014) was used to generate a cohort of acute ischemic and hemorrhagic stroke patients who were discharged to IRFs or SNFs. We generated 2 multivariable effects logistic regression models. Model 1 predicted IRF admission (vs. SNF) using only patient-level factors as fixed effects, whereas Model 2 added a hospital random effect. The impact of the admitting hospital on an individual patients’ probability of IRF care was estimated by taking the difference in predicted probabilities (p^) between the 2 models. Hospital effects were categorized as moderate (10-19%) or large ( 〉 20%) based on the change in size of p^. The magnitude and direction of the random effect terms in Model 2 was used to categorize individual hospitals as being either neutral, SNF-, or IRF- favoring. Results: The cohort included 1,816 acute care hospitals which discharged 135,415 patients to IRFs (n=66,548) or SNFs (n= 68,867). Half of the hospitals were categorized as neutral (n=870, 47.9%) with the remaining being SNF- favoring (n=485, 26.7%) or IRF- favoring (n=461, 25.4%). For half of all patients, acute care hospital had a moderate influence on the type of rehabilitation that they received. For SNF and IRF-favoring hospitals, there were large (55% and 37% of patients) or moderate (30% and 42% of patients) hospital effects on discharge setting for the majority of patients. Conclusion: For the majority of stroke patients, which acute care hospital they happen to be admitted to meaningfully impacts the type of rehabilitation care they receive
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.54.suppl_1.76
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 1467823-8
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    Online Resource
  • 3
    Online Resource
    Online Resource
    Frequency of Electrodiagnostically Measurable Berrettini Anastomosis
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Journal of Clinical Neurophysiology Vol. 37, No. 3 ( 2020-05), p. 214-219
    Details
    In: Journal of Clinical Neurophysiology, Ovid Technologies (Wolters Kluwer Health), Vol. 37, No. 3 ( 2020-05), p. 214-219
    Abstract: Ulnar sensory palmar crossover to digit three (D3), the Berrettini anastomosis, is measurable in routine electrodiagnostic nerve conduction studies. The crossover is reported as occurring in 60% of anatomic dissections, but the frequency of measurable ulnar crossover to D3 and its potential as a nerve conduction pitfall is not established. The purpose of this article was to present descriptive statistics regarding the frequency of measurable Berrettini anastomosis in nerve conduction studies. Methods: A retrospective chart review and data analysis was completed on 248 patients representing 411 extremities with a main outcome measure of ulnar sensory stimulated nerve conduction simultaneous waveform recording on D3 and digit four (D4). Consistent electrodiagnostic technique with waveform recording data analysis in a private practice and independent university waveform verification was completed on sequential patients referred for upper extremity electrodiagnostic testing. Results: Measurable ulnar stimulated D3 sensory nerve action potentials were demonstrated in 34% of patients with amplitudes of 27%, the simultaneously recorded corresponding ulnar D4 amplitudes representing electrophysiological evidence of ulnar sensory crossover. Conclusions: The Berrettini anastomosis can frequently be seen as a small amplitude sensory nerve action potential response, but at times can be observed with an amplitude greater than 10 μV. It is possible that patients with an absent or significantly delayed median nerve response may have simultaneous inadvertent spread of stimulus to ulnar axons measurable on D3 that may be interpreted as a falsely normal response. All electromyographers need to be aware of this potential pitfall.
    Type of Medium: Online Resource
    ISSN: 0736-0258
    URL: Article
    DOI: 10.1097/WNP.0000000000000622
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 2065729-8
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    Online Resource
  • 4
    Online Resource
    Online Resource
    Abstract WP73: Associations Between Acute Hospital Characteristics And Discharge Decisions For Inpatient Versus Skilled Nursing Facility Based Rehabilitation Among Medicare Acute Stroke Patients
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Stroke Vol. 54, No. Suppl_1 ( 2023-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 54, No. Suppl_1 ( 2023-02)
    Abstract: Introduction: Hospitals strongly influence whether acute stroke patients receive stroke rehabilitation at Inpatient Rehabilitation Facilities (IRFs) or Skilled Nursing Facilities (SNFs), but little is known about drivers of variation. Our objective was to quantify the impact of hospital-level factors on discharge decisions. Methods: A cohort of acute stroke patients who were discharged to IRFs or SNFs was generated from Medicare data (2011-2014). A multi-level random effects logistic regression model that included patient- and hospital-level predictors (fixed effects) of discharge to an IRF (vs. SNF) was constructed. From this model, the amount of variation in discharge decisions due to hospitals was estimated from the intraclass correlation coefficient (ICC). Average effect sizes of hospital-level factors were estimated by adjusted odds ratios (aORs). Variations in effect sizes of factors between hospitals was estimated using 80% Interval Odds Ratios (80% IORs) which reflects a range of estimated effect sizes of factors across individual hospitals. Results: The cohort included 1,816 acute care hospitals which discharged 66,548 patients to IRFs and 68,867 patients to SNFs. Acute hospitals accounted for a quarter of the variation in IRF (vs. SNF) discharge (ICC=0.26). Important hospital-level factors associated with IRF discharge included IRF affiliation (aOR=2.53, 95% CI: 2.25-2.84), urban setting (aOR=1.71 95%CI:1.44-2.03) and Southern vs. Mid-west CMS region (aOR=3.12 95% CI: 2.55-3.83). All 80% IORs were wide which indicates substantial variation in the effects of these factors across hospitals which suggests that despite several significant aORs, much of the hospital-level variability remains poorly explained. Conclusion: Hospitals account for a quarter of the variation in use of IRFs (vs. SNFs). Several hospital-level factors were associated with IRF discharge but there was wide variation in the effects of these factors across hospitals.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.54.suppl_1.WP73
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 1467823-8
    Location Call Number Limitation Availability
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    Online Resource
  • 5
    Online Resource
    Online Resource
    Accessory Flexor Digitorum Longus Presenting as Tarsal Tunnel Syndrome: A Case Series
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Clinical Journal of Sport Medicine Vol. 32, No. 3 ( 2022-05), p. e316-e318
    Details
    In: Clinical Journal of Sport Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 32, No. 3 ( 2022-05), p. e316-e318
    Abstract: Tarsal tunnel syndrome (TTS) typically occurs from extrinsic or intrinsic sources of compression on the tibial nerve. We present 3 cases of patients, all of whom have a prolonged time to diagnosis after evaluation with multiple specialties, with foot pain ultimately secondary to an accessory flexor digitorum longus muscle causing TTS. The literature describing the association between TTS and accessory musculature has been limited to single case reports and frequently demonstrate abnormal electrodiagnostic testing. In our series, 2 cases had normal electrodiagnostic findings despite magnetic resonance imaging (MRI) that later revealed TTS and improvement with eventual resection. A normal electromyogram should not preclude the diagnosis of TTS and MRI of the ankle; it should be considered a useful diagnostic tool when examining atypical foot pain.
    Type of Medium: Online Resource
    ISSN: 1050-642X
    URL: Article
    DOI: 10.1097/JSM.0000000000001025
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2045233-0
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