Rehabilitation of the Injured Combatant Vol 1 IndexREHABILITATION OF THE INJURED COMBATANT, Volumes 1 and 2 A AAEM ... and spinal cord injured patients, 179 and traumatic brain injuries,

Index

xxiVolume 1: Pages 1–416; Volume 2: Pages 417–886

REHABILITATION OF THE INJURED COMBATANT, Volumes 1 and 2

A

AAEMSee American Association of Electrodiagnostic Medicine

(AAEM)AAROM

See Active assistive range-of-motion (AAROM)Abdominal binders

elastic, 182, 184Abducens nerve, 291–300

anatomy and function, 291–293Abducens neuropathies, 295–296

electrodiagnosis, 299evaluation, 299imaging, 299–300management, 299–300symptoms and signs, 297–299syndromes, 296–297

Above-elbow (AE) amputations, 43–44long, 44short, 44surgical procedures, 46

Above-elbow prostheses, 34, 56–59versus below-elbow prostheses, 56choice of, 69–71elbow joints for, 56–57, 59fitting, 48–50myoelectric, 69and residual limb problems, 61standard components, 57

Above-knee amputations (AKA), 122–134acute pain management, 125definitions, 122–123energy expenditure for walking, 93functional outcome, 83interdisciplinary team management case study, 835–837joint contracture prevention, 126long-term follow-up, 133–134low, 82mortality rates, 93psychological support, 125, 133–134rehabilitation, 123–127, 143, 147–148reintegration into community, 133selection, 123–124surgical techniques, 122–124unbalanced myodesis in, 140weight bearing, 126

Above-knee prosthesesfitting, 126–127training, 133

ABPMSee American Board of Physical Medicine (ABPM)

ABPM&RSee American Board of Physical Medicine and Rehabilita-

tion (ABPM&R)Accessory nerve, 335–338

anatomy and function, 335–336Accessory neuropathies, 336–338

electrodiagnosis, 338evaluation, 336–338imaging, 338management, 338prognosis, 338symptoms and signs, 336

syndromes, 336Accidental death

incidence, 209–210Accommodation reflex

innervation, 295Ace bandages, 357Acetazolamide, 217Acetylcholine, 450, 785Acetylcholine receptor proliferation

following denervation, 435–436Acetylcysteine, 759Acetylsalicylate

contraindications, 357Achilles tendinitis, 399–400Acid burns, 577–578AC joint

See Acromioclavicular (AC) jointAcknowledgment, 847ACL

See Anterior cruciate ligament (ACL)Acoustic nerve, 315–325

anatomy and function, 315–317Acoustic neuroma, 322Acoustic neuropathies, 317–318

electrodiagnosis, 322–323evaluation, 319–322management, 323–324prognosis, 323symptoms and signs, 318–319

Acromioclavicular (AC) joint, 371–372rehabilitation, 372

ACTHSee Adrenocorticotropic hormone (ACTH)

Actin, 783Action potentials, 424–425, 785

duration, 459loss of ability to provoke, 460measurement, 451propagation, 449See also Compound motor action potentials (CMAP);

Sensory nerve action potential (SNAP)Active assistive range-of-motion (AAROM)

for burn patients, 603–606definition, 602–603

Activities of daily living (ADL)assessment instruments, 852–853and bilateral upper extremity amputees, 63–64and burn patients, 596, 601, 607, 618–621, 631, 676–680limitations, 15and lower extremity amputees, 84, 102–104, 106and quadruple amputees, 149and spinal cord injured patients, 179and traumatic brain injuries, 227–228and upper extremity amputees, 50–52, 62–64See also specific activity

Acupuncturefor phantom limb pain, 147

Acute abdomenin spinal cord injured patients, 184

Acute mountain sickness, 820Adaptic, 591, 594–595, 600, 616Adaptive devices

for bathing, 679for burn patients, 618–621, 631, 674–680

Rehabilitation of the Injured Combatant. Volume 2

xxii Volume 1: Pages 1–416; Volume 2: Pages 417–886

for communication, 620–621, 681–682, 833for donning pressure garments, 679–680for dressing, 679–680for drinking, 619–620for driving, 54, 64, 178–179, 682for environmental control systems, 621for feeding, 619–620, 676–677for functional mobility, 682for grooming, 620, 677–679for hand rehabilitation, 38, 41–42for hearing impairments, 324for home accessibility, 681for housekeeping, 681for keyboard usage, 681–682for kitchen activities, 681for lower extremity amputees, 106as orthosis attachments, 707for reading, 621recreational, 10, 41–42, 52–54, 70–71, 149, 682–683for self-feeding, 619–620, 676–677for spinal cord injured patients, 178–179for toileting, 679vocational, 54for writing, 621See also specific device

Adaptive skillsassessment, 855

Adenosine diphosphate (ADP), 786Adenosine triphosphatase (ATPase), 783–784Adenosine 5′-triphosphate (ATP), 786–787

resynthesis, 786–787Adie’s pupil, 297ADL

See Activities of daily living (ADL)Adler-Scheie test, 287ADP

See Adenosine diphosphate (ADP)Adrenocorticotropic hormone (ACTH), 218Adson maneuver, 501Advisory Board for Medical Specialties, 5–6, 831Advocacy

for brain injured patients, 249, 255AE amputations

See Above elbow (AE) amputationsAerobic capacity

and age, 804–805correlation between body fat percentage and, 795and gender, 803–804and immobilization, 764of military populations, 803–806and occupation, 804–805

Aerobic power, 782, 799–801definition, 799determinants, 800–801measurement, 799–800

Aerobic system, 787Aerobic training, 810–812

adaptation to resistance training, 812adaptive response, 809in integrated program, 813–814in weight control programs, 793

Affective disordersafter traumatic brain injury, 223

Afferent fibersin cranial nerves, 281

AFOSee Ankle/foot orthoses (AFO)

African Americans

counseling concerns, 849Age

as risk factor for injury, 816and severity of burn injury, 579and traumatic brain injury management, 218and vocational rehabilitation, 847See also Elderly; Children

Ageusia, 311Air cushion

three-layered, 757Air-Flex Foot, 117–119Air-fluidized bed, 757Air Force

body fat standards, 796–798disability systems, 884physical therapy services, 25–26

Air Force Convalescent Training Program, 831Airplane splints, 630, 638Air suspension beds, 757Airway compromise

signs of, 583Airway management

of burn patients, 583–585, 598–599Akathisia

after traumatic brain injury, 220Alcohol abuse

and pharmacologic therapy, 240and traumatic brain injury, 229, 239–241, 246

Alignmentdynamic, 104static, 103–104, 127

Alkali burns, 577–578Allergic contact dermatitis

on residual limb, 139Allodynia, 482Allograft skin

See Homograft skinAlternate binaural loudness balance test, 320Altitude

high terrestrial, 820Amantadine hydrochloride, 214–215, 217, 219Amaurotic familial idiocy, 287Ambulation

after spinal cord injury, 175, 177–178, 731after traumatic brain injury, 226by burn patients, 636energy expenditure for, 92–93, 149, 178, 723–724, 731, 733by fracture patients, 733–737impairment, 15by lower extremity amputees, 13, 81, 84, 88, 102, 104, 106,

125–127, 135by multiple amputees, 148–149and musculoskeletal disorders, 358, 384See also Crutch ambulation; Gait pattern; Gait training;

Gait velocityAmerican Association of Electrodiagnostic Medicine (AAEM),

11, 448, 513American Association of Electrotherapy and Radiology, 830American Association of Physical Therapists, 830American Board of Medical Specialties, 6American Board of Physical Medicine (ABPM), 5–6, 831American Board of Physical Medicine and Rehabilitation

(ABPM&R), 6, 832American Burn Association, 579, 583American College of Radiology and Physiotherapy, 4American Medical Association, 5–6, 8

American Board of Physical Medicine, 5–6, 831Council on Physical Therapy, 22

Index

xxiiiVolume 1: Pages 1–416; Volume 2: Pages 417–886

impairment rating scale, 285Special Exhibit Committee on Physical Medicine, 742

American Physical Therapy Association, 20American Spinal Injury Association (ASIA), 167–169Americans with Disabilities Act, 6American Women’s Physical Therapeutic Association, 21Amino acids

and traumatic brain injury, 212Amino acid supplementation

for burn patients, 687Amitriptyline, 476, 492, 495Amnesia

and mild brain injury, 230posttraumatic, 253

Amphetamine, 219Amplification

electrodiagnostic, 451–452Amplitude, 459

motor unit, 457nerve conduction studies, 459, 464

AmputationCivil War, 34, 71–72, 80, 134emotional aspects, 47, 52Korean War, 134mortality rate, 134multiple, 122, 133, 148–149Persian Gulf War, 12–15, 46–47, 80primary indication for, 45psychological trauma, 10quadruple, 149surgical principles, 45–46Vietnam War, 10, 52, 72, 80, 134, 148, 150vocational outcomes after, 150World War I, 35, 81, 93, 95, 134World War II, 34–35, 46, 71–72, 80, 93–95, 134See also Lower extremity (LE) amputations; Upper

extremity (UE) amputations; specific type of amputationAmputation centers

World War II, 7, 10, 34–35, 52, 80–81, 94, 149AMSC

See Army Medical Specialist Corps (AMSC)AMSC-CIR

See Chief of Army Medical Specialist Corps ClinicalInvestigation and Research (AMSC-CIR)

Anaerobic glycolysis, 787–788Anaerobic power, 782, 801–802

definition, 801determinants, 802measurement, 801–802population data, 806

Anaerobic training, 812–813in integrated program, 813–814See also Resistance training

Anaerobiosismuscle, 786, 789

Analgesicsfor burn patients, 599–600, 621–623, 625–626for musculoskeletal injuries, 357–358, 383for phantom limb pain, 145–146for spinal cord injured patients, 191See also Pain management; specific drug

Anderson shoulder ring, 713Anesthesia

for causalgia, 489–490for lumbar pain, 382malpositioning during, 628ocular complications, 296for phantom limb pain, 146, 148

for reflex sympathetic dystrophy, 141, 148for residual limb pain, 142, 147

Anesthesia dolorosa, 308Anesthetics

for musculoskeletal injuries, 372, 375for phantom limb pain, 146See also specific drug

ANGSee Army National Guard (ANG)

Angiographypulmonary, 760–761

Aniracetam, 219Ankle

musculoskeletal disorders, 395–401nerve injuries, 531–545scar compression, 675

Ankle compression injurychronic or repetitive, 538, 541–542

Ankle disarticulationSee Syme’s amputation

Ankle-foot orthoses (AFOs), 704, 715–726ankle joints for, 716–717anterior stops, 715–716, 718–720, 723biomechanical function, 716–720for burn patients, 615, 631, 643components, 715–716design and suitability, 720–722evaluation by biomechanical principles, 722–723indications, 716mediolateral stability, 716–717metabolic requirements, 723–724metal, 715–720for peripheral nerve injuries, 495pistoning, 722–723plastic, 720–723posterior stops, 715, 717–718, 722–723with prostheses, 90specialized designs for patient needs, 723–724Teufel, 723–725VAPC shoe clasp, 722–723, 725

Ankle/foot prostheses, 87, 127Ankle fractures

stress, 397Ankle positioning

for burn injuries, 611Ankle sprains

inversion, 397–399superficial peroneal neuropathy caused by, 541sural entrapment neuropathy caused by, 542tarsal tunnel syndrome caused by, 533

Ankylosis, 380–381Anorexia

after traumatic brain injury, 217and immobilization, 752

Anosmia, 283, 285Anosognosia, 211Antacids, 754Anterior cord syndrome, 170–171Anterior cruciate ligament (ACL), 392–393Anterior drawer test, 392Anterior interosseous nerve, 508Anterior interosseous syndrome, 508–509Anterior scalene syndrome, 501Anterior stops

on ankle-foot orthoses, 715–716, 718–720, 723on knee-ankle-foot orthoses, 729

Anterior tarsal tunnel, 538Anterior tarsal tunnel syndrome, 538–540


xxiv Volume 1: Pages 1–416; Volume 2: Pages 417–886

Antibioticsfor urinary tract infections, 585See also specific drug

Anticholinergic drugsfor traumatic brain injury, 212, 220See also specific drug

Anticholinesterasesfor traumatic brain injury, 218

Anticoagulants, 762–764See also specific drug

Anticonvulsantsfor cranial neuropathies, 329, 335for peripheral neuropathy, 477for phantom limb pain, 146for spinal cord injured patients, 191for traumatic brain injury, 216, 221, 240See also specific drug

AntidepressantsSee Tricyclic antidepressants; specific drug

Antigravity positioning, 470–471, 604, 606–610, 628, 743, 746Antihypertensives

contraindications, 220for spinal cord injured patients, 183–184See also specific drug

Antiinflammatory medicationsfor musculoskeletal injuries, 355, 357–358, 364, 372–373See also Nonsteroidal antiinflammatory drugs (NSAIDs);

specific drugAntiosteoclastic agents

for immobilization osteoporosis, 748, 750Antipersonnel mines

injuries caused by, 82Antispasticity agents

for traumatic brain injury, 216See also specific drug

Anxietyand traumatic brain injury, 251–254

Anxiolyticsand alcohol use, 240for burn patients, 622See also specific drug

APDABSee Army Physical Disability Appeals Board (APDAB)

Aphonia, 332Appetite dysregulation

after traumatic brain injury, 217and immobilization, 752

Appraisal, 847Aquaplast, 617Archives of Physical Medicine and Rehabilitation, 4Arginine supplementation, 687Argyll Robertson pupil, 292, 297, 299Aris Isotoner, Inc., 665Arm amputations

See Upper extremity (UE) amputationsArmed Forces Military Entrance Processing Stations

strength measurement methodology, 806Armed Service Amputation Center, 10, 149Arm scar compression, 673Arm supports

mobile, 676–677, 710–712suspension sling, 712–713

Armyaerobic capacity values, 804–806basic recruit training, 814–816body fat standards, 796–797body weight/fat control program, 793body weight limits, 796

cardiovascular risk screening program, 818physical disability system, 865–883physical therapy, 16, 20–28rehabilitation teams, 16

Army-Baylor University Graduate Program in PhysicalTherapy, 25

Army Medical Command (MEDCOM), 866Army Medical Specialist Corps (AMSC), 23Army National Guard (ANG)

disability compensation, 882–883Army of the Republic of Vietnam (ARVN), 23Army Patient Administration Division (OTSG), 27Army Physical Disability Agency (USAPDA), 865–867

caseload statistics, 879–883history, 865location, 867review by, 876–879

Army Physical Disability Appeals Board (APDAB), 866Army Physical Therapy Registry (Persian Gulf War), 27–28Army Regulations 40-48 and 40-68, 24Army Reserve (USAR)

disability compensation system, 877, 882–883Arterial blood pressure

See Blood pressure (BP)Arthritis

in amputees, 142Arthrogenic contractures, 746Arthroscopy

peroneal neuropathies caused by, 529Artificial muscle

in hand orthoses, 708–709Ashworth scale

for grading muscle tone, 172ASIA

See American Spinal Injury Association (ASIA)Aspartate, 212Aspen Workgroup, 235Aspiration

in spinal cord injured patients, 182Assist mode, 599Ataxia

after traumatic brain injury, 217Atelectasis

in spinal cord injured patients, 182Atlanto-axial instability

C-1 to C-2, 174Atlanto-occipital dislocations, 173ATP

See Adenosine 5 ′-triphosphate (ATP)ATPase

See Adenosine triphosphatase (ATPase)Atrophy

optic, 287See also Muscle atrophy

Atropine, 183Attentional process disruption

after traumatic brain injury, 220Audiogram, 320Audiometry

pure tone, 319Auditory hallucinations, 319Auditory palpebral reflex, 313–314Auditory screening test, 319Auriculotemporal nerve syndrome, 303, 312Autonomic dysregulation

after traumatic brain injury, 217Autonomic hyperreflexia

in spinal cord injured patients, 183–184

Index

xxvVolume 1: Pages 1–416; Volume 2: Pages 417–886

Autonomic instabilitycausalgia-associated, 482

Avellis’s syndrome, 332Axial flaps, 691Axillary nerve, 496

injury to, 499–500Axillary straps

for upper extremity prostheses, 57Axon, 422–423Axonal debris removal

role of macrophages in, 433Axonal degeneration

See Wallerian degenerationAxonal regeneration

after peripheral nerve injury, 431–432, 434, 436after traumatic brain injury, 212

Axonal shear injuries, 209Axonal transport, 425–426

antegrade, 425models, 426retrograde, 425–426

Axon collateral sproutingafter traumatic brain injury, 212–213

Axonotmesis, 429

B

Babinski response, 190Bacitracin, 582, 591Back pain

immobilization for, 743low, 11, 378–389, 857

Baclofenfor cranial neuropathies, 308for phantom limb pain, 146for spinal cord injuries, 191for traumatic brain injury, 216, 220

BAEPsSee Brainstem auditory evoked potentials (BAEPs)

Balancewith knee-ankle-foot orthoses, 730

Balance board trainingfor musculoskeletal injuries, 398

Balkan Wars, 162Ball-bearing mobile arm support, 710–712Barbiturates, 216Barium swallow, 327–328Barthel Index-Granger Adaptation, 852Barton, Walter E., 22Barton Carey garments, 659, 669Baruch, Bernard, 5Baruch Committee, 5Basic recruit training

injuries associated with, 814–816Bathing

adaptive aids, 679Batteries

for myoelectric prostheses, 67Battle fatigue

prevention, 623Battle stress, 16, 623Battle wounds

emotional reaction to, 846–848BE amputations

See Below elbow (BE) amputationsBecker-type ankle joint, 716Bedrest

See Immobilization; Immobility complications

Bedsfor spinal cord injured patients, 182, 186See also specific type of bed

Behavioral approachesto burn pain, 625to phantom limb pain, 147

Behavioral assessment tools, 223Behavioral observations

for neurobehavioral assessment, 242–243Behavioral problems

after traumatic brain injury, 211–213, 222–223, 238–239Behrens, Charles F., 5Belgian Army Medical Corps, 81Bell clapping

residual limb pain caused by, 142–143Bell’s palsy, 311Below-elbow (BE) amputations, 43–44

bilateral, 64long, 44, 52short, 44, 53surgical procedures, 46very short, 44, 53

Below-elbow prostheses, 34, 52–59versus above-elbow prostheses, 56choice of, 69–71elbow joints for, 55fitting, 48–50long, 44, 52myoelectric, 68–69and residual limb problems, 61short, 44, 53standard components, 55suspension and control, 54–56terminal devices, 44, 53–54very short, 44, 53wrist units, 53–55

Below-knee amputations (BKA), 82, 93–122classification, 93energy expenditure for walking, 93functional outcome, 83, 93high, 82indications, 94long, 93long-term follow-up, 106mortality rates, 93postoperative dressings, 96–100preoperative evaluation, 100–101psychological support, 101rehabilitation, 100–106, 143, 147–148residual limb lengthening, 96short, 93standard or medium length, 93surgical techniques, 93–96ultrashort, 93weight bearing, 98–99, 102–103

Below-knee prostheses, 106–120computer aided design/manufacturing, 120–121fitting, 106foot, 97–100, 110, 113immediate postoperative, 96–98selection, 106–107shanks, 112–113sockets, 106–110, 112suspension, 110–112

Bending momentat knee, 717, 723

Benedikt’s syndrome, 296Benserazide, 214–215


xxvi Volume 1: Pages 1–416; Volume 2: Pages 417–886

Benson’s relaxation, 625–626Benzodiazepines

for burn patients, 622for traumatic brain injury, 216, 220–221, 240See also specific drug

Beta-blockersfor causalgia, 490for phantom limb pain, 146for traumatic brain injury, 217, 220See also specific drug

BetadineSee Povidone-iodine

Betapile, 668Bethanecol, 218Bevor’s sign, 169BIA

See Brain Injury Association (BIA)Bicycles

stationary, 125, 635, 800–802Biker’s compression shorts, 657–658, 665Billings, Frank, 4Bine’s test, 320Biobrane, 582, 593, 629Bio-Concepts, Inc., 665Bioconcepts prefabricated glove, 667Biofeedback

for myoelectric prosthesis training, 69for phantom limb pain, 147

Biological dressings, 592–593Bioplasty mesher, 590Biphosphonates, 748, 750Bivalved casts, 639, 747Bladder calculi

in spinal cord injured patients, 194Bladder carcinoma

in spinal cord injured patients, 194Bladder drainage

in immobilized patients, 585, 752in spinal cord injured patients, 193–194

Blink reflex, 302–303electrodiagnostic evaluation, 305

Blisterson burn wound, 632, 656foot, 818on residual limb, 136

Blocking, 463Blood flow distribution, 791Blood loss

from debrided wound, 588Blood pressure (BP)

arterial, 790–791during exercise, 790–791in immobilized patients, 764–765response to maximal exercise, 791

Bobath shoulder roll, 713Body composition

definition, 792and physical capacity, 794–796and physical fitness, 792–799reference values, 792standards, 796–797

Body fat, 792–793android pattern, 793assessment, 793classification, 792essential or obligatory, 792excess, 793, 797gynoid pattern, 793

measurement methodology, 797–799military control programs, 793, 796–799reduction, 793regional distribution, 793, 798storage, 792–793

Body fat percentagecorrelation between aerobic capacity and, 795and fitness level, 792–799military standards, 796–797reference values, 792values for military populations, 794

Body-powered prostheseshybrid (myoelectric and body-powered), 56, 59versus myoelectric prostheses, 68–71for upper extremity amputations, 53, 56, 62

Body strengthSee Strength

Body temperatureregulation, 791

Body weightSee Weight

Bolton, Frances P., 22Bolton Bill, 22Bone changes

after burn injuries, 690in resistance training, 810

Bone homeostasisduring immobilization, 747–748

Bone scansin causalgia, 487–488, 491in musculoskeletal injuries, 381, 385–386in reflex sympathetic dystrophy, 141–142

Bone spursin residual limb, 139–140

Bone stress reactionsSee Stress fractures

Bonnier ’s syndrome, 303, 326Boutonniere deformity, 611, 614, 639Bowden control cable, 55, 57–58Bowel programs

for immobilized patients, 753for spinal cord injured patients, 185

Boyd hindfoot amputation, 86–87Braces

for musculoskeletal injuries, 374, 386Brachial plexopathies, 496–498

anatomic considerations, 496–497in burn patients, 689–690clinical presentation, 498–500electrodiagnosis, 498–500etiology, 497–498

Brachial plexus, 496–497Brachial plexus injuries, 366Bracing

fracture cast, 735functional electrical stimulation for, 732–733

Bradyarrhythmiain spinal cord injured patients, 182–183

Bradycardia, 333Brain

contusions, 209surface anatomy, 223

Brain injuriesSee Traumatic brain injury (TBI)

Brain Injury Association (BIA), 227, 230Brainstem auditory evoked potentials (BAEPs), 322–323Brainstem tumors, 323Brake mechanisms

Index

xxviiVolume 1: Pages 1–416; Volume 2: Pages 417–886

for knee prostheses, 127–128Bretylium, 490Bromocriptine, 214–215, 219–220, 222Brown, Paul W., 10Brown-Séquard syndrome, 170–171Buf-N-Puff, 633Bulimia

after traumatic brain injury, 217Bullet fragment removal

from spinal cord injuries, 164–165Bullets

spinal cord injuries caused by, 164–165traumatic brain injury caused by, 208–209

Bullet shock wavesspinal cord injuries caused by, 164

Bunnell, Sterling, 9, 35–36, 38Bunnell splints, 709Burn centers, 577, 583–584, 633Burn claw deformity, 614Burn cream, 582Burn grafts

See Skin graftsBurn injuries, 575–702

acid, 577–578acute phase, 595–625alkali, 577–578associated illnesses and injuries, 581chemical, 577–578, 583classification, 577–579closed treatment, 600complications, 582depth, 580–581dressings, 582, 587, 592–594, 600, 632electrical, 578–579, 591–592, 595, 691–692emergency care, 583–585first degree, 580flame, 577fourth degree, 581immobilization phase, 595–596, 625–631neurologic complications, 689–690nonhealing wounds, 587open treatment, 600Persian Gulf War, 14–15pigmentation, 605scald, 577second degree, 580–581severity factors, 579–581size, 579–580steam, 577surgical considerations, 582, 628thermal, 577third degree, 581topical treatment, 582treatment, 582–595wound excision, 587–588wound maturation phase, 595–596, 631–684

Burn Net, 600Burn pain, 621–622Burn patients

adaptive equipment, 618–621, 631, 674–680airway management, 583–585, 598–599contracture prevention, 600, 603–610, 627–628, 636, 643–

674edema management, 587, 600, 606, 655–674enteral feeding, 602, 687–688exercises, 596–597, 602–606, 627–628, 635–637, 652–653functional activities, 596, 601, 607, 618–621, 631, 674–680home management, 680–681

inpatient care guidelines, 583–584intubation, 584, 598–600management, 595–693nutritional care, 602, 684–689orthotics, 596, 600, 611–618, 629–630, 637–643outpatient care, 583–584, 636pain management, 599–600, 621–623, 625–626phases of care, 595–596positioning, 607–611psychological support, 596, 623–626, 631, 633, 683–684pulmonary edema in, 584–585reconstructive surgery, 690–693rehabilitation goals, 595, 632return to duty, 637, 683–685vascular access, 584–585

Burn resuscitation formulas, 586Burn scars

assessment, 662–664, 666desensitization, 633–634

Burn shockfluid resuscitation for, 585–587

Burn splints, 615–616Bursae injuries, 356

residual limb pain caused by, 142Bursitis

trochanteric, 389in upper extremity amputees, 61

Burst fractures, 175Bushnell General Hospital, Utah, 35, 80Buspirone, 215–216Bypass prosthesis, 126

C

Cable excursionin upper extremity prostheses, 59

Cable tensiometer, 802Cacosmia, 283CAD

See Computer aided design (CAD)CAI

See Career Assessment Inventory (CAI) Enhanced VersionCalcaneal nerve, 533Calcanectomy

partial, 87Calcarine cortex, 286, 289Calcitonin

for hypercalcemia, 750for immobilization osteoporosis, 748for phantom limb pain, 146, 148

Calcium alginate dressing, 594Calcium channel blockers, 479, 490Calcium gluconate, 578Calcium intake

during immobilization, 751Calcium ions, 783–784Calcium supplementation, 748Callosities

of residual limb, 137Caloric testing, 321Calorie counts

for burn patients, 602, 687–688and immobilization, 752

CAMSee Computer aided manufacturing (CAM)

Camouflage makeupfor burn patients, 673, 690

Canada


xxviii Volume 1: Pages 1–416; Volume 2: Pages 417–886

amputee vocational outcome study, 159Canadian socket design, 132–133Canes

for above-knee amputees, 126for musculoskeletal injuries, 357

CANFIT system, 121Canty, Thomas J., 10Capsaicin, 477–478, 490CAPTE

See Commission on Accreditation for Physical TherapyEducation (CAPTE)

CarafateSee Sucralfate

Carbamazepine, 477for cranial neuropathies, 308, 335for traumatic brain injury, 216, 220–222

Carbidopa, 214–215, 219, 222Carbohydrate metabolism

and burn injuries, 687Carbon Copy II, 92, 116, 120Carbon Copy III, 116–117, 120Carbon dioxide (CO2)

as orthotic power source, 705, 708–709partial pressure (PCO2), 789, 791production, 788–789

Carbon fibershoe shanks/inserts, 90socket reinforcement with, 91–92

Carbon graphite shoe inserts, 89–90Carcinoma

bladder, 194colon, 185

Cardiac enlargementin resistance training, 810

Cardiac output (C.O.)and blood flow distribution, 791maximum, 801and oxygen consumption, 790response to aerobic training, 809response to maximal exercise, 791

Cardiac reconditioning, 765Cardiopulmonary resuscitation (CPR)

after spinal cord injury, 162Cardiorespiratory endurance

See Aerobic powerCardiovascular complications

exertion-related, 818of immobilization, 762–765of spinal cord injury, 182–184

Cardiovascular conditioningand musculoskeletal injuries, 388

Cardiovascular deconditioning, 764–765Cardiovascular function

during exercise, 789–792Cardiovascular response

to aerobic training, 809to resistance training, 809–810

Cardiovascular risk screening program, 818Career Assessment Inventory (CAI) Enhanced Version, 854Career Compensation Act, 865, 879Career content skills

assessment, 855–856Career plan guideline, 857Career Planning Guide Book, 855Caromed Int’l, Inc., 665Carotid sinus reflex, 327, 333Carpal tunnel, 509–510Carpal tunnel release (CTR), 513–514

Carpal tunnel syndrome (CTS), 437–439, 509–514acute, 510, 513–514anatomic considerations, 509–510chronic, 510classification, 511–512clinical presentation, 511–512electrodiagnosis, 512–513etiology, 510–511treatment, 513–514

Castsbivalved, 639, 747fiberglass material, 48, 53, 97–100fracture bracing, 735plaster impression for residual limb, 121serial, 747thumb spica, 377See also Orthoses

CAT/CAM socketSee Contoured Adducted Trochanteric/Controlled

Alignment Method (CAT/CAM) socketCatecholaminergic antagonists, 219–220Catecholamines

for traumatic brain injury, 212–215, 219See also specific drug

CathetersSee Urinary catheters

Cauda equina, 168injuries, 191, 193, 732

Cauda equina syndrome, 170–172Causalgia, 481–496

cardinal characteristics, 482–483case studies, 491–496clinical considerations, 486clinical staging, 483diagnosis, 486–489, 491incidence, 481–482laboratory findings, 486–488pathophysiology, 483–485Persian Gulf War, 482, 491superficial radial nerve compression-associated, 505treatment, 489–491Vietnam War, 482

Cavernous sinusanatomy, 295inflammatory disease, 295septic thrombosis, 296

Cavernous sinus syndrome, 303Cavitation, 747CDP-choline

for traumatic brain injury, 219CED

See Cognitive enhancing drug (CED)Cellulitis

in spinal cord injured patients, 187–188Central Army Physical Review Council, 865Central auditory pathway lesions, 318Central cord syndrome, 170–171Central nervous system (CNS)

burn injury-associated damage, 633–634causalgia-associated changes in, 484effects of alcohol on, 240effects of immobility on, 749neural recovery, 212–213

Central venous pressurein immobilized patients, 764

Centripetal wrapping, 471Centrophenoxine, 219Cerebellar ataxia, 217

Index

xxixVolume 1: Pages 1–416; Volume 2: Pages 417–886

Cerebrospinal fluid markersin traumatic brain injury, 211

Cerebrovascular blood flowand cognitive function, 219

Cerium nitrate, 591Cervical collars, 361Cervical glides

dorsal, 362Cervical radiculopathy, 363–366Cervical soft tissue injuries, 361–363

rehabilitation, 361–362Cervical spine, 167–168Cervical spine injuries, 169, 171, 173–174

complications, 181–182, 191, 193interdisciplinary team management case study, 843–844

Cervical spine orthoses, 174Cervical stabilization exercises, 364–365Cervical stenosis

congenital, 165, 171Cervical traction, 364Cervicothoracic disorders, 361–367

See also specific disorderCervicothoracic stabilization exercises, 364–365Chance fractures, 175Charcot’s spine, 189Check sockets, 52–53, 121, 130Chemical burns, 577–578

treatment, 583Chemosensory testing, 285Chest expansion

elbow lock operation by, 59–60Chest strap

for above-elbow prostheses, 58for humeral neck amputation prostheses, 60

Chief of Army Medical Specialist Corps Clinical Investigationand Research (AMSC-CIR), 27

Childbirthin spinal cord injured patients, 195

Childrenskin graft sites, 595

Chin controlof wheelchair, 177

Chlorhexidine, 597Chlorphenesin, 308Choking

socket, 143Cholelithiasis

in spinal cord injured patients, 185Choline, 218Cholinergic substances

for traumatic brain injury, 216, 218–220See also specific drug

Chopart’s amputationsSee Tarsotarsal amputations

Chorda tympani syndrome, 312Chronaxie, 449Ciliary muscle

innervation, 292–293Cimetidine, 754Circulation, motion, sensation, and temperature (CMST), 616,

626Circulatory complications

after amputation, 137–139in immobilized patients, 764–765

Citalopram, 216Civil War

amputations, 34, 71–72, 80, 134causalgia, 481

cranial neuropathies, 339immobility complications, 742

CKSee Creatine kinase (CK)

Claymore minesinjuries caused by, 82

Clear film dressings, 594–595Cleveland Clinic, 5Clinical symptom complex, 356Clinitron bed, 186–187, 628, 631, 757Clodronate, 748, 750Clonazepam, 220–222, 477Clonidine, 219–220, 479, 490CMAPs

See Compound motor action potentials (CMAPs)CMRR

See Common mode rejection ratio (CMRR)CMST

See Circulation, motion, sensation, and temperature(CMST)

CNSee Cranial nerves (CN)

CNSSee Central nervous system (CNS)

C.O.See Cardiac output (C.O.)

Coagulation necrosiscaused by acid burns, 577–578

Coban, 471, 613, 658–659Cochlear implants, 324Cochlear nerve

anatomy and function, 315–317Cochlear neuropathies, 318–324

evaluation, 319–322management, 323–324

Cocked-hat flap procedure, 37Cockup splint, 709–710Codeine, 622Code of Hammurabi, 864Cognitive-behavioral dysfunction, 217–220, 222–223, 230

and family outcome, 252–253treatment, 218–219, 228, 237–246

Cognitive-behavioral profilingafter traumatic brain injury, 217

Cognitive enhancing drug (CED), 218Cognitive function

drugs that may enhance, 218–220drugs that may interfere with, 219–220

Cognitive remediationfor brain injured patients, 245

Cohen, Henry, 429Colace

See Docusate sodiumCold exposure

differential sensitivity of nerves to, 445effect on nerve conduction velocity, 445and exercise-related injuries, 819–820nerve damage caused by, 443–446tissue injury from, 123See also Frostbite

Cold-induced neuropathies, 443–446clinical considerations, 443–444and duration of exposure, 445electrodiagnosis, 445–446morphologic changes, 445pathophysiology, 444–445prognosis, 444and temperature considerations, 445


xxx Volume 1: Pages 1–416; Volume 2: Pages 417–886

and type of nerve involved, 445Collagen

and hypertrophic scar formation, 644Collagen biosynthesis

in denervated muscles, 435, 465Collagen production phase, 354–355Colle’s fracture

carpal tunnel syndrome caused by, 510, 513Collet-Sicard syndrome, 331–332, 336, 340Colon carcinoma

in spinal cord injured patients, 185Colorectal disease

in spinal cord injured patients, 185Columns of Denis, 174–175Coma

definition, 234Coma/Near Coma Scale, 224Coma Recovery Scale, 224Coma stimulation programs, 235–237Comatose patient

cranial neuropathies in, 280Combat boots

as risk factor for injury, 817Combat stress, 16, 623Combat theater

physical medicine and rehabilitation in, 8–9physical therapy in, 19–30See also specific theater

Commission on Accreditation for Physical Therapy Education(CAPTE), 25

Common mode rejection ratio (CMRR), 452Communication

adaptive devices, 620–621, 681–682, 833by intubated patients, 181

Community mobilityand spinal cord injured patients, 178–179

Community reintegration, 845–861for spinal cord injured patients, 180for traumatic brain injured patients, 224, 227–229See also Return to duty; Vocational rehabilitation

Compartment syndromes, 439–440pronator teres syndrome associated with, 506

Compensation Act, 865, 879Compensation systems

See Physical disability systemComplex regional pain syndrome (CRPS)

diagnostic criteria, 486–489See also Causalgia; Reflex sympathetic dystrophy (RSD)

Complex repetitive discharges, 455Compound motor action potentials (CMAPs)

amplitude, 459, 464inability to elicit, 460measurement, 451in ulnar neuropathy, 462, 517

Compressionfor edema control, 471for musculoskeletal disorders, 357

Compression insertsfor orthoses, 650, 664–674

Compression neuropathy, 436–439classification, 429clinical considerations, 437–439and impulse propagation, 450pathophysiology, 436–437See also specific nerve

Computed tomography (CT)in cranial neuropathies, 285, 299, 341in femoral neuropathy, 527

in musculoskeletal disorders, 381socket design with, 121in spinal cord injury, 163–164, 173, 175in traumatic brain injury, 225, 230

Computer aided design (CAD)of sockets, 120–121

Computer aided manufacturing (CAM)of sockets, 120–121

Computer aided socket design (CASD), 121Computers

for spinal cord injured patients, 179Concentric contractions, 783Concentric needle electrodes, 453

bipolar, 453coaxial, 453

Concussive injuries, 227, 230classification, 230incidence, 210symptoms, 227, 230–231

Conditioning periodand muscle injury avoidance, 356

Condom cathetersskin complications, 186–187

Conduction block, 449–450focal, 430

Conduction slowing with temporal dispersionelectrodiagnostic findings, 461–462

Conduction velocitySee Nerve conduction velocity

Cones, 285–286Confusion

in burn patients, 631Connecticut Chemosensory Clinical Research Center, 283–284Connective tissue

denervation-associated changes, 435, 438–439, 442of nerve, 426–427peripheral neuropathy-associated stretching, 465–467

Consciousnessloss of, 230, 234–235

Constipationin immobilized patients, 752–753

Contact dermatitiscaused by orthoses, 668–669on residual limb, 138–139

Continental United States (CONUS) hospitalsphysical medicine and rehabilitation at, 9See also specific hospital

Continuous passive motion (CPM) devices, 605, 616–618, 639–641, 747

Continuous positive airway pressure (CPAP), 599Contoured Adducted Trochanteric/Controlled Alignment

Method (CAT/CAM) socket, 129–130Contour foam, 670Contracture prevention, 8–9, 226, 746–747

in burn patients, 600, 603–610, 627–628, 636, 643–674in lower extremity amputees, 81, 84, 88, 94, 101–102, 124–

125, 135in spinal cord injured patients, 189in upper extremity amputees, 47

Contracturesarthrogenic, 746formation, 745during immobilization, 745–746myogenic, 435, 465–467, 491, 746soft tissue, 746types, 746

Control mode, 599Control systems

Index

xxxiVolume 1: Pages 1–416; Volume 2: Pages 417–886

above-elbow prostheses, 57–58below-elbow prostheses, 54–56humeral neck amputation prostheses, 60myoelectric prostheses, 65–67

Contusionsbrain, 209lumbar, 386–389

CONUSSee Continental United States (CONUS) hospitals

Conus medullaris, 168injuries, 193

Conus medullaris syndrome, 170, 172Convalescent hospitals

pre-World War II, 5Convalescent leave, 872Convergence system, 294Coping skills

and vocational rehabilitation, 846Cordectomy, 192Corneal reflex, 302–303

electrodiagnostic evaluation, 306–307Coronary artery disease

in spinal cord injured patients, 184Corps of Invalids, 72Cortical blindness, 287, 291Corticosteroids

for causalgia, 490for musculoskeletal injuries, 358, 361, 366–367, 374, 377See also specific drug

Corticotropin-releasing hormone, 217Cortisone, 542, 544Cosmetic covers

for above-knee prostheses, 132for foot prostheses, 117, 119for myoelectric prostheses, 68–69, 71

Cosmetic prostheseshand, 43

Costoclavicular syndrome, 501Cough, 333

impaired, 182Coulter, John S., 5Coumadin, 183Council on Medical Education, 5Council on Physical Therapy (American Medical Association),

22Counseling

See Emotional counseling; Psychological support; Psycho-therapy

Counterforce bracesfor epicondylitis, 374

Courageas characteristic of soldier, 846

CPSee Creatine phosphate (CP)

CPAPSee Continuous positive airway pressure (CPAP)

CPM devicesSee Continuous passive motion (CPM) devices

C-polymodal nociceptors (C-PMN), 484–485CPR

See Cardiopulmonary resuscitation (CPR)Cramp

heat, 819Cranial nerves (CN), 280

anatomy and function, 280–281decompression, 280I. See Olfactory nerveII. See Optic nerve

III. See Oculomotor nerveIV. See Trochlear nerveV. See Trigeminal nerveV1. See Ophthalmic nerveV2. See Maxillary nerveV3. See Mandibular nerveVI. See Abducens nerveVII. See Facial nerveVIII. See Acoustic nerveIX. See Glossopharyngeal nerveX. See Vagus nerveXI. See Accessory nerveXII. See Hypoglossal nerve

Cranial neuropathies, 279–352causes, 280in comatose patient, 280incidence, 280prognosis, 280See also specific cranial nerve

Creatine kinase (CK), 579Creatine phosphate (CP), 786–787Cricopharyngeus sphincter dilation, 329Cricothyroid muscle, 333Croatia, 28Crocodile tears, 312Cross-bridges, 783–784Crossed adduction maneuver, 371CRPS

See Complex regional pain syndrome (CRPS)Crush injury

carpal tunnel syndrome caused by, 510, 514Crutch ambulation

for above-knee amputees, 126carpal tunnel syndrome caused by, 510–511by multiple amputees, 148for musculoskeletal injuries, 357patient education, 102–104, 106for spinal cord injured patients, 178

Crutch palsy, 503–504Cryotherapy

for musculoskeletal injuries, 357–358, 371–373, 383CT

See Computed tomography (CT)CTR

See Carpal tunnel release (CTR)CTS

See Carpal tunnel syndrome (CTS)Cubital tunnel, 514–515Cubital tunnel release, 519Cubital tunnel syndrome, 514, 516, 519Cultural values

and counseling approaches, 849Cultured autologous kertinocite grafts, 591–592Cutaneous sensation

and neurological evaluation of spinal cord injury, 169Cuthbertson, D. P., 742Cybex dynamometer, 635, 801Cyclanedelate, 219Cycle ergometry, 800, 802Cycling tests

for anaerobic power, 801–802Cyproheptadine, 217Cysts

epidermoid, 137Cytidene 5′-diphosphocholine

See CDP-cholineCytotec

See Misoprostol


xxxii Volume 1: Pages 1–416; Volume 2: Pages 417–886

D

Daily living skillsSee Activities of daily living (ADL)

Dantrolene sodium, 217Deafferentation pain, 475Death

accidental, 209–210exertion-related, 817

Debridementburn wounds, 587–589, 597of devitalized tissues, 81, 135enzymatic, 588–589instruments, 587–588for pressure sores, 187See also Excision

Decompression sickness, 166Deconditioning

cardiovascular, 764–765prevention, 8–9, 81, 84, 126

Deep brain stimulationfor phantom limb pain, 146

Deep heating, 467, 746–747Deep peroneal nerve, 538Deep venous thrombosis (DVT), 183, 762–764

differential diagnosis, 763–764prevention, 763–764versus pulmonary embolism, 763

Degenerative arthritisin amputees, 142

Degloving injuries, 37Dehydration, 819Dejerine’s anterior bulbar syndrome, 340Deltoid aid, 639Dematomes

for spinal cord injury evaluation, 168Dementia

immobility-related, 749Demerol, 495Demyelination

See Conduction blockDendrites, 422–423Denervation

end organ changes following, 431–436muscle changes following, 434–436

Denervation supersensitivity, 435–436, 456after traumatic brain injury, 213

Dens fractures, 174Dental anesthesia

ocular complications, 296Dentistry

and oral contractures, 638role in medical evaluation board, 868

Department of Defense (DoD)disability directives, 865

Department of Veterans AffairsSee Veterans Administration

L-deprenylfor traumatic brain injury, 214

Depressionafter traumatic brain injury, 242, 245–246, 251–254in spinal cord injured patients, 196

De Quervain’s tenosynovitis, 376–377Dermapad, 670Dermatitis

contact, 138–139, 668–669stasis, 137–138

Dermis

artificial, 592Desensitization

of burn scar, 633–634hyperesthetic, 472–473, 491–492, 495

Desipramine, 219, 476Detraining, 808–809Detrusor-sphinctor dyssynergia

in spinal cord injured patients, 193–194DEXA

See Dual photon x-ray absorptiometry (DEXA)Dexamethasone, 315, 377Dextroamphetamine, 214–215Diabetes mellitus

in spinal cord injured patients, 185Diabetic ischemic neuropathy, 296Diarrhea, 333Diathermy, 467, 746–747

microwave, 746ultrasound, 467, 746–747, 758

Diazepam, 213Didronel, 221Dietary considerations

See NutritionDietary fiber

for immobilized patients, 753Dietitians, 22–23Dietrick, J. E., 742Differential amplification

electrodiagnostic, 451–452Digital control systems

for myoelectric prostheses, 65Digital neuropathies, 543–545

anatomic considerations, 543clinical presentation, 544differential diagnosis, 544electrodiagnosis, 544etiology, 543–544treatment, 544–545

DigitsSee Fingers

Dihydroergotamine, 219Diltiazem, 479DIP disarticulation

See Distal interphalangeal (DIP) disarticulationDiphosphonate EHDP, 748Diplopia, 297

management, 299–300Disability event

adaptive stages to, 847–848Disability ratings, 873–875Disability Rating Scale, 224Disarticulation

and residual limb/prosthesis interface, 89See also specific type of disarticulation

Discography, 381Disks

herniations, 381internally disrupted, 380

Disk spacenarrowing, 380

Dislocationsanterior interosseous syndrome caused by, 508–509brachial plexopathies caused by, 497, 499neuropathies associated with, 440–443pronator teres syndrome caused by, 506–507

Disodium diphosphonate, 748Disodium ethane-1-hydroxy-1,1-diphosphonate, 748Distal interphalangeal (DIP) disarticulation, 37

Index

xxxiiiVolume 1: Pages 1–416; Volume 2: Pages 417–886

Distal metatarsal amputations, 85Division of Special Hospitals and Physical Reconstruction,

830–831Dizziness, 319Docusate sodium, 753DoD

See Department of Defense (DoD)Dopamine, 219Dopamine agonists

for traumatic brain injury, 213–215, 217, 220–222See also specific drug

Doppler ultrasonographycolor-flow, 763

Dorrance hooks, 53Dorsal cord stimulation

for phantom limb pain, 146–148Dorsal root entry zone (DREZ) lesioning, 146, 148, 192Dorsal root ganglia, 167–168Dorsal scapular nerve, 496Dorsiflexion assist orthosis

spring wire, 715Dorsiflexion (anterior) stops

on ankle-foot orthoses, 715–716, 718–720, 723on knee-ankle-foot orthoses, 729

Double-stopped ankle joint, 716Dow Corning prosthetic foam, 670Dow Corning silicone gel sheeting, 669–670Downey Hand Center, 472–473Doxepin, 476–477, 492Dressing

adaptive aids, 679–680See also Activities of daily living (ADL)

Dressingsbiological, 592–593for burn wounds, 582, 587, 592–594, 600, 632calcium alginate, 594clear film, 594–595hydrocolloid, 594local compression, 357for lower extremity amputations, 84, 87–88, 94, 96–100,

102–106, 124–125postgraft changing, 626–627for pressure sores, 187rigid, 87–88, 96, 99for skin grafts, 591–594, 626–627, 629soft, 96, 125synthetic, 593–594for upper extremity amputations, 48–50See also Immediate postoperative rigid dressing (IPORD);

specific type of dressingDREZ lesioning

See Dorsal root entry zone (DREZ) lesioningDrinking

adaptive devices, 619–620Driving

adaptive aids, 54, 64, 178–179, 682and brain injured patients, 227

Dual-control cablefor upper extremity prostheses, 57–60

Dual photon x-ray absorptiometry (DEXA), 799Duane’s retraction syndrome, 296Duoderm, 594, 656, 662, 673Durnin-Womersley equations, 797–798DVT

See Deep venous thrombosis (DVT)Dycem, 620Dynamic constant resistance

See Isotonic exercises

Dynamic response feet, 92, 115–120, 127Dynamic splinting, 747Dynamic strength

measurement, 802Dynamometer, 802

Cybex, 635, 801isokinetic, 802–803

Dysarthria, 312, 340–341Dysautonomia

central, 211Dysesthetic pain, 475Dysgeusia, 311Dyskinesias

after traumatic brain injury, 221Dysosmia, 283, 285Dysphagia, 332, 334–335

after traumatic brain injury, 222Dysphonia, 332Dysreflexia

autonomic, 183–184Dystonia

after traumatic brain injury, 220Dysvascular amputees

bilateral, 149residual limb pain, 139

E

Earanatomy, 315–317burn injury positioning concerns, 608prosthetic, 655

Early recovery management programs (ERMPs)for brain injured patients, 226, 236

Eccentric contractions, 783, 813Ectopic bone

in residual limb, 139–140ECU

See Environmental control unit (ECU)Edema

after peripheral neuropathy, 470–471, 491–492, 496in burn patients, 587, 600, 606, 655–674physiology, 470prevention, 88, 104–106, 124–125pulmonary, 584–585, 820stump, 134, 138

Edema-sleeves, 658Edinger-Westphal nucleus, 286, 291–292Education

See Patient education; Family educationEducational experiences

and vocational assessment, 851EEG

See Electroencephalography (EEG)Efferent fibers

in cranial nerves, 281Elastic abdominal binders

for spinal cord injured patient, 182, 184Elastic bands

for below-elbow prostheses, 55Elastic digi-sleeves, 658Elastic hoods, 650Elastic sport garments, 665Elastic stockinettes

for amputations, 48–50, 94, 97, 125Elastic stretch, 465Elastic tubular supports, 658–660Elastic wrapping


xxxiv Volume 1: Pages 1–416; Volume 2: Pages 417–886

for burn patients, 601, 606, 610–611, 613, 615, 630, 645, 656,658–660

for lower extremity amputations, 87–88, 94, 96–98, 103–105, 124–125

for upper extremity amputations, 48–50Elastin, 355Elastogel, 667, 669–670Elastomers

in orthotic inserts and overlays, 670Elastomer silicone shoe inserts, 642–643Elbow

contracture prevention, 47cubital tunnel at, 514–516, 519immobilization orthoses, 630positioning for burn injuries, 610scar compression, 672–673ulnar nerve injury at, 514–519

Elbow disarticulation, 44prostheses, 44surgical procedures, 46

Elbow disorders, 372–376rehabilitation, 376

Elbow flexion test, 515Elbow-locking cable

for upper extremity prostheses, 57–60Elbow orthoses, 639

functional, 713static, 713support of, 713–715

Elderlyskin graft sites, 595

Electrical arc, 578Electrical burns, 578–579

combined with thermal injuries, 578–579treatment, 591–592, 595, 691–692

Electrical motoras orthotic power source, 705, 708–709

Electrical muscle stimulationfor peripheral nerve injuries, 481

Electrical stimulationfor cranial neuropathies, 315for edema control, 470–471for musculoskeletal injuries, 358–359, 374, 383for peripheral nerve injuries, 479–481for spinal cord injured patients, 192See also Transcutaneous electrical nerve stimulation

(TENS)Electrical stimulators

implantable functional, 179Electrocochleography, 322Electrodes

electrodiagnostic, 453electroencephalographi, 284–285electromyographic, 453–454ground, 453myoelectric, 65, 67needle, 453surface, 453, 456–457transcutaneous electrical nerve stimulation, 480

Electrodiagnosis, 11–12of accessory neuropathies, 338of acoustic neuropathies, 322–323amplification, 451–452of anterior interosseous syndrome, 509of anterior tarsal tunnel syndrome, 539of brachial plexopathies, 498–500of carpal tunnel syndrome, 512–513classes of disorders detectable by, 448

of cold-induced nerve injuries, 445–446in compartmental syndromes, 440and determination of injury severity, 459–462of digital neuropathies, 544electrodes, 453of facial neuropathies, 314–315of femoral neuropathy, 526–527filters, 452–453of foot and ankle nerve injuries, 531general principles, 448of glossopharyngeal neuropathies, 328history, 420of hypoglossal neuropathies, 340–341instrumentation, 450–453of ischemic nerve injuries, 440limitations, 464–465localization with, 461–463of lumbosacral plexopathy, 523–524of oculomotor neuropathies, 299of olfactory neuropathies, 284–285of peripheral nerve injuries, 448–465of peroneal neuropathy, 529–530of posterior interosseous nerve entrapment, 505of pronator teres syndrome, 508of radial neuropathy, 503recovery monitoring with, 460, 463–464, 468of residual limb pain, 142of sciatic neuropathy, 525–526of superficial peroneal neuropathy, 541of supracondylar process syndrome, 506of sural entrapment neuropathy, 543of tarsal tunnel syndrome, 535of thoracic outlet syndrome, 501–502timing of, 460–461of trigeminal neuropathies, 305of ulnar neuropathy, 514, 517–519, 521–522utility of, 459–465of vagus neuropathies, 333–334See also specific instrument

Electroencephalography (EEG)in olfactory nerve injuries, 284–285

Electrogustometry, 314Electrolyte homeostasis, 750Electromechanical digitization

for socket design, 121, 130Electromyography (EMG), 453–458

in anterior interosseous syndrome, 509in brachial plexopathies, 499in carpal tunnel syndrome, 512–513and determination of injury severity, 459–462electrodes, 453–454in femoral neuropathy, 527filter settings, 452in foot and ankle nerve injuries, 531in hypoglossal neuropathies, 340–341insertional activity, 454instrumentation, 450–453of laryngeal nerves, 330, 333–334limitations, 464–465in lumbosacral plexopathy, 523at maximal contraction, 458at minimal contraction, 456motor unit electrical morphology, 456–457motor unit recruitment, 457–458in peroneal neuropathy, 530in posterior interosseous nerve entrapment, 505in pronator teres syndrome, 508recovery monitoring, 463–464

Index

xxxvVolume 1: Pages 1–416; Volume 2: Pages 417–886

at rest, 454–456in sciatic neuropathy, 525in supracondylar process syndrome, 506in ulnar neuropathy, 519See also Nerve conduction studies (NCS)

Electronystagmography (ENG), 322Electrophysiologic assessment

of spinal cord injury, 173of traumatic brain injury, 211

Electroretinography (ERG), 290Electrotherapy, 830Elevation

See Antigravity positioningEl Salvador, 28Elset wrap, 658–659Emergency medical care

burn injuries, 583–585spinal cord injury, 162traumatic brain injury, 225

EMGSee Electromyography (EMG)

Emotional counselingfor brain injured patients, 227–228for burn patients, 596, 623–626, 631, 633, 683–684cultural concerns, 849group, 849for hearing-impaired patients, 325for immobilized patients, 750in interdisciplinary team management, 832for lower extremity amputees, 84, 88, 101, 125, 133–134resistance to, 850for spinal cord injured patients, 180, 195–196for upper extremity amputees, 47, 52in vocational rehabilitation, 848–850See also Psychological support; Psychotherapy

Emotional needsfollowing injury, 847

Emotional reactionto war-related injuries, 846–848

Emotional sequelaeof traumatic brain injury, 238–239, 243–246, 253

Endocrine adaptationin resistance training, 810

Endocrinologic complicationsof immobility, 750–751of spinal cord injury, 185

Endoneurium, 427transection, 430–431

End organ changesfollowing denervation, 431–436

EnduranceSee Aerobic power; Anaerobic power

Energy expenditure for walkingwith ankle-foot orthoses, 723–724at different levels of lower extremity amputations, 92–93with functional electrical stimulation, 733of hemiplegic ambulation, 723with knee-ankle-foot orthoses, 729measurement, 723by multiple amputees, 149of normal ambulation, 724of paraplegic ambulation, 731with reciprocating gait orthoses, 732by spinal cord injured patients, 178of wheelchair locomotion, 731

Energy needsof burn patients, 684–686

Energy transfer

in exercise, 787–788Energy transformation

within muscle, 786ENG

See Electronystagmography (ENG)Enteral feeding

of burn patients, 602, 687–688Entrapment syndromes

of foot and ankle, 531–545lower extremity, 522–531upper extremity, 496–522See also Compression neuropathy; specific nerve

Environmental control systemsadaptive devices, 621

Environmental control unit (ECU)for spinal cord injured patients, 177, 179

Environmental stimulationand comatose patient, 236

Enzymatic debridement, 588–589Ephedrine sulfate, 184Epicondylar muscles

stretching, 373Epicondylitis, 355, 372

differential diagnosis, 372lateral, 372–374medial, 372–374rehabilitation, 373–374

Epidermoid cystson residual limb, 137

Epidural anesthesiafor lumbar pain, 382for residual limb pain, 142, 147

Epilepsyposttraumatic, 221

Epineurium, 427transection, 431

Épluchage, 597Equinus deformities, 83ERG

See Electroretinography (ERG)Ergometry

cycle, 800, 802Ergot alkaloids

for traumatic brain injury, 215, 219See also specific drug

ERMPsSee Early recovery management programs (ERMPs)

ERTL procedurefor lower extremity amputation, 95–96

Esophageal dysfunction, 333Esophageal manometry, 334Ethacrynic acid, 750Ethical issues

with traumatic brain injury, 235Ethnic groups

counseling concerns, 849Etidronate disodium, 221, 748, 750Etiracetam, 219Evoked potentials

gustatory, 314olfactory, 284trigeminal, 307–308visual, 290–291

Excision, 587–588, 597to fascia, 588instruments, 587–588tangential, 587–588

Exercise(s)


xxxvi Volume 1: Pages 1–416; Volume 2: Pages 417–886

acute responses to, 791for burn patients, 596–597, 602–606, 627–628, 635–637, 652–

653cardiovascular function during, 789–792energy generating systems for, 782energy transfer in, 787–788for immobility complications, 744, 765for lower extremity amputees, 88, 102–103, 123, 125medical problems associated with, 814–820mental concentration during, 635for musculoskeletal injuries, 355, 358, 383–385, 387–389for peripheral neuropathy, 469–470, 492, 495–496physiological principles, 787–792pulmonary function during, 788–789, 801for spinal cord injury, 167See also Physical capacity for exercise; Physical training;

specific type of exerciseExercise intolerance

in immobilized patients, 765Exertional rhabdomyolysis, 818Exidine

See ChlorhexidineExophthalmus, 297Exoskeleton prostheses, 132Expectancy

principle of, 623Explosions

burns caused by, 581Extension exercises

for musculoskeletal injuries, 383Extensor spasms

in spinal cord injured patients, 190–191Exteroceptive sensations

phantom limb, 143Eye closure

reflex, 313–314Eyelid muscles

innervation, 294Eye movement

clinical evaluation, 299muscular control, 293–294supranuclear control system, 294

Ezeform, 617

F

Facial dyskinesis, 312Facial exercise program

for burn patients, 653Facial movement

innervation, 310–311testing, 312–313

Facial myokymia, 314–315Facial nerve, 308–315

anatomy and function, 308–311Facial neuropathies, 311–315

electrodiagnosis, 314–315evaluation, 312–314management, 315prognosis, 315symptoms and signs, 312syndromes, 311–312

Facial orthosescompression inserts, 650fitting, 652–655immobilization, 630transparent, 638, 650–655wearing instructions, 651–652, 655

Facial pain, 304, 308Facial paralysis, 311–312Facial scars

camouflage makeup, 673, 690management, 638plastic surgery strategies, 692–693

FADSee Flavin adenine dinucleotide (FAD)See McMaster Family Assessment Devise (FAD)

Fadingof phantom limb sensation, 143

Falklands War, 443Family

role in interdisciplinary team, 833Family Adaptability and Cohesion Scales, 254Family assessment

in vocational rehabilitation, 853–854Family education

after brain injuries, 227–228, 231, 245, 254after burn injury, 601–602, 624after spinal cord injury, 180

Family Environment Scale, 254Family Needs Questionnaire (FNQ), 254Family outcome

after traumatic brain injury, 250–255Famotidine, 754Fascia

excision to, 588graft adherence on, 588

Fascicular compositionof peripheral nerves, 426–427, 435, 438–439, 442

Fasciculation potentials, 455Fasciitis, 355

plantar, 400–401Fast twitch (type 2) fibers, 784, 802, 809Fat

See Body fatFat-free mass, 792

correlation between body strength and, 795–796Fatigue

muscle, 786Fat intake

and burn injuries, 687FDA

See Food and Drug Administration (FDA)Fecal impaction

in immobilized patients, 753in spinal cord injured patients, 185

Feedingadaptive devices, 619–620, 676–677

Felbamate, 222Femoral neck stress fractures, 397Femoral nerve, 526Femoral neuropathy, 526–527

anatomic considerations, 526clinical presentation, 527electrodiagnosis, 526–527etiology, 526–527treatment, 527

Fenfluramine, 217Fentanyl (Fentaugh), 622Fertility

in spinal cord injured patients, 194–195FES

See Functional electrical stimulation (FES)Fiberglass cast material, 48, 53, 97–100Fiberglass orthoses, 617Fibrillation potentials, 454, 494

Index

xxxviiVolume 1: Pages 1–416; Volume 2: Pages 417–886

quantification, 455Fibrillations, 454Fibroblasts

and hypertrophic scar formation, 644Fibula

excess length, 140hypermobile, 140stress fractures, 397

Fifth ray amputations, 86Figure-8 clavicle strap, 638–639Figure-8 elastic bandage wraps, 656Figure-8 harness, 55–58Figure-8 wrapping technique, 88, 104–105, 125Filters

electrodiagnostic, 452–453Finances

and brain injured patients, 229and spinal cord injured patients, 180

Finger extension attachmentsfor hand orthoses, 705–706

Finger prostheses, 39extension, 39fabrication, 39See also Thumb prostheses

Fingerslengthening procedures, 36pollicization, 36–37scar compression, 671single amputation, 37See also Digital neuropathies

Finger splint, 615Finger wraps, 613Finkelstein’s test, 376Finnish War, 15First Conference of the International Federation of Automatic

Control, 65Fish-mouth flaps

for transfemoral amputation, 124Fitness

See Aerobic power; Physical fitnessFitzsimons Army Hospital, Colorado, 10, 52, 80, 148–149Fixation

for limb length preservation, 95Fixed ankle orthoses, 734–735Flame burns, 577Flavin adenine dinucleotide (FAD), 786Flex Foot, 116–117, 120

variants, 117–119Flexibility

decreased, 358–359as risk factor for injury, 817

Flexibility exercisesfor musculoskeletal injuries, 356, 359, 367–369, 386–387,

395Flexicare bed, 757Flexion exercises

for hamstring strain, 391–392Flexor hinge hand orthoses, 707–709

external power-driven, 708–709passive prehension, 709shoulder harness-driven, 708wrist extensor-driven, 707–708

Flexor pollicis longus tendon rupture/entrapment, 508–509Flexor spasms

in spinal cord injured patients, 190Flex Sprint, 117–118Flex Syme’s foot, 91, 117–118Flex Vertical Shock Pylon, 117, 119

Flex Walk, 117–118Fluid intake

during immobilization, 751Fluid resuscitation

average requirements, 585for burn shock, 585–587typical programs, 586

Flunarizine, 222Fluoride, 748Fluoroscopy

swallowing study, 327–328Fluoxetine, 215–217, 220, 476Fluvoxamine, 216Flynn phenomenon, 299FNQ

See Family Needs Questionnaire (FNQ)Foam finger pressure wraps, 615Foam rubber

in finger prostheses, 39for residual limb padding, 61

Follicular hyperkeratosisof residual limb, 137

Food and Drug Administration (FDA)drug approval, 214

Footarch height, 817musculoskeletal disorders, 395–401nerve injuries, 531–545positioning for burn injuries, 611scar compression, 676

Foot amputationsSee Partial foot amputations

Foot blisters, 818Foot fractures

stress, 397Foot orthoses

for burn injuries, 631, 641–643for superficial peroneal neuropathy, 542

Foot prostheses, 89–92in above-knee prostheses, 127in below-knee prostheses, 97–100, 110, 113dynamic response, 92, 115–120, 127multiaxis, 114–115, 120multiflex, 114–115selection, 120single-axis, 113–114See also specific type of prosthesis

Footwearas risk factor for injury, 817

Forced vital capacities (FVCs), 181Forearm

scar compression, 673strengthening exercises, 376

Forearm orthosiswith friction joints, 712

Forefoot amputation, 82Forequarter amputations, 43–45

prostheses, 59–60, 67Fort Sam Houston, Texas, 25Foster Kennedy syndrome, 287Foster turning frame, 186Fothergill’s disease

See Tic douloureuxFour bar hydraulic knee joint, 128Fovea centralis, 286Foville’s syndrome, 296, 311Fracture cast bracing, 735Fracture-dislocations


xxxviii Volume 1: Pages 1–416; Volume 2: Pages 417–886

neuropathies associated with, 440–443spinal, 175

Fracturesbrachial plexopathies caused by, 497, 499carpal tunnel syndrome caused by, 510, 513cranial neuropathies caused by, 280early ambulation after, 733–737interdisciplinary team management case study, 833–835lumbosacral plexopathy caused by, 523–524neuropathies associated with, 440–443posterior interosseous nerve entrapment caused by, 504pronator teres syndrome caused by, 506radial neuropathy caused by, 503sciatic neuropathy caused by, 525spinal, 173–175in spinal cord injured patients, 189stress, 396–397, 816–818ulnar neuropathy caused by, 516See also specific type of fracture

Frankel gradingof incomplete spinal cord injury, 169–170

Frastec, 594Free flaps, 591–592, 691–692Free radicals

and traumatic brain injury, 212Freezing injury

caused by volatile liquids, 577See also Cold exposure; Frostbite

Fresnel lenses, 299Frey’s syndrome, 303Friction feeder, 712Friction joints

for above-elbow prostheses, 57Friedreich’s ataxia, 217Frostbite, 123, 595–596, 637, 819–820

See also Cold exposureFunctional activities

assistive devices, 682for burn patients, 596, 601, 607, 618–621, 631, 674–680See also Activities of daily living (ADL)

Functional adaptation complex, 356Functional assessment

in traumatic brain injury, 224in vocational rehabilitation, 852–853, 855

Functional Assessment Inventory, 852–853Functional Assessment Measure, 224Functional biomechanical deficit, 356Functional capacity

effect of immobilization on, 743Functional electrical stimulation (FES), 606–607, 683, 709

for bracing, 732–733energy expenditure for walking with, 733for immobility complications, 743–745of peroneal nerve, 725–726

Functional Inventory Measure, 224Functional orthoses

shoulder/elbow, 713Functional outcome

after spinal cord injury, 170–173, 175–176after traumatic brain injury, 211–212

Functional substitutionafter traumatic brain injury, 212

Fundoscopy, 288Furacin, 582Furosemide, 750FVCs

See Forced vital capacities (FVCs)

G

GABAergic agentsfor traumatic brain injury, 213, 216, 219–220, 222

Gabapentin, 477, 490Gag reflex, 327, 332Gait pattern

with knee-ankle-foot orthoses, 729–731with metal ankle-foot orthoses, 718–720with plastic ankle-foot orthoses, 722–723with reciprocating gait orthoses, 732swing-through, 178

Gait trainingfor lower extremity amputees, 84, 88–89, 98, 102, 104, 106,

126, 133for multiple amputees, 149

Gait velocityat different levels of lower extremity amputation, 92–93with functional neuromuscular stimulation, 733in hemiplegic ambulation, 724in normal ambulation, 724in paraplegic ambulation, 731in wheelchair locomotion, 731

Gamma-vinyl GABAfor traumatic brain injury, 217

Ganglionic blockadefor causalgia, 489

Gangliosidesfor cranial neuropathies, 291for spinal cord injury, 167

Gangreneafter cold-exposure injury, 123

Gastric fluidshypersecretion, 333

Gastric ulcersin immobilized patients, 753–755

Gastritisstress, 184–185

Gastrocnemius-soleus musclesstretching, 398–399

Gastrointestinal complicationsof immobilization, 752–755of spinal cord injury, 184–185

Gaze stabilization, 324GCS

See Glasgow Coma Scale (GCS)Gender

and lifting strength, 806and physical capacity for exercise, 803–804as risk factor for injury, 816See also Women; Men

General Functioning Scale, 254Geniculocalcarine tract, 286Genitourinary complications

of spinal cord injury, 162, 181, 193–194See also specific complication

Genucentric knee orthoses, 736Genu recurvatum, 736Glasgow Assessment Scale, 224Glasgow Coma Scale (GCS), 211Glasgow-Liege Scale, 211Glasgow Outcome Scale (GOS), 224, 237Glenohumeral joint injuries, 370–371Glossopharyngeal breathing (GPB), 182Glossopharyngeal nerve, 325–329

anatomy and function, 325–326Glossopharyngeal neuralgia, 326, 328–329

Index

xxxixVolume 1: Pages 1–416; Volume 2: Pages 417–886

Glossopharyngeal neuropathies, 326–329electrodiagnosis, 328evaluation, 327–328imaging, 328management, 328–329prognosis, 328symptoms and signs, 327syndromes, 326–327

Glovesexternal vascular support, 659, 667Isotoner, 616, 618, 658–659, 667

Glucocorticoidsfor musculoskeletal injuries, 357–358, 364

Glucose intoleranceimmobilization-induced, 750–751

Glutamate, 212Glutamine supplementation, 687Glycerin suppositories, 753Glycolysis

anaerobic, 787–788Goal setting

and vocational rehabilitation, 847Goldthwait, Joel, 830Gordon Occupational Checklist, 854GOS

See Glasgow Outcome Scale (GOS)Gottfried Medical, Inc., 665GPB

See Glossopharyngeal breathing (GPB)Gradenigo’s syndrome, 296, 303Gradient pressure, 471, 645, 667

See also Vascular support garments; specific type of garmentGraefe disease, 296Granger, Frank B., 4Graph-lite prosthetic foot, 115Grasp

orthotic substitution for, 704–705Gray, Barbara, 23Gray matter, 165–166

damage, 165Greissinger foot prosthesis, 114, 120Grenada, 23Grieving process

in lower extremity amputees, 84Grooming

adaptive devices, 620, 677–679Ground electrodes, 453Growth cone, 432, 434Guanethidine infusion, 490Gunshot wounds

burns secondary to, 581cranial neuropathies caused by, 280, 287, 295–296, 326, 339spinal cord injuries caused by, 164–165traumatic brain injury caused by, 208–209See also Penetrating nerve injuries

Gustatory evoked potentials, 314Gustatory hyperhidrosis syndrome, 312Gustatory sensation, 310–311Gustatory sweating, 333Gustometry, 312Guttmann, L., 9Guyon’s canal, 514, 519–520

compression injury at, 520–521lesions within, 522

H

Hairs

coiled, 137Haldol, 220Hallucinations

auditory, 319in burn patients, 631olfactory, 283

Hallux valgus deformity, 85Halo skeletal traction, 630Halstead-Reitan Neuropsychological Battery, 195, 237Hamilton Rating Scale for Depression, 223Hamstring injuries, 390–392Hand

external vascular support, 658–659positioning for burn injuries, 610scar compression, 672

Hand amputations, 36–43central, 40, 43classification, 40occupational therapy, 41rehabilitation, 37–38, 41–42

Hand centersat military hospitals, 9World War II, 35, 38

Hand continuous passive motion machine, 616–618, 640–641Hand contractures

reduction, 709Hand controls

for driving, 54, 64, 178–179Hand deformities

caused by burns, 614, 639Hand function

with myoelectric prostheses, 69Hand injuries, 376–378

World War II, 35Hand orthoses, 38, 704–709

adaptive aid attachments, 707attachment principles, 704–705basic opponens, 705–706for burn injuries, 611, 630–631, 639–641flexor hinge, 707–709grasp assist, 704–705long opponens, 706–707power sources, 705, 708–709with radial extension, 704–705reach assist, 704–706, 710–713for specific functions, 705–707for ulnar neuropathy, 522

Hand prehension patterns, 705Hand prostheses, 36, 38–43

cosmetic, 43Hand reconstruction, 36–37

after burn injuries, 692–693World War II, 35

Hand splintshort opponens, 705

Hand terminal devices, 53, 70Hangman’s fracture, 174Harness designs

for upper extremity prostheses, 55–56Harris hemisling, 713Hassles Scale, 253HDL

See High density lipoprotein (HDL)Head injuries

and alcohol use, 239–241associated with spinal cord injuries, 195versus brain injuries, 208, 231


xl Volume 1: Pages 1–416; Volume 2: Pages 417–886

cranial neuropathies caused by, 280, 286, 295, 303, 311, 317,326, 331, 336, 339

incidence, 210olfactory dysfunction caused by, 282–283vertigo after, 319vocational rehabilitation, 856See also Traumatic brain injury (TBI)

Head orthosesfor burn patients, 638See also Facial orthoses

Head scarsmanagement, 645–655

Head tilt test, 299Healing

delayed, 135Hearing aids, 324Hearing impairments, 312, 318–319

adaptive devices, 324causes, 318–319incidence, 318management, 323–325prevention, 325

Hearing lossconductive, 318, 323–324sensorineural, 318, 324

Hearing scotomas, 319–320Hearing threshold level (HTL), 318Heart rate (HR), 790

exercise training based on, 790in immobilized patients, 764maximum, 790neural control, 790response to maximal exercise, 791

Heat cramp, 819Heat exhaustion, 819Heating modalities

used with stretching, 467, 746–747Heat injuries

See Thermal injuries; Burn injuriesHeat rash, 819Heat stress, 818–819Heat stroke, 819Heel cutoff

reduction of knee bending moment by, 717Heel pain, 536–537Heelstrike phase

with metal ankle-foot orthoses, 717–720with plastic ankle-foot orthoses, 722–723

Hematoma formationafter amputation, 134

Hemiinattentionafter traumatic brain injury, 220

Hemipelvectomy, 124functional outcome, 83

Hemiplegic ambulationenergy requirements, 723–724

Hemispatia neglectafter traumatic brain injury, 220

Hemodynamic changesafter amputation, 137–139in immobilized patients, 764–765

Hemorrhagespunctate, 209

Hemostasisin debrided wound, 588

Henneman’s size principle, 457Heparin, 183, 763–764Hering-Brewer reflex, 331

Herpes zoster, 296Hertzman, Carl, 8Heterograft

porcine skin, 593Heterotopic ossification (HO), 188

neurogenic, 221Hibiclens

See ChlorhexidineHigh-altitude pulmonary edema, 820High density lipoprotein (HDL), 182Highet’s grading system, 474–475High-threshold mechanoreceptors (HTM), 484Hill-Burton Act Amendments, 6Hindfoot amputations

surgical technique, 86–87See also Tarsotarsal amputations

Hines Veteran Administration Hospital, Chicago, 162Hinges

for above-elbow prostheses, 56–57for below-elbow prostheses, 53, 55step-up, 44, 53

Hippositioning for burn injuries, 610, 631scar compression, 675

Hip contracturesprevention, 101–102, 135in spinal cord injured patients, 189

Hip disarticulation, 124functional outcome, 83socket design, 132–133surgical technique, 124

Hip disorders, 389–392See also specific disorder

Hip stabilization orthoses, 704Hip subluxation

in spinal cord injured patients, 190Hirschberg reflex, 299Hispanics

counseling concerns, 849Histamine2-receptor antagonists, 754HIV

See Human immunodeficiency virus (HIV)HO

See Heterotopic ossification (HO)Hoffman-Tinel sign, 430Hollister Odor Absorbent dressing, 668Holmes-Adie syndrome, 287, 297Homan’s sign, 763Home accessibility aids, 681Home-based services

for brain injured patients, 228Home management

of burn patient, 680–681Homograft skin, 593Hook terminal devices, 53, 70Horizontal segment

of facial nerve, 309Horner’s syndrome, 303, 340Hospital

vocational assessment in, 850–857vocational rehabilitation in, 846–857

Hospital dischargevocational rehabilitation after, 858–859

Housekeepingadaptive aids, 681

Housingfor brain injured patients, 227, 229for spinal cord injured patients, 180, 196

Index

xliVolume 1: Pages 1–416; Volume 2: Pages 417–886

HRSee Heart rate (HR)

HTLSee Hearing threshold level (HTL)

HTMSee High-threshold mechanoreceptors (HTM)

Hubbard tank, 597Hughlings-Jackson syndrome, 332Human immunodeficiency virus (HIV)

disability cases, 881Humeral neck amputations, 44–45

prostheses, 59–60Humeral rotation devices, 56–57Hydergine, 219Hydration status assessment, 751Hydrocephalus

communicating, 211Hydrocolloid dressings, 594Hydrofluoric acid, 578Hydrogen-ion homeostasis, 788Hydronephrosis

in spinal cord injured patients, 193–194Hydrostatic weighing, 797–7995-Hydroxytryptophan, 217Hygiene

residual limb, 84, 107–108, 134, 136Hypafix, 668Hyperacusis, 312Hyperalgesia, 482Hypercalcemia

immobilization-induced, 750in spinal cord injured patients, 185treatment, 750

Hypercalcuria, 751Hyperemia

nerve damage caused by, 443–444reactive, 137

Hyperesthesia, 472Hyperesthetic desensitization, 472–473, 491–492, 495Hypermetabolic-catabolic response, 684Hypermobile segments

lumbar, 380, 383Hyperosmia, 283Hyperpathia, 482Hyperpigmentation

of burn wounds, 605, 633of residual limb, 136

Hyperplasiaverrucose, 138

Hyperpyrexiaafter traumatic brain injury, 217

Hyperreflexiaautonomic, 183–184

Hypersensitivitydenervation, 435–436, 456

Hypertensionin spinal cord injured patients, 183–184

Hypertonicitydefinition, 208in spinal cord injured patients, 190–191See also Spasticity

Hypertrophic scars, 643–645, 655–674Hyperventilation

reflex, 789Hypnosis

for burn pain management, 622–623for phantom limb pain, 147

Hypnotics

for phantom limb pain, 146Hypogeusia, 311Hypoglossal nerve, 338–342

anatomy and function, 338–339stimulation, 340–341

Hypoglossal neuropathies, 339–340electrodiagnosis, 340–341imaging, 341management, 341–342prognosis, 341symptoms and signs, 340syndromes, 340

Hyposmia, 283Hypotension

orthostatic, 175, 177, 184Hypothermia, 819

and traumatic brain injury, 213Hypoxic brain injury, 211, 234–235

I

IASPSee International Association for the Study of Pain (IASP)

ICSee Intermittent catheterization (IC)

IceSee Cryotherapy

Icelandic-New York (ISNY) socket, 130Ileus

in spinal cord injured patients, 184Iliotibial band (ITB) syndrome, 389–390Ilizarov technique

of stump lengthening, 96Imaging studies

in accessory neuropathies, 338in glossopharyngeal neuropathies, 328in hypoglossal neuropathies, 341in musculoskeletal injuries, 381–382in oculomotor neuropathies, 299–300in olfactory neuropathies, 285in spinal cord injury, 163–164, 173, 175, 192in traumatic brain injury, 211, 225, 230–231See also specific type of study

Imipramine, 476Immediacy

principle of, 623Immediate postoperative prosthesis (IPOP)

advantages and disadvantages, 98construction, 96–98for lower extremity amputations, 88, 96–98, 100, 124, 126for upper extremity amputations, 48and wound breakdown, 99–100

Immediate postoperative rigid dressing (IPORD)advantages and disadvantages, 99for lower extremity amputations, 87–88, 96, 99, 103–106,

124–126weight bearing, 99–100, 102and wound breakdown, 99–100, 135

Immersion foot, 443–446Immobility complications, 741–777

cardiovascular, 762–765endocrine, 750–751functional electrical stimulation for, 743–745gastrointestinal, 752–755historical background, 742integumentary, 755–758management, 743–765metabolic, 750–751


xlii Volume 1: Pages 1–416; Volume 2: Pages 417–886

monetary impact, 742musculoskeletal, 356, 359, 743–765neurologic, 748–750pathophysiology, 743Persian Gulf War, 742, 745, 756prevention, 8–9, 84, 101, 226respiratory, 758–762urinary tract, 751–753Vietnam War, 742See also Pressure sores; Contractures

Immobilizationfor back injuries, 383complications caused by, 102, 135, 175contractures during, 745–746for musculoskeletal injuries, 358–359, 371–372, 378, 385postgraft, 627, 629therapeutic use, 743types, 743

Immobilization orthosespostgraft, 629–631

Immobilization osteoporosis, 747–748, 750Immobilization phase

of wound care, 595–596, 625–631Impingement syndrome

in spinal cord injured patients, 189Inactivity

See ImmobilizationIncentive spirometry, 759–760Incontinence

in spinal cord injured patients, 193Independent living

for brain injured patients, 227, 229for spinal cord injured patients, 180, 196

Indomethacin, 354Induction Medical Form, 869–871Infantry

musculoskeletal injuries rate, 815–816Infection

after amputation, 134Inferior vena cava filters, 183Inflamed joints

immobilization of, 743Inflammatory reaction, 354, 357Inhalation analgesics

for burn patients, 622Inhalation injury, 584–585, 598–599, 620Innervation

muscular, 784–785vascular, 428

Innervation ratio, 448–449Inserts

for orthoses, 650, 664–674Inspiration

factors affecting, 181–182Insulin, 185Integumentary system

See SkinIntensity

of training, 807, 810, 812–813Interdigital neuromas, 544–545Interdigital web spacers, 615–616, 640, 642Interdisciplinary team, 7, 829–844

Army, 16case studies, 833–844in combat theater, 8–9composition of, 831–833concept of, 6–7historical perspective, 830–831

for lower extremity amputation, 81, 85, 89, 92, 101, 127,133, 147–148

for spinal cord injury, 175, 180, 195for traumatic brain injury, 208, 225–229, 255for upper extremity amputation, 47World War II, 9–10

Interdisciplinary team conference, 830Interest assessment

in vocational rehabilitation, 854–855Interest Check List, 854Interference pattern, 458Intermittent catheterization (IC)

in spinal cord injured patients, 193Intermittent mandatory ventilation mode, 599International Association for the Study of Pain (IASP), 481Interphalangeal (IP) joint

amputation at, 37extension attachments, 706

Interphalangeal (IP) joint stabilizers, 709Inter-potential interval (IPI), 463Interview

for neurobehavioral assessment, 242–243for vocational assessment, 853

Intracompartmental pressure, 440Intrafascicular derangement, 430Intrinsic bar

long opponens splint with, 706–707Intubation

of burn patients, 584, 598–600Inversion sprains

ankle, 397–399Investigation report

line of duty (LOD), 868–869, 877IOMED, 66Ion channels

cell membrane, 423–424Iowa City Buckner Microstomia Prevention Appliance (MPA),

615–616IPI

See Inter-potential interval (IPI)IPOP

See Immediate postoperative prosthesis (IPOP)IPORD

See Immediate postoperative rigid dressing (IPORD)Iraq

See Persian Gulf WarIschemia

residual limb pain caused by, 139Ischemic brain injury, 211, 234–235Ischemic cord injury, 166Ischemic neuropathy, 439–440Ischial containment sockets, 129–130Ischial weight-bearing orthoses, 734–735Ishihara’s chart, 288ISNY socket

See Icelandic-New York (ISNY) socketIsokinetic dynamometer, 802–803Isokinetic exercises, 813

for musculoskeletal injuries, 360for peripheral neuropathy, 470

Isokinetic fatigue test, 801Isometric contractions, 783Isometric exercises, 813

for immobility complications, 743for musculoskeletal injuries, 360, 362, 369, 371–374, 377for peripheral neuropathy, 469

Isotoner gloves, 616, 618, 658–659, 666–667Isotonic compression gloves, 471

Index

xliiiVolume 1: Pages 1–416; Volume 2: Pages 417–886

Isotonic exercises, 813for musculoskeletal injuries, 360, 362, 393for peripheral neuropathy, 469

Israeli Defense Forcecombat injuries, 13–16, 72, 150, 162exertion-related deaths, 817stress fractures, 817

Isshiki thyroplasty, 335ITB syndrome

See Iliotibial band (ITB) syndromeItching

after burn injury, 633

J

Jackson’s syndrome, 340Jacob’s ladder effect, 578Jaeger cards, 288Jay cushion, 196Jay Medical Ltd., 196Jefferson fracture

C-1, 173–174Jeltrate, 654Jitter, 463Job coach

for brain injured patients, 248–250Job search assistance, 858Job site training/enabling

for brain injured patients, 249Jobst custom stockings, 660Jobst Institute, Inc., 665Jobst Interim glove, 659Jobst Intermittent Compression Pump, 606–607, 682Jogger’s foot, 534, 537Joint capsule tightness

in spinal cord injured patients, 189Joint contractures

prevention, 88, 101–102, 125–126, 135in spinal cord injured patients, 189

Joint immobilizersprefabricated, 358

Joint mobility, 387passive resistance, 172See also Range-of-motion exercises

Jointsburn injury-induced changes, 690inflamed, 743preservation, 83See also specific joint

Jones, Sir Robert, 20Joule’s law, 579Joystick control

of wheelchair, 177Jugular foramen syndrome, 326, 332

K

KAFOsSee Knee-ankle-foot orthoses (KAFOs)

Kainate, 212Kanamycin, 591Kaneda instrumentation, 175Keloid, 644Kerlix, 600, 613, 630, 645Ketorolac, 495Kevlar shank-ankle-foot unit, 116Kevlar socks

for foot prostheses, 116Keyboard usage

adaptive aids, 681–682Kinaire bed, 604, 608, 628Kinaire foot cushion, 611Kinesiotherapist, 831Kinesthetic sensations

phantom limb, 143Kinetic Concepts, 182, 186Kinetic sensations

phantom limb, 143Kinnairbed, 186Kirk, Norman T., 38Kirkaldy-Willis’ degenerative cascade, 379Kitchen activities

adaptive aids, 681Klenzak-type ankle joint, 716–717Kling, 600, 630Kluver-Bucy syndrome, 222Knee

bending moment at, 717, 723fixed/locked, 734–735joint salvage, 93, 123positioning for burn injuries, 610–611scar compression, 675valgus deformity, 736–737varus deformity, 736–737

Knee alignmentorthoses for, 736–737

Knee-ankle-foot orthoses (KAFOs), 178, 726–733anterior stops, 729bilateral, 178, 731–732components, 726–729knee stabilization force, 726–727metabolic requirements, 729pelvic bands, 730–731reciprocating gait, 732Scott-Craig, 729, 732shear forces, 727–729standing balance, 730types, 726–727

Knee cage designs, 736Knee continuous passive motion machine, 618Knee contractures

prevention, 135in spinal cord injured patients, 189

Knee disarticulation, 82, 122–124advantages, 122functional outcome, 83indications, 124prostheses, 83, 123surgical technique, 124

Knee dislocationsstretch neuropathies associated with, 440–441

Knee disorders, 392–395ligament, 355, 392–395See also specific disorder

Knee lockmanual, 128

Knee orthosesgenucentric, 736

Knee prostheses, 127–133biomechanically stable, 128brake mechanisms, 127–128classification, 128disarticulation, 83fabrication, 129–131polycentric (four-bar), 128single axis, 128sockets, 129–131


xliv Volume 1: Pages 1–416; Volume 2: Pages 417–886

stability of, 127–128suspension, 131

Knee shearwith knee-ankle-foot orthoses, 727–729

Knee stabilitywith ankle-foot orthoses, 720, 723with knee-ankle-foot orthoses, 726–727

Knuckle-bender orthosis, 709Korean War

amputations, 134physical therapy, 22–23

Krukenberg procedure, 64Krusen, Frank H., 5, 8Kuehlthau, Brunetta A., 22Kushion flex, 670Kuwait

See Persian Gulf War

L

Labyrinthine segmentof facial nerve, 309

Lachman test, 392Lacrilube, 315Lacrimation

dysfunction, 312Lactate threshold, 789Lactic acid accumulation, 787, 789Lamb’s wool, 668Lamotrigine, 222Language disorders

after traumatic brain injury, 222Larrey, Barron, 443Laryngeal nerves

evaluation, 333–334muscles supplied by, 331paralysis, 331–332stimulation, 330

Laryngoplasty, 335Laryngoscopy, 333Laser beam scanning

for socket design, 121Latency, 459

residual, 512Lateral geniculate body, 286, 289Lateral plantar nerve, 532–533

branch-I entrapment, 536–537Lateral rotational treatment

for pulmonary complications, 759Lawson General Hospital, Georgia, 35, 80L-dopa

See LevodopaLeak speech, 181LE amputations

See Lower extremity (LE) amputationsLeave

convalescent, 872Lebanese Civil War, 14–15, 482, 490Lecithin, 218Leeds anxiety and depression scales, 251, 253Legal issues

with traumatic brain injury, 235Legal representation

during physical disability review process, 875Leg amputations

See Lower extremity (LE) amputationsLeg disorders

musculoskeletal, 395–401

See also specific disorderLehmann, Justus F., 6Levator palpebrae muscle

innervation, 292–293Levodopa, 214–215, 219, 222Lichenification

of residual limb skin, 136–137Lidocaine, 361, 372, 382, 513Lifting strength

gender differences, 806measurement, 806

Ligament injuries, 355, 392–394spinal, 173–174See also specific injury

Ligament of Struthers, 506Ligaments

function, 355resistance training-induced changes, 810

Limb length preservation, 83, 95–96Limb salvage

versus lower extremity amputations, 81–83, 122–123Line of duty (LOD)

disability payments, 865investigation report, 868–869, 877

Linersfor prosthetic sockets, 107–108, 140–141

Lingual nervecompromise, 304

Lipid, 792Lipid intake

and burn injuries, 687Lisfranc’s amputations

See Tarsometatarsal amputationsLisuride, 214–215Lithiasis, 751Lithium carbonate, 240LLB

See Long leg braces (LLB)LMB finger pressure wraps, 612–613, 615, 658Load cells, 802Local anesthetic blocks

for phantom limb pain, 146Local flaps, 691Locked ankle orthoses, 734–735Lockjaw, 304LOD

See Line of duty (LOD)Longitudinal arch, 537

medial plantar nerve entrapment at, 537–538Long leg braces (LLB), 733Long’s Line, 129Long-term care facilities

for brain injured patients, 226–227Long thoracic nerve, 496

injury to, 498Lorazepam, 220Low-air-loss bed, 186, 757Low back pain, 11, 378–389, 857Lower extremity (LE) amputations, 79–159

causes, 34complications, 134–148early, 122–123and energy expenditure for walking, 92–93indications, 122level selection, 83, 135versus limb salvage, 81–83, 122–123multiple, 148–149nerve recovery in, 82

Index

xlvVolume 1: Pages 1–416; Volume 2: Pages 417–886

patient education, 84, 101–102rehabilitation, 81–85, 93, 101, 106sensory feedback, 85, 93surgical procedures, 83–84World War II, 34–35See also Above-knee amputations (AKA); Below-knee

amputations (BKA); specific type of amputationLower extremity nerve injuries, 522–531

See also specific injuryLower extremity orthoses, 704, 715–737

See also specific type of orthosisLower extremity prostheses

long-term maintenance, 92, 106, 133–134postoperative fitting, 85psychological support, 84residual limb interface, 89, 96–97, 104, 107, 129, 131, 136–

137, 142–143temporary, 84, 88, 96–100See also specific type of prosthesis

Lower extremity scar compression, 675–676Lower respiratory tract infection

in immobilized patients, 759Low load

definition, 603Low threshold mechanoreceptors (LTM), 484Lumbar plexus, 522–523Lumbar radiculopathy, 379–381Lumbar spine

contusions, 386–389Kirkaldy-Willis’ degenerative cascade, 379muscle strain, 386–389pars interarticularis injury, 385–386posterior element pain, 384

Lumbar spine disorders, 378–389classification, 378–382diagnosis, 378–382imaging, 381–382rehabilitation, 382–385

Lumbar sympathetic blockagefor causalgia, 489–490

Lumbosacral plexopathy, 522–524anatomic considerations, 522–523clinical presentation, 523electrodiagnosis, 523–524etiology, 523

Lumbosacral spine, 167–168injury, 169

Lumbrical bar hand orthosisfor ulnar neuropathy, 522

Lund and Browder chart, 580Luria-Nebraska Neuropsychological Battery, 195

M

Macerationof residual limb skin, 136

Macfarlane microstomia correction device, 638Macrophages

role after denervation, 433Madigan Army Medical Center, Washington, 10–11Mafenide acetate, 582Magnesium depletion

immobilization-induced, 750Magnetic resonance imaging (MRI)

in cranial neuropathies, 285, 299, 341in musculoskeletal injuries, 381neuroma location with, 140socket design with, 121, 130

in spinal cord injury, 163–164, 173, 192in traumatic brain injury, 225, 230

Makeupfor burn patients, 673, 690

Mallet finger, 614Mandibular nerve, 300Mangled Extremity Syndrome Index (MESI), 82, 122–123Mannitol, 585Marcus-Gunn pupil, 290Mare Island Naval Hospital, California, 10, 52, 149Marine Corps

body fat standards, 796–798Marital instability

and brain injuries, 253–254and spinal cord injured patients, 196

Martin-Gruber anastomosis, 517–518Massage

desensitization with, 634external, 471for phantom limb pain, 147–148

Massage and Therapeutic Exercise (McMillan), 21Masseter inhibitory reflex

electrodiagnostic evaluation, 305Masseter reflex, 302

electrodiagnostic evaluation, 305Master knot of Henry

See Longitudinal archMastication muscles

paralysis, 304–305Mastoid segment

of facial nerve, 309Maturation phase, 355Maxillary nerve, 300Maximum physiologic potential, 743Maximum voluntary isometric contraction (MVC), 744Mayo Clinic, 5, 9McCance, R. A., 742McCloskey General Hospital, 35, 80McGuire General Hospital, Virginia, 80MCL

See Medial collateral ligament (MCL)McMaster Family Assessment Devise (FAD), 252, 254McMillan, Mary, 20–22, 830MCP joint

See Metacarpophalangeal (MCP) jointMCVOST

See Medical College of Virginia Olfactory Screening Test(MCVOST)

Meatal segmentof facial nerve, 309

MEBSee Medical Evaluation Board (MEB)

Mechanical ventilationin burn patients, 599

MEDCOMSee Army Medical Command (MEDCOM)

Medial antebrachial cutaneous nerve injury, 498–499Medial capsuloligamentous injuries, 374–376Medial collateral ligament (MCL), 393–394Medial cutaneous nerve, 496Medial plantar nerve, 532–533, 543

entrapment at longitudinal arch, 537–538Medial tibial stress syndrome, 395–396Median nerve, 496, 506–507, 509–510Median neuropathy, 505–514

case scenario, 491–493compression sites, 505–506orthotics, 640–641


xlvi Volume 1: Pages 1–416; Volume 2: Pages 417–886

Methylprednisolone, 163, 167, 513Metropolitan Life Insurance tables, 793, 797Mexiletine, 146, 148, 477–478MF2K

See Medical Force 2000 (MF2K)Microfoam tape, 670Microstomia correction devices, 638Microstomia Prevention Appliance (MPA), 615–616Microwave diathermy, 746Midazolam, 622Midfoot amputations, 85

prosthetic fitting and training, 90surgical technique, 86See also Tarsometatarsal amputations; Transmetatarsal

amputationsMilitary history of patient

in disability compensation evaluation, 868–869Military Medical Retention Board (MMRB), 867Military Occupational Specialty-Military Medical Retention

Board (MOS/MMRB), 867Military pensions

See Physical disability systemMilitary performance

physical fitness and training for, 781–827Military populations

body fat percentage values/standards, 794physical capacity for exercise, 803–806

Military servicesbody fat measurement methodology, 797–799body fat standards, 796–797physical disability system, 863–885weight control programs, 793, 796–797

Millard-Gubler syndrome, 296, 311Mind-body connection, 846Mineral requirements

of burn patients, 687Mini compartment syndrome, 540Minnesota Multiphasic Personality Inventory (MMPI-2), 195,

239, 241, 244–245, 857Minority groups

counseling concerns, 849Miosis

in darkness, 299Misdirection syndrome, 299Misoprostol, 754–755Missile wounds

brachial plexopathies caused by, 497spinal cord injuries caused by, 164traumatic brain injury caused by, 208–209

Mithramycin, 750MMPI-2

See Minnesota Multiphasic Personality Inventory (MMPI-2)

MMRBSee Military Medical Retention Board (MMRB)

MMTNSee Myelinated mechanothermal nociceptors (MMTN)

Mobility trainingfor lower extremity amputees, 84, 102

Mobilizationafter spinal cord injury, 175See also Ambulation

Möbius’ syndrome, 296, 311Modular Flex Foot, 117–118Moleskin, 668Monopolar needle electrodes, 453Morphine, 217, 600Morphine sulfate, 495

Medical College of Virginia Olfactory Screening Test(MCVOST), 284

Medical diagnosesand disability compensation evaluation, 872

Medical Evaluation Board (MEB), 865–868establishment, 868membership, 868Narrative Summary (NARSUM), 868–872versus Physical Evaluation Board (PEB), 872

Medical Force 2000 (MF2K), 28–29Medical history of patient

in disability compensation evaluation, 868–869Medical treatment facilities (MTFs)

brain injury rehabilitation centers, 225–226physical medicine and rehabilitation at, 9–16spinal cord injury treatment at, 163See also specific center

Medicare/Medicaid, 6Medications

See Pharmacologic therapy; specific medicationMedroxyprogesterone acetate, 222Medulla, 790–791Megacolon

in spinal cord injured patients, 185Melanocyte stimulating hormone (MSH), 218Mellaril, 220Membrane instability

denervation, 435–436Membrane potential, 423–425, 449

alteration following denervation, 436Memory function

and neurotransmitter systems, 218and traumatic brain injury, 218, 230

Menmilitary body fat standards, 796, 798percent body fat values, 794physical capacity for exercise, 803–804reference body composition values, 792

Menace reflex, 313Mendez, Cristobal, 742Mental concentration

during exercise periods, 635Mental status alterations, 230Meperidine, 495Mephanesin, 308Merthiolate, 632, 656Mesencephalon, 291–292Meshed skin grafts, 589–591, 644MESI

See Mangled Extremity Syndrome Index (MESI)Metabolic requirements

of burn patients, 684–686See also Energy expenditure for walking

Metabolismeffect of immobility on, 742, 750–752

Metacarpalsphalangization, 36

Metacarpophalangeal (MCP) jointamputation at, 37, 42extension attachments, 705–706

Metal orthosesankle-foot, 715–720

MetamucilSee Psyllium hydrophilic mucilloid fiber

Methadone, 495, 600, 622N-methyl D-aspartate, 212Methyldopa, 220Methylphenidate hydrochloride, 214–215, 219

Index

xlviiVolume 1: Pages 1–416; Volume 2: Pages 417–886

Morton’s toe neuroma, 543MOS/MMRB

See Military Occupational Specialty-Military MedicalRetention Board (MOS/MMRB)

Motion Control, Inc., 66Motivation

to recover, 846–847Motoneurons, 449–450, 784–785Motoneuron weakness

after spinal cord injury, 167Motor cortex, 790Motor fitness, 782Motor function

after peripheral neuropathy, 464–465and ulnar neuropathy, 516

Motor unit, 448–449, 784–785activity duration, 456electrical morphology, 456–457recording phases, 456–457recruitment, 457–458, 785size, 448–449

Motor unit potentialamplitude, 457polyphasic, 456–457, 463–464

Mouthpositioning for burn injury, 609

Mouth stretchfor facial contractures, 652

Mouth-stretching devices, 652–653, 655Movement disorders

after traumatic brain injury, 220–221MP

See Myoelectric prosthesesMPA

See Microstomia Prevention Appliance (MPA)MRI

See Magnetic resonance imaging (MRI)M.S. Contin, 622MSH

See Melanocyte stimulating hormone (MSH)MTFs

See Medical treatment facilities (MTFs)Mucomist

See AcetylcysteineMuenster socket, 53Multiaxis foot prostheses, 114–115, 120Multidisciplinary approach

See Interdisciplinary teamMultiflex ankle/foot, 114, 120Multiple sclerosis, 296, 322Multireceptive neurons, 484Muscle

denervation-induced changes in, 434–436Muscle(s)

antagonist, 782artificial, 708–709contractility, 783–784energy stores, 787energy transformation within, 786fiber types, 784force development, 785immobility-induced ultrastructural changes in, 744–745innervation, 784–785oxidative capacity, 801and physical fitness, 792–799structure and function, 782–786

Muscle atrophyafter denervation, 435

in burn patients, 606due to immobilization, 744–745

Muscle fatigue, 786Muscle fibers

classification, 784contractile tension loss in, 786fast twitch (type 2), 784, 802, 809slow twitch (type 1), 784structure, 783type distribution, 784

Muscle hypertrophy, 809Muscle mass

and body weight, 793correlation between body strength and, 795–796, 803increase in, 793–794loss in, 794

Muscle sitesfor myoelectric prostheses, 69

Muscle sorenessavoidance, 603

Muscle strainlumbar, 386–389

Muscle strengthSee Strength

Muscle tonegrading, 172, 208

Muscular contractionconcentric, 783eccentric, 783isometric, 783mechanism, 783–784neural control, 784–786static, 783types, 782–783

Muscular enduranceSee Anaerobic power

Musculocutaneous flaps, 691–692Musculocutaneous nerve injury, 499Musculoskeletal disorders, 353–356

components, 356–357diagnosis, 356–357exercise-associated, 814–817forward care, 8, 11–13, 24healing, 355–356, 358–360local effect minimization, 357–358mechanisms, 354–355pathophysiology, 354–356Persian Gulf War, 11–13physical therapy for, 20, 24rehabilitation, 8, 11–13, 29, 356–401return to duty, 360in spinal cord injured patients, 188–189symptoms and signs, 355–356World War I, 354See also specific disorder

Musculoskeletal systemeffect of immobility on, 743–748

Mustard, 578MVC

See Maximum voluntary isometric contraction (MVC)Myasthenia gravis, 296Myelin, 422–423Myelinated mechanothermal nociceptors (MMTN), 484Myelin debris removal

role of macrophages in, 433Myelin sheath

denervation-induced changes in, 433Myelin thickness


xlviii Volume 1: Pages 1–416; Volume 2: Pages 417–886

and conduction velocity, 449Myelograms, 381Myocardial infarction

silent, 184Myoclonus

after traumatic brain injury, 220–221Myocutaneous flaps

for pressure sores, 187Myodesis, 95, 124

definition, 122versus myoplasty, 122unbalanced, 140

Myoelectric electrodes, 65, 67Myoelectric prostheses

above-elbow, 56advantages and disadvantages, 69, 71below-elbow, 53bilateral, 62components, 67–68control systems, 65–67versus conventional prostheses, 68–71cosmetic covers for, 68–69, 71evaluation of candidates, 68history, 65humeral neck, 59hybrid (myoelectric and body-powered), 62rehabilitation issues, 68–69sensory feedback with, 67, 69for upper extremity amputations, 44–46, 65–69Utah brand, 67–68

Myoelectric testing device, 69Myofibrils, 783–784Myofibroblasts

and hypertrophic scar formation, 644Myofilaments

denervation-induced loss, 434–435Myogenic contractures, 746

in denervated muscles, 435, 465–467, 491Myokymic discharges, 455Myoplasty, 95

definition, 122versus myodesis, 122

Myosin, 783–784Myositis ossificans

See Heterotopic ossification (HO)Myotendinous contracture

in spinal cord injured patients, 189Myotomal levels

for neurological evaluation of spinal cord injury, 169

N

NAD+See Nicotinamide adenine-dinucleotide (NAD+)

Naftidrofuryl, 219Naloxone, 216Naltrexone, 216–217Naprosyn, 492, 495Narcotics

for musculoskeletal injuries, 364for phantom limb pain, 146, 148for spinal cord injured patients, 191–192

Narrative Summary (NARSUM)Medical Evaluation Board (MEB), 868–872

National Center for Medical Rehabilitation Research, 6National Head Injury Foundation (NHIF), 227National Institutes of Health, 6

obesity definition, 793, 797

Navybody fat standards, 796–798disability system, 883–884obesity definition, 793, 797physical therapy services, 25–26

Neckcontracture prevention, 630, 638, 649–652passive stretches for, 362positioning for burn injuries, 609scar management, 645–655strengthening, 362

Neck and tongue syndrome, 303Neck injuries, 361–363

cranial neuropathies caused by, 280, 336See also specific injury

Neck orthoses, 630, 638, 650–652Necrosis

after amputation, 135Necrotic muscle

left in wound, 81Needle electrodes, 453

concentric, 453monopolar, 453single fiber, 453

Negative feedback loopin musculoskeletal injuries, 357

Neoprene, 670Nerve blocks

for lumbar pain, 382for residual limb pain, 147

Nerve conduction blockelectrodiagnostic findings, 460–461

Nerve conduction studies (NCS), 458–459in accessory neuropathies, 338action potential duration, 459amplitude, 459in anterior interosseous syndrome, 509in brachial plexopathies, 498–500in carpal tunnel syndrome, 512–513in compartmental syndromes, 440conduction velocity, 459and determination of injury severity, 459–462electrodes, 453in facial neuropathies, 314–315in femoral neuropathy, 526–527filter settings, 452in foot and ankle nerve injuries, 531in hypoglossal neuropathies, 340–341instrumentation, 450–453latency, 459limitations, 464–465localization with, 462in lumbosacral plexopathy, 524in peroneal neuropathy, 529–530in posterior interosseous nerve entrapment, 505in pronator teres syndrome, 508in radial neuropathy, 503recovery monitoring, 463–464in sciatic neuropathy, 525–526in superficial radial nerve compression, 505in sural entrapment neuropathy, 543in tarsal tunnel syndrome, 535timing of, 460–461in ulnar neuropathy, 514, 517–522in vagus neuropathies, 333–334

Nerve conduction velocity calculation, 459effects of temperature on, 445and myelin thickness, 449

Index

xlixVolume 1: Pages 1–416; Volume 2: Pages 417–886

Nerve entrapmentperipheral, 192–193

Nerve excitability studiesin facial neuropathies, 314

Nerve fibersmyelinated, 422–423unmyelinated, 422–423

Nerve impulse propagation, 424–425, 449–450, 785Nerve root stimulation

for thoracic outlet syndrome, 502Nerve tissue pressure thresholds, 438Nerve trunk pain, 475Nerve trunk transection, 431Neural adaptation

in resistance training, 810Neural connection alterations, 212Neuralgia

atypical, 280trigeminal, 280

Neural membrane stabilizersfor peripheral nerve injuries, 477–478, 490

Neural recovery mechanisms, 212–213, 431–432Neural reserve

and brain injury prognosis, 210Neuroanatomy, 422–423, 426–427Neurobehavioral assessment, 231, 237

protocol, 242–244test interpretation and reporting, 244–245test selection and administration, 243–244theoretical rationale, 241–242

Neurobehavioral programsfor brain injured patients, 228

Neurobehavioral Rating Scale, 223Neurogenic heterotopic ossification

after traumatic brain injury, 221Neurogenic spinal arthropathy

See Charcot’s spineNeuroimaging

in traumatic brain injury, 211, 225, 230–231Neuroleptics

for phantom limb pain, 146for traumatic brain injury, 217, 220, 240

Neurological complicationsof burn injury, 689–690of immobility, 748–750of spinal cord injury, 189–193

Neurological evaluation, 167–173, 195myotomal levels, 169segmental reflexes, 171–172sensory levels, 169

Neurologic stateslow level, 234–235

Neuromasacoustic, 322in lower extremity amputees, 122, 140and phantom limb pain, 144, 146–147in upper extremity amputees, 61

Neuromatrix theoryof phantom limb pain, 126, 145

Neuromedical issueswith traumatic brain injury, 217, 222–224

Neuromedical workupstandard, 227

Neuromuscular junction, 425, 450, 784–786failure, 460

Neuromusculoskeletal conditionsphysical therapy for, 20, 24–26See also Musculoskeletal disorders; specific disorder

Neuron, 422–423motor, 449–450, 784–785multireceptive, 484vascular supply, 427–428

Neuronal reorganization, 212Neuronal signaling, 423–425Neuronal sparing, 212–213Neuropathic pain

classification, 475management, 475–479

Neuropathydiabetic ischemic, 296evaluation, 82Persian Gulf War, 11–14, 38, 80See also Cranial neuropathies; Peripheral nerve injuries;

Spinal cord injury (SCI); specific injuryNeurophysiology, 212–213, 423–426, 448–450

of peripheral nerves, 448–450Neuropraxia, 429Neuropsychological tests

interpretation and reporting, 244–245selection and administration, 243–244See also specific test

Neuropsychopharmacology, 214–222Neurosignature, 145Neurotmesis, 429Neurotoxic cascade

after traumatic brain injury, 212–213Neurotransmitters, 425, 450, 785

and traumatic brain injury, 212–213, 218NHIF

See National Head Injury Foundation (NHIF)Nicardipine, 479Nicotinamide adenine-dinucleotide (NAD+), 786Nifedipine, 183–184, 47997th General Hospital, Germany, 11Nitrofurantoin, 752Nitrogen balance equations, 688, 750Nitropaste, 183Nizatidine, 754NMS conditions

See Neuromusculoskeletal conditionsNodes of Ranvier, 423Nonphysician healthcare providers, 24–26

See also specific type of providerNonsteroidal antiinflammatory drugs (NSAIDs)

adverse effects, 193for musculoskeletal injuries, 354, 357, 367, 383for peripheral nerve injuries, 478–479, 490for phantom limb pain, 145, 148for traumatic brain injury, 221See also specific drug

Nootropicsfor traumatic brain injury, 219See also specific drug

Noradrenergic treatmentfor traumatic brain injury, 213, 220

Norepinephrine, 212, 219, 476Normal shape, normal alignment (NSNA) socket, 129, 139Northwestern University, 5, 9Nortriptyline, 219, 476Nose

positioning for burn injury, 609prosthetic, 655

Nose orthosis, 655NSAIDs

See Nonsteroidal antiinflammatory drugs (NSAIDs)N-ter-face, 591, 594


l Volume 1: Pages 1–416; Volume 2: Pages 417–886

Numb cheek syndrome, 303–304Numb chin syndrome, 304Nurses

role in interdisciplinary team, 832–833World War II, 22

Nursingduring acute phase of burn injury, 596–607during immobilization phase of burn injury, 625–627during wound maturation phase of burn injury, 632–635

Nutritionand amputation complications, 135and burn patients, 602, 684–689and cranial neuropathies, 285, 296and immobilization, 752, 754and pressure sores, 187

Nutritional assessmentof burn patients, 684–687of immobilized patient, 752

Nutritional monitoringof burn patients, 688–689

Nutrition care planningfor burn patients, 687–688

Nystagmus, 319, 321

O

Oakland Naval Hospital, 149Ober’s test, 390Obesity, 793

Navy definition, 793, 797OBLA

See Onset of blood lactate accumulation (OBLA)Obstipation

in spinal cord injured patients, 185Occulocardiac reflex, 333Occupation

and aerobic fitness, 804and disability compensation evaluation, 869–872and lower back pain, 378–389physical training specific to, 808, 814

Occupational therapistsKorean War, 23role in interdisciplinary team, 7, 831–832

Occupational therapyfor above-knee amputees, 133in Army, 16for functional impairments, 15history, 830–831importance of, 8–9for lower extremity amputations, 84, 102for mild traumatic brain injury, 231for multiple amputees, 149for nerve injuries, 12for spinal cord injured patients, 179–180for upper extremity amputations, 38, 41–42, 52See also Vocational rehabilitation

Occupational Therapy Association, 831Ocular muscles

innervation, 293–294Ocular neuromyotonia, 297Oculomotor nerve, 291–300

anatomy and function, 291–295muscles innervated by, 293–294

Oculomotor neuropathies, 295–300electrodiagnosis, 299imaging, 299–300management, 299–300symptoms and signs, 297–299

syndromes, 296–297valuation, 299

Odontoid fractureC-2, 174

Odorfrom vascular support garments, 656See also Smell

Odor identification test, 283OEA

See Operations, Evaluations, and Analysis Officer (OEA)Office of The Surgeon General (OTSG), 20, 22–23, 80

Army Patient Administration Division, 27Reconditioning Division, 22

OHSee Orthostatic hypotension (OH)

Ohm’s Law, 451Olfactometer, 284Olfactory evaluation, 283–285Olfactory evoked potentials, 284Olfactory hallucination, 283Olfactory nerve, 282–285

anatomy and function, 282–283Olfactory neuropathies, 282–285

electrodiagnosis, 284–285evaluation, 283–284imaging, 285incidence, 282management, 285prognosis, 285symptoms and signs, 283

Olfactory recognitiondiminished, 283

Olfactory threshold tests, 284Omeprazole, 754Omniderm, 594One repetition maximal lift, 806One repetition maximum (1RM), 802, 812Onion skin pattern of Dejerine, 169Onset of blood lactate accumulation (OBLA), 789Open axillary abduction splint

See Airplane splintsOpen circular amputation, 45–46, 83, 134

advantages, 94disadvantages, 95surgical technique, 94

Open flap techniquefor limb revision, 95

Operation Job Match, 855Operations, Evaluations, and Analysis Officer (OEA), 877Ophthalmic nerve, 300Ophthalmoplegia, 295–296Opioid antagonists

for traumatic brain injury, 216–217, 222Opioids

and traumatic brain injury, 218Opponens hand splints, 705–707Opsite, 593–594Optic atrophy, 287Optic chiasm, 288Optic nerve, 285–291

anatomy and function, 285–286Optic neuropathies, 286–290

evaluation, 288–290incidence, 286–287management, 291prognosis, 291symptoms and signs, 287–289syndromes, 287

Index

liVolume 1: Pages 1–416; Volume 2: Pages 417–886

Optic radiations, 286, 289Optic tract, 286, 289Optokinetic reflex, 294Oral contractures

management, 638Oral phase

of swallowing, 327“O” ring

in upper extremity prostheses, 55, 58Orthopedic felt, 668Orthopedic mechanics

See ProsthetistsOrthopedics

in combat theater, 8history, 830–831Persian Gulf War, 27role, 15Vietnam War, 24

Orthopedic traumaimmobilization for, 743

Orthoplast, 617Orthoses, 703–740

algorithm for use of, 612for burn patients, 596, 600, 611–618, 629–630, 637–643commonly used materials, 617compression inserts, 650, 664–674contact dermatitis caused by, 668–669lower extremity, 704, 715–737for nerve injuries, 12–13overlays, 664–674for peripheral nerve injuries, 471–472, 492, 495postgraft immobilization, 629–631for shin splints, 396for skeletal insufficiency, 733–737upper extremity, 704–715See also specific type of orthosis

Orthostasisimmobility-related, 748–749, 765

Orthostatic hypotension (OH)in spinal cord injured patients, 175, 177, 184

Orthotists, 832Osteomyelitis, 134

in spinal cord injured patients, 187–188Osteomyoplasty, 95–96Osteoperiosteal bone flaps, 95–96Osteoporosis

immobilization, 747–748, 750in spinal cord injured patients, 189

Otoform K, 667, 670Otoscopic examination, 321Ototoxic drugs, 323OTSG

See Office of The Surgeon General (OTSG)Otto Bock 1D10 Dynamic Foot, 120Otto Bock hands, 69–70Outpatient care

for burns, 583–584, 636transition from inpatient care to, 858–859for traumatic brain injury, 227–228

Overhead walkers, 604–605Overlays

for orthoses, 664–674Overload, 472, 807

musculoskeletal, 357, 359–360physiological response of bone to, 817progression, 807

Overstretchingcomplications, 466

Overt Aggression Scale, 223Overtraining, 809Overweight, 793

definition, 793, 797Overwork injury

clarification, 467–468foot and ankle, 531–532

Overwork weaknessdefinition, 467

Oxcarbazepine, 222Oxford technique, 469Oxidative capacity

of muscle, 801Oxidative phosphorylation, 786–787Oxotremorine, 218Oxycodone, 622Oxygen (O2)

partial pressure (PO2), 789, 791utilization, 788

Oxygen consumption (VO2), 787, 789and cardiac output, 790See also Volume of maximum oxygen consumption

(VO2max)Oxygen content

arterial, 801Oxygen transport system

factors that limit, 792, 800–801Oyster shell orthoses, 655

P

Paced Auditory Serial Addition Test, 243PAFOs

See Plastic ankle-foot orthoses (PAFOs)Pain

acute, 621back, 11, 378–389, 743, 857burn, 621–622causalgia-associated, 482chronic, 621deafferentation, 475dysesthetic, 475facial, 304, 308heel, 536–537nerve trunk, 475neuropathic, 475patellofemoral, 394–395posterior element, 384–385at residual limb/prosthesis interface, 142–143retroauricular, 312in spinal cord injured patients, 191–192throat, 332–333See also Phantom limb pain; Residual limb pain

Pain clinicsfor phantom limb pain, 147–148

Pain managementfor burn patients, 599–600, 621–623, 625–626for causalgia, 489–492, 495for lower extremity amputation, 88, 125, 134, 147for musculoskeletal disorders, 357–358for peripheral nerve injuries, 474–479for spinal cord injured patients, 191–192See also specific type of drug or treatment

Pain syndromessympathetically maintained, 428, 481

Palatal archevaluation, 327

Palatal reflex, 327


lii Volume 1: Pages 1–416; Volume 2: Pages 417–886

Palatedefective elevation, 332examination, 333

Palmar stimulationfor carpal tunnel syndrome, 512

Palm orthosis, 640–641, 667Pamidronate, 750Panama, 23Papaverine hydrochloride, 219Papilledema, 287Parallel bars

and amputees, 103–104, 148and spinal cord injuries, 177–178

Paralytic ileusin burn patient, 602

ParaosteoarthropathySee Heterotopic ossification (HO)

ParaplegiaSee Spinal cord injury (SCI)

Paraplegic ambulation, 177–178, 731energy expenditure, 731

Parathyroid hormone levelsin immobilized patients, 750

Paratrigeminal syndrome, 303Parenteral nutrition support

for burn patients, 688Parinaud’s syndrome, 297Parkinsonism

after traumatic brain injury, 220, 222Parkland shoe, 615Parosmia, 283Paroxetine, 215–216, 220Pars interarticularis injury, 385–386Pars stress reaction, 385Partial anterior interosseous syndrome, 509Partial calcanectomy, 87Partial foot amputations, 85–93

joint contractures, 88long-term follow-up, 92prosthetic fitting and training, 89–92rehabilitation, 87–89surgical technique, 85–87See also specific type of amputation

Partial pressure of carbon dioxide (PCO2), 789response to maximal exercise, 791

Partial pressure of oxygen (PO2), 789response to maximal exercise, 791

Partner-resisted exercises, 812PA Section

See Physician Assistant (PA) SectionPassive prehension orthoses, 709Passive range-of-motion (PROM)

for burn patients, 605–606, 616–618contraindications, 603definition, 602

Passpointing, 321Patch test

for allergic contact dermatitis, 139Patellar tendon bearing, total contact socket (PTB-TCS), 107,

139hard, 108soft, 107supracondylar, 108–109

Patellar tendon-bearing orthosis, 735–736Patellar tendon-bearing prosthesis

alignment check using, 103–104Patellofemoral pain syndrome, 394–395Patient

role in interdisciplinary team, 833Patient age

See Age; Children; ElderlyPatient controlled analgesia (PCA), 88, 125Patient education

after burn injury, 601–602after spinal cord injury, 175–180, 186–187after traumatic brain injury, 231, 245in hand rehabilitation, 38and hearing impairments, 323–325for lower extremity amputees, 84, 101–102, 133, 138for musculoskeletal injuries, 382–383for upper extremity amputees, 52, 65, 68–69

Patient Evaluation Conference System, 224Patient history

in disability compensation evaluation, 868–869Patten bottom

orthoses with, 734–735Pattern recognition system

using phantom limb sensation, 66Pavlov ratio, 165PCA

See Patient controlled analgesia (PCA)PDB

See Physical Disability Branch (PDB)PEB

See Physical Evaluation Board (PEB)PEBLO

See Physical Evaluation Board Liaison Officer (PEBLO)Pectoralis minor syndrome, 501PEEP

See Positive end-expiratory pressure (PEEP)Pelvic bands

with knee-ankle-foot orthoses, 730–731Pelvic fractures

lumbosacral plexopathy caused by, 523–524Pelvic tilts, 384Pemoline, 214–215Penetrating nerve injuries, 446–448

case studies, 491–496classification, 429clinical considerations, 447–448pathophysiology, 446–447prognosis, 447–448

PensionsSee Physical disability system

Pentazocine, 503Pentoxifylline, 219Peptic ulcer disease, 753–755Percy Jones General Hospital, Michigan, 35, 80Pergolide, 214–215Perineurium, 427

and traction-related neuropathies, 442transection, 430–431

Peripheral nerve injuries, 419–574in burn patients, 689–690classification, 429–431cold-induced, 443–446compression, 436–439electrical muscle stimulation, 481electrical stimulation intervention, 479–481electrodiagnosis, 448–465end organ changes following, 431–436epidemiology, 420–422foot and ankle, 531–545hyperesthetic desensitization therapy, 472–473ischemic, 439–440localization, 461–463

Index

liiiVolume 1: Pages 1–416; Volume 2: Pages 417–886

lower extremity, 522–531mechanisms, 436–448orthotic management, 471–472, 492, 495pain management, 474–479penetrating, 446–448, 491–493Persian Gulf War, 11–14, 420, 422, 446, 525pharmacological intervention, 475–479prognosis, 459–462range-of-motion maintenance, 465–467rehabilitative management, 465–481reinnervation following, 431–432, 434, 436, 460, 463secondary injury prevention, 435, 465sensory reeducation, 473–474severity determination, 459–462in spinal cord injured patients, 192–193strength maintenance and improvement, 467–470stretch, 440–443surgical repair postponement, 465upper extremity, 496–522Vietnam War, 447, 497during World Wars, 420–422, 447See also Causalgia; specific injury

Peripheral nervesanatomy, 422–423, 426–427axonal transport, 425–426causalgia-associated changes in, 484degeneration, 431–434effect of immobility on, 749fascicular composition, 426–427, 435, 438–439, 442impulse propagation, 423–425neuroanatomy, 422–423physiology, 423–426, 448–450regeneration, 431–432, 434, 436, 460, 463vascular system, 427–428

Peroneal nerve, 527–528deep, 538functional electrical stimulation, 725–726superficial, 540

Peroneal neuropathy, 527–531anatomic considerations, 527–528in burn patients, 689case scenario, 493–496clinical presentation, 529dislocation-associated, 440–441electrodiagnosis, 529–530etiology, 528–529fracture-associated, 441–442superficial, 540–542treatment, 530–531

PERSCOMSee Total Army Personnel Command (PERSCOM)

Pershing, John J., 11Persian Gulf War, 23

amputations, 12–15, 46–47, 80Army Physical Therapy Registry, 27–28brain injuries, 15burn injuries, 14–15causalgia, 482, 491disability case statistics, 879–880, 883functional impairments, 15hand rehabilitation, 38immobility complications, 742, 745, 756musculoskeletal injuries, 11–13nerve injuries, 11–14, 38, 80, 420, 422, 446, 525physical therapy, 25–28rehabilitation services, 10–16rehabilitation teams, 7wrist-hand orthoses use, 709

Personalityafter traumatic brain injury, 217, 223, 238–239premorbid, 195–196

Personnel Management Officers (PMOs), 865, 877PFTs

See Pulmonary function tests (PFTs)Phalangization, 36–37Phalen’s test, 511Phantom limb

pattern recognition system using, 66Phantom limb pain, 14, 143–147, 475

definition, 143differential diagnosis, 148duration and frequency, 144incidence, 143–144in lower extremity amputees, 88pathophysiology, 126, 144–145prevention, 147treatment, 145–148in upper extremity amputees, 61See also Residual limb pain

Phantom limb sensationafter lower extremity amputation, 126, 143classification, 143definition, 143explanation, 126, 143fading, 143management, 126, 143telescoping, 88, 143

Pharmacologic therapyand alcohol use, 240auditory complications, 323for burn patients, 599–600debilitating side effects, 851for immobilization osteoporosis, 748ocular complications, 296for peripheral nerve injuries, 475–479for phantom limb pain, 126, 145–146, 148for traumatic brain injury, 214–222, 232–233See also specific drug or drug class

Pharyngeal phaseof swallowing, 328

Pharyngeal reflex, 327Phenobarbital, 221Phenoxybenzamine, 490Phenytoin, 477, 490

for cranial neuropathies, 308for traumatic brain injury, 216, 221

Phosphagen system, 787–788Phosphorylation

oxidative, 786–787Photographs

in burn wound management, 599, 655Photoreceptors, 285–286Phthalazinol, 217Physiatrist

definition, 4, 6, 229, 832duties beyond physical rehabilitation, 8role in interdisciplinary team, 832role in surgical decision process, 83, 96role in traumatic brain injury care, 226, 229

Physiatryhistory, 4–6, 831See also Interdisciplinary team

Physical activityas risk factor for injury, 817

Physical capacity for exercise, 799–803aerobic, 803–806


liv Volume 1: Pages 1–416; Volume 2: Pages 417–886

and age, 804–805and body composition, 794–796and gender, 803–804of military populations, 803–806and occupation, 804

Physical Disability Branch (PDB), 865, 873Physical disability systems, 863–885

Air Force, 884Army, 865–883history, 864–865Navy, 883–884statistics, 879–883triservice comparison statistics, 883

Physical Evaluation Board (PEB), 71, 150, 250, 865–866, 872–873

caseload statistics, 879–883formal hearing process, 874–876location, 867versus Medical Evaluation Board (MEB), 872Navy, 883and preexisting conditions, 876presumptions applied to, 876–877process, 873–877USAPDA review, 876–879

Physical Evaluation Board Liaison Officer (PEBLO), 868, 872–874

Physical examinationfor disability compensation evaluation, 869

Physical fitness, 781–827and body composition, 792–799definition, 782and disability compensation evaluation, 873and musculoskeletal disorders, 360as risk factor for injury, 817See also Physical capacity for exercise

Physical fitness standardsand age, 804–805DoD directive, 782, 796–799and gender, 803–804and training programs, 811

Physical medicine and rehabilitation (PMR)in combat theater, 8–9at medical centers, 9–16overview, 4, 6–8, 229

Physical profilein physical disability system, 867–868

Physical therapistsArmy, 7, 20, 24–25, 28–29in civilian practice, 25deployed to third world countries, 28and early ambulation, 84education, 25role in interdisciplinary team, 831–832shortage, 28Vietnam War, 23–24

Physical therapyfor above-knee amputees, 133Army, 16, 20–28in evolving doctrine, 28–29history, 830–831for lower extremity amputees, 103–104, 106for mild traumatic brain injury, 231for multiple amputees, 149Persian Gulf War, 25–28for spinal cord injured patients, 175Vietnam War, 23–24in wartime environment, 19–30

Physical therapy technicians, 830

Physical toleranceand vocational assessment, 851

Physical training, 782, 807–811adaptive response to, 807, 809–810cardiovascular disease associated with, 818definition, 807duration, 807, 810, 812–813frequency, 807, 810–813heart rate-based, 790intensity, 807, 810, 812–813job-specific, 808, 814length, 810–811medical problems associated with, 814–820mode, 810–811, 813musculoskeletal injuries associated with, 814–817principles, 807–809specificity, 808and weight control programs, 793–794See also Exercise; specific type of exercise

Physical training programs, 811–814components, 810–811initiation, 811integrated, 813–814objectives, 811as risk factor for injury, 816–817

Physician Assistant (PA) Section, 23Physicians

role in Army physical disability system, 867–868role in interdisciplinary team, 831

Physiotherapy aidesWorld War I, 21

Physostigmine, 218Pigskin, 582Pin fixation

for limb length preservation, 95PIP joint

See Proximal interphalangeal (PIP) jointPiracetam, 219, 221Piriformis syndrome, 525Pirogoff hindfoot amputation, 86–87Pistoning

of ankle-foot orthoses, 722–723Plantar digital nerve, 543Plantar fasciitis, 400–401Plantar flexion (posterior) stops

on ankle-foot orthoses, 715, 717–718, 722–723Plantar nerve

lateral, 532–533, 536–537medial, 532–533, 537–538, 543

Plastazote, 670Plaster of Paris

in immediate postoperative prostheses, 97–100socket design with, 121, 130

Plaster orthoses, 617Plastic ankle-foot orthoses (PAFOs), 720–723Plastic deformation

factors influencing, 465–466Plastic materials

in sockets, 130Plastic stretch, 465Plastic surgery

for burn injuries, 690–693Plug fit socket, 129Plumb line

alignment check using, 103–104PMOs

See Personnel management officers (PMOs)PMR

Index

lvVolume 1: Pages 1–416; Volume 2: Pages 417–886

See Physical medicine and rehabilitation (PMR)Pneumatic compression

intermittent, 471for lower extremity amputations, 87, 124, 127

Pneumoniain spinal cord injured patients, 182

PNFSee Proprioceptive neuromuscular facilitation (PNF)

Polio epidemics, 6Pollicization

of remaining fingers, 36–37Polycushion, 668–670Polyflex, 617Polyform, 617Polymyxin, 591Polyurethane membranes, 593–594Polyurethane pads

in immediate postoperative prostheses, 96–97Porcine skin heterograft, 593Positioning

during acute phase of burn care, 607–611antigravity, 604, 607–610, 628, 743, 746during immobilization phase of burn care, 628–629for pressure sore prevention, 757during wound maturation phase of burn care, 637

Positive end-expiratory pressure (PEEP), 599Positive sharp waves, 454–456, 494

quantification, 455Postconcussive symptoms, 230–231

pharmacologic therapy, 232–233Postconcussive syndromes

neurodiagnostic evaluation, 232Posterior cord syndrome, 170Posterior element pain

acute, 384–385Posterior flap method

of lower extremity amputation, 95Posterior interosseous nerve, 503–504Posterior interosseous nerve entrapment, 503–505Posterior stops

on ankle-foot orthoses, 715, 717–718, 722–723Posterior tibial nerve, 532

See also Tarsal tunnel syndromePostpolio syndrome, 467Posttraumatic amnesia (PTA)

and family outcome, 253Posttraumatic stress disorder (PTSD)

in burn patients, 631, 683–684and vocational rehabilitation, 858

Postureand musculoskeletal injuries, 362–364

Posturography, 321Postvoid residual volume

determination, 752Potassium depletion

immobilization-induced, 750Potential reserve, 743Povidone-iodine, 582, 597Power sources

for hand orthoses, 705, 708–709Powers ratio, 173Power tests

anaerobic, 801–802Pramiracetam, 219Prazosin, 220Prednisone, 357, 490Preexisting conditions

and disability compensation review, 876

Pregnancyin spinal cord injured patients, 195

Prentke Romich Light Talker, 620–621Prentke Romich Touch Talker, 620–621Presbycusis, 319Pressure intolerant areas

in sockets, 107Pressure relieving devices, 757Pressure sores, 162, 181, 186, 190, 755–758

causes, 186, 755classification, 187, 757–758distribution, 755–756identification of patients at risk for, 756–757incidence, 187, 756prevention, 186, 756–757treatment, 187, 758

Pressure tolerant areasin sockets, 107

Pressure wrapbulky, 629–630

PrilosecSee Omeprazole

Primary irritant dermatitison residual limb, 139

Primidone, 221Progression

overload, 807Projectile-related injuries

See Bullets; Penetrating nerve injuries; Shell fragmentwounds

Prolonged stretchfor burn patients, 603, 636definition, 603with diathermy, 746

PROMSee Passive range-of-motion (PROM)

Pronator teres muscle, 506–507Pronator teres syndrome, 506–508Prone positioning

anticontracture, 608, 746Proportional control systems

for myoelectric prostheses, 65–67Propranolol, 217, 220, 490Proprioception changes

burn injury-associated, 633Proprioceptive neuromuscular facilitation (PNF), 359Proprioceptive training

for musculoskeletal injuries, 393, 398Prostheses

bypass, 126and early ambulation, 13exoskeleton, 132fabrication, 80facial, 655for multiple amputees, 148–149shower, 133stubbie, 133, 148–149temporary, 12–14, 84, 88World War II technology, 35See also Myoelectric prostheses; specific type of prosthesis

Prosthetic foam, 670Prosthetic sockets

See SocketsProsthetists, 80, 133, 832Protein

and burn injuries, 687–688status evaluation, 689synthesis, 750


lvi Volume 1: Pages 1–416; Volume 2: Pages 417–886

Prothrombin time (PT), 763Proximal interphalangeal (PIP) joint

amputation at, 37Proximity

principle of, 623Pruritus

after burn injury, 633Pseudo-anterior interosseous syndrome, 508Pseudo-Graefe’s sign, 299Pseudo-Graefe’s syndrome, 297Pseudo-obstruction

in spinal cord injured patients, 185Psychiatrists

role on medical evaluation board, 868Psychological disturbances

with amputation, 10immobility-related, 749treatment, 16

Psychological shock, 624Psychological support

after brain injury, 227–228for burn patients, 596, 623–626, 631, 633, 683–684for immobilized patients, 750in interdisciplinary team management, 832for lower extremity amputees, 84, 88, 101, 125, 133–134for multiple amputees, 149for phantom limb pain, 147–148and physical recovery, 846for spinal cord injured patients, 180, 195–196for upper extremity amputees, 47, 52See also Emotional counseling; Psychotherapy

Psychologistsrole in interdisciplinary team, 832

Psychosocial outcomedeterminants of, 846–847of traumatic brain injury, 238–241

Psychostimulantsfor traumatic brain injury, 214–215, 219See also specific drug

Psychotherapyfor brain injured patients, 245–246for burn pain management, 623for phantom limb pain, 147–148

Psyllium hydrophilic mucilloid fiber, 753PT

See Prothrombin time (PT)PTA

See Posttraumatic amnesia (PTA)PTB-TCS

See Patellar tendon bearing, total contact socket (PTB-TCS)Pterygoid reflex

electrodiagnostic evaluation, 305–306Ptosis, 297, 299PTs

See Physical therapistsPTSD

See Posttraumatic stress disorder (PTSD)Pubis stress fractures, 397Public Health Service

physical therapy services, 25Public Law No. 101-336

See Americans with Disabilities ActPulmonary angiography, 760–761Pulmonary complications

of immobilization, 758–762of spinal cord injury, 181–182See also specific complication

Pulmonary compromise

after spinal cord injury, 181signs of, 583

Pulmonary edemain burn patients, 584–585high-altitude, 820

Pulmonary embolism, 183, 760–762versus deep venous thrombosis, 763diagnosis, 760–762prevention, 762treatment, 762

Pulmonary functionduring exercise, 788–789, 801

Pulmonary function tests (PFTs), 758–759Pulmonary management

of burn patients, 584–585, 598–599of immobilized patients, 758–762

Punctate hemorrhages, 209Pupil

muscles regulating, 294myotonic, 297

Pupillary light reflex, 288–290, 296innervation, 294

Pushoffwith metal ankle-foot orthoses, 718–720with plastic ankle-foot orthoses, 722–723

Pylonin immediate postoperative prostheses, 98–100, 135

Pyridoxine, 513

Q

Quadrilateral sockets, 129Quadriplegia

See Spinal cord injury (SCI)Quadruple amputation, 149Quality of life

for spinal cord injured patients, 195for traumatic brain injured patients, 224

Quisqualate, 212

R

Racial groupscounseling concerns, 849

Radial amputationsdefinition, 40prostheses, 39–42

Radial nerve, 496, 502Radial neuropathy, 438–439, 502–505

anatomic considerations, 502–503case scenario, 491–493clinical presentation, 503compression, 505electrodiagnosis, 503etiology, 503fracture-associated, 440–441orthotics, 640–641, 705–706in spinal cord injured patients, 192treatment, 503–504

Radiculopathycervical, 363–366lumbar, 379–381

Radiographyin musculoskeletal injuries, 381, 385–386in residual limb problems, 140–143in spinal cord injury, 163, 188in tarsal tunnel syndrome, 535

Raeder’s syndrome, 303Ramsay-Hunt syndrome, 311–312

Index

lviiVolume 1: Pages 1–416; Volume 2: Pages 417–886

Rancho Los Amigos Scale, 224Range of motion

definition, 602–603and hand rehabilitation, 38and peripheral nerve injuries, 465–467

Range-of-motion exercisesfor accessory neuropathies, 338for brain injured patients, 226for burn patients, 596–597, 602–606, 628early initiation, 9for edema control, 470for immobility complications, 746for lower extremity amputees, 84, 101–103, 135for musculoskeletal injuries, 359, 362, 372, 376–378for peroneal neuropathy, 531for phantom limb pain, 147–148for spinal cord injured patients, 189for upper extremity amputees, 47

Ranitidine, 754Rash

heat, 819Ratchet splint, 709Rating by analogy, 873–874Ray amputations

prosthetic fitting and training, 89surgical technique, 86

Raynaud’s phenomenon, 444Ray resection

for finger amputations, 37–38Reach

orthotic substitution for, 704–706, 710–713Reachers, 179, 679Reading

adaptive devices, 621Reamputation (revision), 83, 134, 148

surgical technique, 94–95Reappraisal, 847Reciprocating gait orthoses (RGOs), 732Reconstruction aides

World War I, 20–21Reconstructive surgery

for burn patients, 690–693Recovery principle

in training, 807Recreational adaptive aids, 10, 41–42, 52–54, 70–71, 149, 682–

683Recreational therapists

role in interdisciplinary team, 832Recreational therapy

for above-knee amputees, 133for brain injured patients, 227for burn patients, 636–637, 682–683definition, 832for spinal cord injured patients, 179–180, 195See also Exercise; Sports; specific activity

Rectus musclesinnervation, 292–293

Redundancyafter traumatic brain injury, 212

Reed College, Oregon, 20Referral questions

for neurobehavioral assessment, 242–243Reflex arc, 785Reflex detrusor contractions

in spinal cord injured patients, 193Reflexes

facial nerve, 312–314glossopharyngeal nerve, 327

hyperactive, 190–191laryngeal nerves, 333segmental, 171–172trigeminal nerve, 302–307vagus nerve, 331See also specific reflex

Reflex hyperventilation, 789Reflex sympathetic dystrophy (RSD), 141–142, 148, 749Regional blockade

for causalgia, 489–490Rehabilitation nurse

role in interdisciplinary team, 832–833Rehabilitation services

Persian Gulf War, 7, 10–16Vietnam War, 7–10

Rehabilitation teamSee Interdisciplinary team

Reichert’s syndrome, 326–327Reinnervation

after peripheral nerve injury, 431–432, 434, 436after traumatic brain injury, 212electrodiagnostic monitoring, 460, 463–464, 468and functional recovery, 464–465

Reiter, Reinhold, 65Relaxation techniques

for burn pain management, 600, 623, 625–626for phantom limb pain, 147

Remodeling phase, 355Remotivation, 847Renal calculi

in spinal cord injured patients, 194Renal failure

in spinal cord injured patients, 193Reparative phase, 354–355Reserpine, 490Residual limb

definition, 43edema, 134, 138electrical stimulation, 67and energy expenditure for walking, 93hygiene concerns, 84, 107–108, 134, 136interface with lower extremity prostheses, 89, 96–97, 104,

107, 129, 131, 136–137, 142–143lengthening, 96in lower extremity amputees, 134, 136in multiple amputees, 148–149plaster cast impression, 121topographic measurement, 121in upper extremity amputees, 61very short below elbow, 44, 53vibration/percussion, 147weight bearing, 91–92, 98–99, 102–103

Residual limb paincauses, 139–143differential diagnosis, 142, 148postoperative management, 88, 125, 134, 147referring, 142, 148See also Phantom limb pain

Residual limb pain syndrome, 14Residual limb wrapping

See Stump wrappingResin

in above-knee prostheses, 130in foot prostheses, 90

Resistancenegative, 813variable, 813

Resistance detraining, 808


lviii Volume 1: Pages 1–416; Volume 2: Pages 417–886

Resistance training, 810–813adaptation of aerobic training modes to, 812adaptive response to, 809–810cardiovascular response to, 809–810equipment, 812for lower extremity amputees, 103for muscle mass buildup, 793–794for musculoskeletal injuries, 359–360for peripheral neuropathy, 467specificity, 808in weight control programs, 793See also Isotonic exercises; Strength training

Respiratorsfor burn patients, 599

Respiratory failureafter spinal cord injury, 181signs of, 583

Respiratory managementof burn patients, 584–585, 598–599of immobilized patients, 758–762

Respiratory quotient (RQ), 686Respiratory tract infection

in immobilized patients, 759Reston foam, 668Restructuring, 847Retina, 286, 288Retired List

history, 864–865Temporary Disability (TDRL), 865, 873–874, 876, 883

RetirementSee Physical disability system

Retroauricular pain, 312Return to duty

of amputees, 150of brain injured patients, 246–250of burn patients, 637, 683–685importance, 16of lower extremity amputees, 106of multiple amputees, 149and musculoskeletal disorders, 360transition to, 858–859of upper extremity amputees, 70–73during Vietnam War, 9, 23–24, 72, 150See also Vocational assessment; Vocational rehabilitation

RevisionSee Reamputation (revision)

RGOsSee Reciprocating gait orthoses (RGOs)

Rhabdomyolysisexertional, 818in spinal cord injured patients, 193

Rheobase, 449Rheumatologic disorders

in amputees, 142Rhodopsin, 285–286Rigidity, 208Ring fracture

C-1, 173–174C-2, 174

Rinne’s test, 320–321Ritalin, 2191RM

See One repetition maximum (1RM)Rocker bottom

orthoses with, 734–735Rocker soles

in shoes, 90, 114Rods, 285–286

Roentgenographyin anterior tarsal tunnel syndrome, 539in causalgia, 486–487in pulmonary embolism, 760–761

Roger’s sign, 304ROHO bed, 611, 757Rolyan Silicone Elastomer, 667Romania, 28Romberg test, 321Room temperature

for burn patients, 599–600Roosevelt, Franklin D., 5, 21Rotating beds

for spinal cord injured patients, 182, 186Rotator cuff injuries, 367–370

in spinal cord injured patients, 189Rotobed, 631Roto-Rest Traumabed, 182, 186RQ

See Respiratory quotient (RQ)RSD

See Reflex sympathetic dystrophy (RSD)Rucksack palsy, 497–498Rule of 9s, 580Rule of the Palm, 579–580Rusk, Howard A., 5, 831Russia, 28

S

Sabolich foot, 120Saccadic deficits, 299Saccadic system, 294SACH foot

See Solid-ankle cushion heel (SACH) footSacral plexus, 522–523Saddle harness

for above-elbow prostheses, 57–58SAFE (stationary attachment, flexible endoskeleton) pros-

thetic foot, 92, 114–115, 120Sagittal flap method

of lower extremity amputation, 95, 124Saliva

hypersecretion, 333pooling, 312

Salivary flow meter, 312Salivation

loss, 312measurement, 328

Salmon calcitonin, 748Saltatory conduction, 449Salt depletion, 819Sanderson, Marquerite, 20–21Saphenous nerve, 526Sarcomeres, 783Saturday night palsy, 192, 503Saudi Arabia

See Persian Gulf WarScald burns, 577Scalp donor

use and healing, 594Scapular retractors/stabilizers, 368

strengthening exercises, 363Scar(s)

in burn patients, 643–674hypertrophic, 643–645, 655–674location on residual limb, 136skin grafts, 644

Index

lixVolume 1: Pages 1–416; Volume 2: Pages 417–886

Scar compression, 655–674ankle, 675arm, 673elbow, 672–673fingers, 671foot, 676hand, 672hip, 675knee, 675lower extremity, 675–676shoulder, 673thumb, 671–672trunk, 674upper extremity, 671–673wrist, 672

Scarpa’s triangle, 129, 139Schirmer lacrimation test, 312Schmidt’s syndrome, 332Schwann cells, 422–423

denervation-related changes in, 433and reinnervation, 434

SCISee Spinal cord injury (SCI)

Sciatic nerve, 524, 528Sciatic neuropathy, 438, 524–526

anatomic considerations, 524–525clinical presentation, 525electrodiagnosis, 525–526etiology, 525Persian Gulf War, 525

SCL-90See Symptom Checklist-90 (SCL-90)

Scoop type prostheses, 42–43Scott-Craig orthoses, 729, 732Seat-belt type injuries

spinal, 175Seattle Ankle, 116Seattle Foot, 115–116, 120Seattle Lightfoot, 92, 115–116, 120Seattle orthosis, 721Second General Hospital, Germany, 11Sedation

of burn patients, 622, 626for phantom limb pain, 146

Seddon’s classificationof peripheral nerve injuries, 429

Segmental dysfunctionlumbar, 379

Segmental hypermobilitylumbar, 380, 383

Seizuresposttraumatic, 221–222

Seizure thresholdeffects of alcohol on, 240

Selective serotonin reuptake inhibitors (SSRIs)for traumatic brain injury, 216

Self-careSee Activities of daily living (ADL); specific activity

Self-Directed Search, 854Self-feeding

adaptive devices, 619–620, 676–677Self-management skills

assessment, 855Sensory abnormalities

causalgia-associated, 482Sensory aphasia, 320Sensory deprivation

in immobilized patients, 748–750

Sensory feedbackin lower extremity amputees, 85, 93with myoelectric prostheses, 67, 69

Sensory fibersspecial, 280–281

Sensory levelsfor neurological evaluation of spinal cord injury, 169

Sensory nerve action potential (SNAP)amplitude, 459, 464in brachial plexopathies, 500in carpal tunnel syndrome, 512in compression injuries, 437inability to elicit, 460measurement, 451in thoracic outlet syndrome, 501–502in ulnar neuropathy, 518

Sensory recoveryafter peripheral neuropathy, 464–465classification, 474–475

Sensory reeducation, 473–474, 492discriminative, 474protective, 474

Sensory stimulationand burn patients, 631and comatose patient, 236and immobilized patients, 749–750

Sensory Stimulation Assessment Measure, 224Separated without benefits (SWOB), 876Separated with severance pay (SWSP), 876Serial casting, 747Series elastic component, 785Serotonergic drugs

for traumatic brain injury, 215–217, 221See also specific drug

Serotonin, 476Sertraline, 215–217, 220Servo Pro system, 66–67Sexual counseling

after brain injury, 254after burn injury, 635

Sexual functionin burn patients, 634–635in spinal cord injured patients, 194–195in traumatic brain injured patients, 222

Shanksfor below-knee prostheses, 112–113endoskeletal, 113exoskeletal, 113thermoplastic, 109–110

Shear forceswith knee-ankle-foot orthoses, 727–729

Sheepskin, 668Sheet grafts, 589, 644Shell fragment wounds

brachial plexopathies caused by, 497burns secondary to, 581

Shin splints, 395–396Shock

burn, 585–587psychological, 624spinal, 172

Shoesfor ankle-foot orthoses, 718for burn patients, 615–616, 641–643inserts, 89–90as risk factor for injury, 817rocker soles, 90, 114toe fillers, 89


lx Volume 1: Pages 1–416; Volume 2: Pages 417–886

Shouldercontracture prevention, 47instability, 370–372positioning for burn injuries, 609–610scar compression, 673

Shoulder bypass suspension hoops, 714–715Shoulder cap design, 714Shoulder continuous passive motion machine, 618Shoulder disarticulation, 43–45

prostheses, 45, 59, 67surgical procedures, 46

Shoulder dislocationstretch neuropathies associated with, 440–441treatment, 370–371

Shoulder disorders, 367–372in spinal injured patients, 189See also specific disorder

Shoulder flexion assists, 714–715Shoulder harness-driven flexor hinge orthoses, 708Shoulder orthoses, 630, 638–639

functional, 713static, 713support of, 713–715

Shoulder stabilizersorthotic, 713

Shoulder suspensionfor above-knee prostheses, 131

Shower prostheses, 133Shower trolley method

of wound cleansing, 598–599Shrinker socks, 104–105Sickness Impact Profile, 253Side-lying positioning

anticontracture, 608, 746SIDS

See Sudden infant death syndrome (SIDS)SII

See Strong Interest Inventory (SII)Silastic, 670Silesian belt, 131, 133Silicone

in above-knee prostheses, 132in foot prostheses, 90in orthotic inserts and overlays, 670suction sockets, 112, 131

Silicone finger trough, 615Silver nitrate, 582Silver sulfadiazine, 582Singer procedure

for lower extremity amputation, 96Single-axis foot prosthesis, 113–114Single-axis knee prostheses, 128Single-control system

for below-elbow prostheses, 55Single photon emission computed tomography (SPECT)

in musculoskeletal injuries, 381, 386in traumatic brain injury, 225, 231

Sinus arrestin spinal cord injured patients, 182–183

Sittinganticontracture position, 610by spinal cord injured patients, 175–177

Situational assessmentin vocational rehabilitation, 856

Sjögren’s syndrome, 303Skeletal insufficiency

orthoses for, 733–737See also Dislocations; Fractures; specific injury

Skeletal muscleSee Muscle(s)

Skew flap methodof lower extremity amputation, 95

Skiing programfor amputees, 10, 149

Skinartificial, 592human cadaver, 593

Skin careduring acute phase of burn injury, 596–607during immobilization phase of burn injury, 625–627for lower extremity amputations, 85during wound maturation phase of burn injury, 632–635See also Skin traction management

Skin care pads, 667, 669–670Skin complications

in brain injured patients, 226causalgia-associated, 482–483in immobilized patients, 755–758in lower extremity amputees, 134, 136–137in spinal cord injured patients, 162, 181, 186–188, 755–758in upper extremity amputees, 61See also Pressure sores; specific complication

Skin desensitization programfor lower extremity amputations, 88, 125, 141, 148for spinal cord injured patients, 191

Skin flaps, 96, 122, 691–693Skin fold procedure

for body fat measurement, 797–798Skin grafts, 589–592

adherence, 588, 590for burn wounds, 587cultured epidermal cells, 591–592donor sites, 589, 594–595, 644dressings, 591–594, 629flaps, 96, 122, 691–693insensate, 85instruments, 587meshed, 589–591, 644movement, 590orthoses, 629–630postgraft dressing changes, 626–627postoperative immobilization, 627, 629for pressure sores, 187, 758for reconstruction, 691–693scarring, 644sheet, 589, 644split-thickness, 96, 122, 589surgical staples for, 590vascular support, 646–649, 655–674wound management, 590–591

Skin necrosisafter amputation, 135

Skin reactionsallergic, 138–139

Skin tensionin residual limb, 136

Skin traction managementerrors, 94for lower extremity amputations, 83, 94, 100, 124–125for upper extremity amputations, 45

Sleep apneaobstructive, 182

Sleeve suspensionfor below-knee prostheses, 111

Sling suspensionsfor arm support, 712–713

Index

lxiVolume 1: Pages 1–416; Volume 2: Pages 417–886

shoulder, 713Slow twitch (type 1) fibers, 784Smell

altered sense of, 283–285loss of, 282–285testing, 283–285See also Odor

Smith and Nephew prosthetic foam material, 667Smoke inhalation injury, 584–585, 598–599, 620Smooth pursuit system, 294SNAP

See Sensory nerve action potential (SNAP)Snellen charts, 288Social isolation

of brain injured patients, 238–239Social workers

role in interdisciplinary team, 833Society for Physical Therapy Physicians, 5Sock(s)

for foot prostheses, 116for immediate postoperative dressing/prostheses, 97–100,

104–106for suction suspension systems, 112, 131

Socketsfor above-elbow prostheses, 56–57for above-knee prostheses, 129–131for below-elbow prostheses, 52–53for below-knee prostheses, 106–110, 112carbon fiber reinforcement of, 91–92computer aided design/manufacturing, 120–121, 130construction, 109–110fabrication, 120–121, 130for forequarter amputation prostheses, 59hip disarticulation, 132–133for humeral neck amputation prostheses, 59for knee prostheses, 129–131liners, 107–108, 140–141loose, 142myoelectric electrodes embedded in, 67for partial foot prostheses, 89–91pressure areas, 107and residual limb problems, 61, 107Syme’s, 91–92transfemoral, 124transpelvic amputation, 132–133See also specific type of socket

Sof-Care alternating pressure mattress, 757Sof-Kling, 610, 658Soft tissue

contractures, 746handling during surgical amputation, 122musculoskeletal, 354retraction, 94

Soft tissue injuriescervical, 361–363rehabilitation, 8–9

Sole inserts, 642–643Sole plate

for ankle-foot orthoses, 718rigid, 90

Solid-ankle cushion heel (SACH) foot, 92, 96, 98, 100, 113, 120,127

Soma, 422–423Somatosensory evoked potentials

filter settings, 452Sorbisan, 594Sound pressure, 319Spasticity

in brain injured patients, 226definition, 208in spinal cord injured patients, 167, 172, 178, 190–191

SPECTSee Single photon emission computed tomography

(SPECT)Speech and language therapists

role in interdisciplinary team, 833Speech discrimination test, 320Speech disorders

after traumatic brain injury, 222Speech reading, 324Speech therapy

for hypoglossal neuropathies, 341–342for mild traumatic brain injury, 231

Spenco second skin, 670–673Spenco skin care pad, 667, 669Sphincter pupillae muscle

innervation, 294Spinal cord changes

and phantom limb pain, 126, 144–145Spinal cord compression

identification, 163Spinal cord injury (SCI), 14, 161–205

bilateral knee-foot-ankle orthoses for, 731–732causes, 162, 166–167classification, 165, 169complete, 169, 176–178complication management, 181–196complication prevention, 165, 181–196emergency treatment, 162endocrinologic complications, 185first and second echelon MTF treatment, 162–163gastrointestinal complications, 184–185genitourinary complications, 162, 181, 193–194head injuries associated with, 195imaging studies in, 163–164incidence, 162incomplete, 169–170, 178interdisciplinary team management case study, 841–843ligamentous, 173–174long-term follow-up, 180–196mortality and morbidity, 162, 181musculoskeletal complications, 188–189neurological complications, 189–193neurological evaluation, 167–173neurosurgical treatment, 163–165nonpenetrating, 165orthoses, 703–740pathophysiology, 165–167patient education, 175–180, 186–187penetrating, 165prognosis, 170–171psychological complications, 195–196pulmonary complications, 181–182recovery, 167, 175–179, 195recreational rehabilitation, 179–180, 195rehabilitation, 9, 175–180skin complications, 162, 181, 186–188, 755–758third echelon MTF treatment, 163treatment by level of injury, 173–175Vietnam War, 162vocational rehabilitation, 179–180, 195, 856walking after, 177–178, 731wheelchair use after, 175–177World War I, 162World War II, 162zone of injury recovery, 167, 172–173


lxii Volume 1: Pages 1–416; Volume 2: Pages 417–886

Spinal Cord Injury Model Systems Program, 162Spinal cord injury units, 162

organization, 196Spinal manipulative therapy, 362Spinal nerve root entrapment, 381Spinal nerves, 168Spinal shock, 172Spinal trigeminal tract, 169Spine

evaluation, 173–175instability, 163, 189management, 173–175stability, 163–164, 387–389See also specific part of spine

Spine alignmentrestoration and maintenance, 163

Spine deformitiesin spinal cord injured patients, 189

Spine injuriesSee Spinal cord injury (SCI)

Spine rehabilitation program, 382–385Spine stabilization exercises, 387–389Spiral groove area

injuries and compression in, 502–503Spirometry

incentive, 759–760Splinting, 747

dynamic, 747Splints, 358, 378

airplane, 630, 638Bunnell, 709burn, 615–616cockup, 709–710finger, 615hand, 705–707ratchet, 709shin, 395–396

Split socketfor below-elbow prostheses, 53

Split-thickness skin grafts (STSGs), 589, 691–693Split Toe Flex Foot, 117–118Spondylolisthesis, 385Spondylolysis, 385–386Spondylosis, 381Spontaneous activity, 454–456, 494Sport garments

elastic, 665Sports

brachial plexopathies associated with, 497–499foot and ankle nerve injuries caused by, 531–532, 538, 540,

543–544peroneal neuropathies associated with, 529See also Exercise; specific sport

Sprainscervical, 361See also Ankle sprains

Spring balances, 802Springlite Chopart prosthesis, 90Springlite Company, 90Springlite II, 119–120Springlite Syme’s prosthetic foot, 92Springlite toe fillers, 89Sprint runs

maximal, 801Spurling’s maneuver, 364SSRIs

See Selective serotonin reuptake inhibitors (SSRIs)Standing balance

with knee-ankle-foot orthoses, 730Standing table exercise, 603–604Stapedial reflex, 312

testing, 320Stasis dermatitis

after amputation, 137–138Static orthosis

for shoulder/elbow support, 713Static strength

measurement, 802Static stretch, 359Stationary attachment, flexible endoskeleton (SAFE) pros-

thetic foot, 92, 114–115Stationary bicycles, 125, 635, 800–802Steam burns, 577STEN (STored ENergy) Foot, 120Step length

with ankle-foot orthoses, 720Step-up hinges, 44, 53Sternocleidomastoid muscle

and accessory neuropathies, 336–338Steroids

for carpal tunnel syndrome, 513for cranial neuropathies, 280, 291, 315for digital neuropathies, 544for superficial peroneal neuropathy, 541–542See also specific drug

Stimulantsfor spinal cord injury, 167for traumatic brain injury, 214–215, 219See also specific drug

StingersSee Brachial plexus injuries

Stool softenersfor immobilized patients, 753

Straincervical, 361, 843–844in concussive brain injuries, 230

Strength, 782, 802–803correlation between muscle mass and, 795–796, 803definition, 802determinants, 803dynamic, 802gender differences, 806immobility-associated loss, 743–744measurement, 802–803, 806population data, 806static, 802

Strength detraining, 808Strength-duration relationship

in motor neurons, 449–450Strength training, 813

basic requirements, 468for burn patients, 635–636in integrated program, 813–814for musculoskeletal injuries, 359–360, 363, 367, 369–372,

375–377for peripheral nerve injuries, 467–470

Stressbattle, 16, 623control principles, 623heat, 818–819

Stress fractures, 396–397, 816–818Stress gastritis

in spinal cord injured patients, 184–185Stress ulcers, 753–755Stretch

elastic, 465

Index

lxiiiVolume 1: Pages 1–416; Volume 2: Pages 417–886

plastic, 465prolonged, 603, 636, 746terminal, 604

Stretching exercisesfor burn patients, 628, 636, 652heating modalities used with, 467, 746–747for musculoskeletal injuries, 371, 373, 390–391, 398–399for peripheral neuropathies, 465–467

Stretch neuropathies, 440–443brachial plexus, 498–499clinical considerations, 440–441pathophysiology, 441–442peroneal nerve, 528prognosis, 442–443

Strickland, Benjamin A., Jr., 5, 9Stroke volume (SV), 790–791, 801, 809Strong-Campbell Interest Inventory, 195Strong Interest Inventory (SII), 854Structured Clinical Interview, 223Stryker turning frame, 186STSG

See Split thickness skin graft (STSGs)Stubbie prostheses, 133, 148–149Stump edema syndrome, 134, 138Stump wrapping

complications, 125for lower extremity amputations, 87–88, 94, 96–98, 103–

105, 125for upper extremity amputations, 48–50

Stutteringafter traumatic brain injury, 222

Subclavius nerve, 496Substance abuse

and pharmacologic therapy, 240and traumatic brain injury, 229, 239–241, 246

Substance P inhibitorsfor peripheral nerve injuries, 478

Succinylcholinecontraindications, 183

Sucralfate, 754Suction sockets

for above-elbow prostheses, 56for above-knee prostheses, 131silicone, 112

Suction transtibial prostheses, 111Sudden infant death syndrome (SIDS), 323Suicide

by spinal cord injured patients, 196Sulfamethoxazole, 752Sulfamyalon

See Mafenide acetateSummation, 785Sunburn, 580–581Sunderland’s classification

of peripheral nerve injuries, 429–431Sun exposure

and burn patients, 633, 636Superficial peroneal nerve, 540Superficial peroneal neuropathy, 540–542Superficial radial nerve compression, 505Superior mesenteric artery syndrome, 755Superior oblique muscle

innervation, 292–293Superior orbital fissure syndrome, 303Supersensitivity

denervation, 435–436, 456Supine positioning

anticontracture, 608

Supported employment modelfor brain injured patients, 247–250

Support groupsfor above-knee amputees, 134family, 255for hearing impaired patients, 325for multiple amputees, 149

Support Systems International, Inc., 186–187Supracondylar cuff suspension

of below-knee prostheses, 110Supracondylar process syndrome, 506Suprapatellar-supracondylar patellar tendon bearing socket,

109Suprascapular nerve, 496

injury to, 498–499Sural entrapment neuropathy, 542–543Sural nerve, 542Surface electrodes, 453, 456–457Surgical complications

of lower extremity amputations, 134–148Surgical procedures

for above-knee amputations, 122–123for amputations, 45–46for anterior interosseous syndrome, 509for below-knee amputations, 93–96for brachial plexopathies, 497brachial plexopathies caused by, 499for burn wounds, 587–595, 628for carpal tunnel syndrome, 513–514for cranial neuropathies, 308, 335cranial neuropathies caused by, 280, 303, 332, 336delayed, 83, 465for digital neuropathies, 544–545for lower extremity amputations, 83–84neuromonitoring during, 280for peripheral neuropathies, 465peroneal neuropathies caused by, 529for phantom limb pain, 146–148for posterior interosseous nerve entrapment, 505for pressure sores, 187, 758safety factors, 628for spinal cord injury, 163–165for superficial peroneal neuropathy, 542for tarsal tunnel syndrome, 536for thoracic outlet syndrome, 502for ulnar neuropathy, 519for upper extremity amputations, 45–46See also specific procedure or injury

Surgical staplesfor skin grafting, 590

Surgical teammultispecialty, 83

Suspensionabove-elbow prostheses, 57–58above-knee prostheses, 131below-elbow prostheses, 54–56below-knee prostheses, 110–112humeral neck amputation prostheses, 60immediate postoperative prostheses, 97–100suction, 112, 131supracondylar, 108

Suspension bedsair, 757

Suspension beltsfor above-knee prostheses, 131for below-knee prostheses, 97–100, 110–111total elastic, 131transtibial prostheses, 131


lxiv Volume 1: Pages 1–416; Volume 2: Pages 417–886

Suspension hoopsshoulder bypass, 714–715

Suspension sling arm support, 712–713SV

See Stroke volume (SV)Swallowing, 326–328

dysfunction, 327–328, 332, 334–335Swallowing reflex, 327Swan-Ganz line, 584–585Swan neck deformity, 639Swimming

by burn patients, 636Swing-through gait, 178

with knee-ankle-foot orthoses, 729–731SWOB

See Separated without benefits (SWOB)SWSP

See Separated with severance pay (SWSP)Syme’s amputations, 82

complications, 87functional outcome, 83joint contractures, 88long-term follow-up, 92prosthetic fitting and training, 87, 89–92rehabilitation, 87–89surgical technique, 87weight bearing, 91–92

Syme’s sockets, 91–92Sympathectomy

for causalgia, 490Sympathetically maintained pain syndromes, 428, 481Sympathetic blockade

for causalgia, 489–490for reflex sympathetic dystrophy, 141, 148

Sympathetic nervous systemcausalgia-associated changes in, 484–485

Symptom Checklist-90 (SCL-90), 253Synaptic function

modification, 212Synaptogenesis

reactive, 167, 212–213Syndrome of Kiloh and Nevin

See Anterior interosseous syndromeSynkinesis, 315Synthetic dressings

for skin grafts, 593–594Syringomyelia

posttraumatic, 192Syrinx

acute posttraumatic, 173

T

Tachycardia, 333Tacrine

See Tetrahydro-9-aminoacridine (THA)Tangential excision

burn wound, 587–588Tapia’s syndrome, 340Tardy ulnar palsy, 514, 516Tarsal tunnel, 532–533

anterior, 538Tarsal tunnel syndrome, 531–536

anatomic considerations, 532–533anterior, 538–540clinical presentation, 534–535differential diagnosis, 535electrodiagnosis, 535

etiology, 533–534treatment, 535–536

Tarsometatarsal amputations, 85disadvantages, 83prosthetic fitting and training, 90surgical technique, 86

Tarsotarsal amputations, 85disadvantages, 83surgical technique, 86–87

Taste buds, 310–311Taste sensation, 310–311

loss, 312Taylor, N. L., 742Tay-Sachs disease, 287TBI

See Traumatic brain injury (TBI)TBSA

See Total body surface area (TBSA)TCL

See Tibial collateral ligament (TCL)TC-3 socket, 131–132TDRL

See Temporary Disability Retired List (TDRL)TDs

See Terminal devices (TDs)Tearing

excessive, 312Tears

artificial, 315Technetium 99m bone scintigraphy

in causalgia, 487–488, 491Tegaderm, 593–594, 670Tegapore, 591, 594Telephone adaptations, 620Telescoping

of phantom limb sensation, 88, 143Temazepam, 220Temperature

high ambient, 818–819wet-bulb globe, 819See also Body temperature; Cold exposure; Heating

modalitiesTemporary Disability Retired List (TDRL), 865, 873–874, 876,

883Tendinitis, 355

Achilles, 399–400rehabilitation, 355rotator cuff, 369in upper extremity amputees, 61

Tendinosis, 355Tendons

function, 354healing phases, 354–355injuries, 354–355resistance training-induced changes in, 810

Tendon transfers, 179Tenodesis grip, 179Tenosynovitis

De Quervain’s, 376–377Ten repetition maximum (TRM), 469TENS

See Transcutaneous electrical nerve stimulation (TENS)Tensiometer

cable, 802Terminal devices (TDs)

below-elbow prostheses, 44, 53–56body-powered, 53, 56hand, 53

Index

lxvVolume 1: Pages 1–416; Volume 2: Pages 417–886

hook, 53myoelectric, 53, 56, 59recreational, 53–54selection of, 70–71vocational, 54World War II-era, 35See also Control systems

Terminal stretching, 604TES belt

See Total elastic suspension (TES) beltTetanus, 785Tetrahydro-9-aminoacridine (THA), 216, 218–219Teufel orthosis, 723–725THA

See Tetrahydro-9-aminoacridine (THA)Theraband, 369–370, 374Thermal injuries, 577

combined with electrical burns, 578–579Thermography

in causalgia, 488Thermoplastic materials

in above-knee prostheses, 130–131, 133in below-knee prostheses, 109–110in finger prostheses, 39

Thigh corsetswith side joints, 110–111

Thiothexene, 220Thomas M. England General Hospital, New Jersey, 80Thoracic outlet syndrome (TOS), 192, 366–367, 500–502

classification, 500clinical presentation, 501differential diagnosis, 366electrodiagnosis, 501–502etiology, 500–501rehabilitation, 367treatment, 502

Thoracic spine injuries, 169complications, 182, 193

Thoracolumbar fractures, 174–175Thoracolumbosacral orthosis (TLSO), 175Thorax vascular support garment, 661Three-jaw chuck grasp, 40–41Three-state control systems

for myoelectric prostheses, 66Throat pain, 332–333Thromboembolism, 762–764Thrombolytic therapy, 762, 764Through-knee amputations, 122–134

prostheses, 132Thumb

amputation levels, 37preservation, 36–37reconstruction, 36–37, 39scar compression, 671–672ulnar collateral ligament injury, 377–378

Thumb prostheses, 39–41Thumb spica cast, 377Thyroarytenoid muscle, 333Thyroid ophthalmopathy, 296Thyrotropin-releasing hormone, 217Tibial beveling

inadequate, 140Tibial collateral ligament (TCL), 393–394Tibial fractures

stress, 397type IIIC, 82–83

Tibial nerve, 532Tibial neuropathy

and ankle-foot orthoses use, 718–720case scenario, 493–496See also Tarsal tunnel syndrome

Tic douloureux, 280, 303, 308of glossopharyngeal nerve, 326, 328–329

Ticsafter traumatic brain injury, 220

Tilt-in-space recline wheelchair, 177Tilt table, 175, 603–604, 765Tincture of benzoin, 656–657Tinel’s sign, 140

in anterior tarsal tunnel syndrome, 539in carpal tunnel syndrome, 511in superficial peroneal neuropathy, 541in tarsal tunnel syndrome, 534in ulnar neuropathy, 515

Tinnitus, 318, 323Tissue complex injury, 356Tissue overload complex, 356–357Tissue proliferation

on residual limb, 136–137TKA line

See Trochanter, knee, ankle (TKA) lineTLSO

See Thoracolumbosacral orthosis (TLSO)Toe amputations, 85

prosthetic fitting and training, 89surgical technique, 85

Toe dragwith plastic ankle-foot orthoses, 723

Toe fillersfor shoes, 89

Toe flexion orthosis, 643Toe transfer

for thumb amputation, 37Toileting

adaptive aids, 679See also Activities of daily living (ADL)

Tokyo Metropolitan Rehabilitation Center socket, 131–132Tolosa-Hunt syndrome, 295Tongue

disorders, 340evaluation, 340–341exercises, 341–342numbness, 304sensory innervation, 310

TOSSee Thoracic outlet syndrome (TOS)

Total Army Personnel Command (PERSCOM), 866–867Total body surface area (TBSA), 579–580

estimation, 580Total elastic suspension (TES) belt, 131Total peripheral resistance (TPR), 790–791Tourniquet injuries, 690Tracheostomy

after spinal cord injury, 181in burn patients, 599–600

Tractionfor back pain, 384–385halo skeletal, 630neuropathies associated with, 440–443, 498

Traction framefor upper extremity amputations, 45–46

Transcarpal amputations, 44Transcutaneous electrical nerve stimulation (TENS)

acupuncture-like, 480for burn pain management, 623complications, 480–481


lxvi Volume 1: Pages 1–416; Volume 2: Pages 417–886

conventional, 480for musculoskeletal disorders, 358for peripheral nerve injuries, 479–481, 490for phantom limb pain, 142, 147–148for residual limb pain, 142for spinal cord injured patients, 191technique, 480

Transfemoral amputations, 122, 124bilateral, 122, 133, 148–149indications, 123surgical technique, 124

Transfemoral sockets, 124, 129–131Transferable skills assessment

in vocational rehabilitation, 855–856Transfer training

for amputees, 102–104, 106for spinal cord injured patients, 175, 189

Transmetacarpal amputations, 44Transmetatarsal amputations

disadvantages, 86functional outcome, 83prosthetic fitting and training, 89–90surgical technique, 86

Transpelvic amputationssocket design, 132–133

Transphalangeal amputations, 44Transportation

skin traction systems for, 45–46, 83, 124Transtibial amputations, 95

complications, 101indications, 123rehabilitation, 102, 106

Transtibial prosthesessuction, 111, 131suspension belts, 131

Transverse amputationsprostheses, 39

Trapezius muscleand accessory neuropathies, 337–338

Traumacal, 602Traumatic brain injury (TBI), 207–277

and alcohol use, 229, 239–241, 246appetite dysregulation after, 217ataxia after, 217autonomic dysregulation after, 217behavioral dysfunction after, 212–213, 217–219, 222–223,

228, 245–246case management, 228–229classification, 208–209, 230closed or nonpenetrating, 208–209cognitive dysfunction after, 217–219, 222–223, 228, 237–

238, 245–246community based rehabilitation, 228–229definition, 230diagnosis, 230–231, 234early recovery management programs, 226–227emergency medical treatment, 225epidemiology, 209–210etiology, 208–210family education, 227, 255family outcome, 227–228, 231, 245, 250–255functional outcome, 211–213, 224versus head injuries, 208, 231home based rehabilitation, 228incidence, 229interdisciplinary team management case study, 837–841low level neurologic states, 234–235management, 226, 228, 230–234

mild, 229–234, 250military rehabilitation, 229–237model systems continuum of care, 225–229morbidity, 226, 234, 240movement disorders after, 220–221neural recovery mechanisms, 212–213neurobehavioral assessment, 231, 237, 241–245neurobehavioral outcome, 237–246neurobehavioral programs, 228neurogenic heterotopic ossification after, 221neuromedical issues, 217, 222–224nomenclature, 208–209ocular complications, 295, 299open or penetrating, 208–210orthoses, 704–740outpatient clinical services, 227–228outpatient rehabilitation team, 227Persian Gulf War, 15pharmacologic treatment, 214–222, 232–233prevention, 255prognostication issues, 210–212psychosocial outcome, 238–241rehabilitation, 226–227rehabilitation team, 225–229seizures after, 221–222sexual dysfunction after, 222social concerns, 235speech and language disorders after, 222surgical treatment, 225–226vocational rehabilitation, 228, 243, 246–250, 856

Trazodone hydrochloride, 215–216, 220–221, 476–477Treadmills

motor-driven, 800Tremors

after traumatic brain injury, 220Trenchfoot, 443–446Triamcinolone, 358Triasmus, 304Triceps pad, 55Tricyclic antidepressants

dosage, 476for peripheral neuropathy, 475–477, 491–492for phantom limb pain, 146, 148for reflex sympathetic dystrophy, 141–142side effects, 476for spinal cord injury, 191for traumatic brain injury, 214–215, 220, 222, 240See also specific drug

Trigeminal evoked potentials, 307–308Trigeminal nerve, 300–308

anatomy and function, 300–303reflexes involving, 302–303, 305–307

Trigeminal neuralgiaSee Tic douloureux

Trigeminal neuropathies, 303–304electrodiagnosis, 305evaluation, 304–305management, 308symptoms and signs, 304syndromes, 303–304

Trigeminal sensory neuropathy, 303Triggering, 463Trigger point injections, 382Trimethoprim, 752TRM

See Ten repetition maximum (TRM)Trochanter, knee, ankle (TKA) line, 127–128Trochanteric bursitis, 389

Index

lxviiVolume 1: Pages 1–416; Volume 2: Pages 417–886

Trochlear nerve, 291–300anatomy and function, 291–292

Trochlear neuropathies, 295–300electrodiagnosis, 299evaluation, 299imaging, 299–300management, 299–300symptoms and signs, 297–299syndromes, 296–297

Tropomyosin, 783Troponin, 783Truman, Harry S, 22Trunk

scar compression, 674L-tryptophan, 216–217, 221Tube feeding

of burn patients, 602Tubigrip external vascular supports, 657–660, 667Tubiton Oedema sleeves, 613, 658–659Tumors

brainstem, 323cranial neuropathies secondary to, 280, 296, 317–318

Turkey, 28Twitch, 785Two-state control systems

for myoelectric prostheses, 65–66Tympanometry, 320

U

UCL-BCSee University College of London Bioengineering Center

(UCL-BC)UDS

See Utah Dynamic Socket (UDS)UE amputation

See Upper extremity (UE) amputationsUlcerations

of residual limb, 136Ulcers

in spinal cord injured patients, 184–185stress, 753–755See also Pressure sores

Ulnar amputationsdefinition, 40prostheses, 42–43

Ulnar collateral ligament injury, 377–378Ulnar nerve, 514, 519–520Ulnar neuropathy, 438, 514–522

anatomic considerations, 514–515, 519–520in burn patients, 689case scenario, 491–493clinical presentation, 515–516, 520–521differential diagnosis, 517, 521at elbow, 514–519electrodiagnosis, 514, 517–519, 521–522etiology, 516, 521treatment, 519, 522at wrist, 519–522

UltrasoundDoppler color-flow, 763in musculoskeletal injuries, 374, 377socket design with, 121, 130

Ultrasound diathermy, 467, 746–747, 758Underwater weighing, 797–799Unit assignment

and aerobic fitness, 804and disability compensation evaluation, 869–872

and vocational rehabilitation, 847Unit dB, 320United Kingdom

military pension laws, 864Royal Air Force, 7, 16, 71, 150spinal cord injury units, 162

United Nations (UN), 25Universal Below-the-Knee Bicycle Attachment, 125University College of London Bioengineering Center (UCL-

BC), 121Unna dressings, 615, 632, 645, 656, 658–659Upper extremity

anticontracture positioning, 746scar compression, 671–673

Upper extremity (UE) amputations, 33–77activities of daily living, 50–52, 62–64bilateral, 61–65myoelectric prosthesis use, 68–69nerve recovery in, 82nomenclature and functional levels, 43–45psychological support, 47, 52rehabilitation, 46–52skin traction systems, 45surgery principles, 45–46vocational rehabilitation, 38, 41–42, 47, 52, 54, 71–73World War II, 34–35See also Above-elbow (AE) amputations; Below-elbow (BE)

amputations; specific type of amputationUpper extremity nerve injuries, 496–522

See also specific injuryUpper extremity orthoses, 704–715

See also specific type of orthosisUpper extremity prostheses

choice of, 69–71hybrid (myoelectric and body-powered), 56, 59post-Civil War era, 34postoperative fitting, 48–49and residual limb problems, 61training of amputee, 52, 65, 68–69See also specific type of prosthesis

Urinary cathetersin burn patients, 585condom, 186–187in immobilized patients, 585in spinal cord injured patients, 193

Urinary incontinencein spinal cord injured patients, 193

Urinary retentionin immobilized patients, 585, 752in spinal cord injured patients, 193–194

Urinary systemeffect of immobility on, 751–753

Urinary tract infections (UTIs)in immobilized patients, 751–752in spinal cord injured patients, 162, 181, 194–195

Ur-Nammu, 864USAPDA

See Army Physical Disability Agency (USAPDA)USAR

See Army Reserve (USAR)Utah Dynamic Socket (UDS), 56Utah myoelectric prosthesis, 67–68

V

Vagus nerve, 329–335anatomy and function, 329–331muscles innervated by, 331


lxviii Volume 1: Pages 1–416; Volume 2: Pages 417–886

paralysis, 331Vagus neuropathies, 331–335

electrodiagnosis, 333–334evaluation, 333management, 334–335prognosis, 334symptoms and signs, 332–333syndromes, 332

VA hospital systemSee Veterans Affairs (VA) hospital system

Valgus, 716–717knee deformity, 736–737

Valium, 216, 220Valleix phenomenon, 534Valproic acid, 216, 220–221, 477Valsalva’s maneuver, 192–193Vancouver General Hospital burn scar assessment, 662–664VAPC shoe clasp orthosis, 722–723, 725Vari-Flex Foot, 117–119Varus, 716

knee deformity, 736–737Vascular access

in burn patients, 584–585Vascular innervation

of peripheral nerves, 428Vascular reconstruction, 82Vascular studies

for amputation complications, 135, 139Vascular support

after burn injury, 635, 645–649, 655–674for edema control, 471upper extremity, 671–673

Vascular support garments, 655–674adaptive aids for donning, 679–680custom-measured, 659–660, 665design, 661fitting, 661–662prefabricated, 665sources, 664–665use guidelines, 662See also specific type of garment

Vascular systemof peripheral nerves, 427–428spinal cord injury-associated disruption, 166

Vasoconstriction, 791Vasodilation, 791Vasopressin, 218VASRD

See Veterans Administration Schedule for Rating Disabili-ties (VASRD)

Vegetative statedefinition, 234permanent, 234–235, 237persistent, 234–235prognosis, 211social concerns, 234–235stimulation programs, 235–237

Velcro closuresfor above-knee prostheses, 131–132for below-knee prostheses, 110for bilateral upper extremity amputees, 64for hand prostheses, 39–43

Velfoam, 667–668Venography

contrast, 762–763Venous insufficiency

after amputation, 137–138Venous stasis

and elastic wrap support, 601Venous thrombosis

See Deep venous thrombosis (DVT)Ventilators, 181Ventilatory equivalent, 789Ventilatory regulation

during exercise, 788–789, 801Verapamil, 479Vernet’s syndrome, 326, 336Verrucose hyperplasia

of residual limb, 134, 138Versed

See MidazolamVertebral bodies, 167–168Vertigo, 319, 324

positional, 324Vesicoureteral reflux

in spinal cord injured patients, 193–194Vestibular nerve

anatomy and function, 317dysfunction, 319, 323–324evaluation, 321–322

Vestibular system, 294, 317Vestibulocochlear nerve, 316Vestibuloocular reflex, 292

innervation, 295Veterans Administration

and physical disability system, 864–865, 873vocational rehabilitation program, 858–859

Veterans Administration Schedule for Rating Disabilities(VASRD), 868, 872–873

rating codes, 874–875, 881Veterans Affairs (VA) hospital system, 7–8, 34, 81

brain injury treatment centers, 225–226spinal cord injury centers, 14, 196

Veterans Affairs Medical Centerupper extremity amputee care, 50, 52vocational counselor, 47

Veterans Benefit Counselor, 859Veterans Health Service

kinesiotherapy, 831Veterans Reserve Corps, 72Vibration

desensitization with, 633–634Vicarious functioning

after traumatic brain injury, 212Vietnam Head Injury Study, 27, 210Vietnam War

amputations, 10, 52, 72, 80, 134, 148, 150causalgia, 482immobility complications, 742peripheral nerve injuries, 447, 497physical therapy, 23–24rehabilitation services, 7–10return to duty during, 9, 23–24, 150spinal cord injuries, 162vocational rehabilitation case study, 847–848

Vigabatrin, 222Villaret’s syndrome, 340Vincamine, 219Virchow-Robin spaces, 192Visual acuity

alteration, 287–289, 300Visual evoked potentials, 290–291Visual field defects, 287–289Visual field testing, 288Visual pathways, 287

symptoms and signs, 288–289

Index

lxixVolume 1: Pages 1–416; Volume 2: Pages 417–886

Visual perception, 294, 300Vitamins

for burn patients, 687VO2

See Oxygen consumption (VO2)Vocal cord paralysis, 332Vocational assessment, 850–857

for brain injured patients, 248–250and educational experiences, 851family, 853–854functional, 852–853interest, 854–855interview, 853measurement tool validity/reliability, 851–852and medication effects, 851and nature of disability, 851and physical tolerance, 851situational, 856transferable skills, 855–856

Vocational Interest, Experience, and Skill Assessment, 854Vocational outcomes

of amputees, 150of brain injured patients, 234, 246–250of spinal cord injured patients, 196See also Return to duty

Vocational rehabilitation, 845–861for amputees, 150for brain injured patients, 228, 243, 246–250, 856case studies, 847–848, 850coordination of necessary services for, 859in-hospital phase, 846–857for lower extremity amputees, 84, 93, 101, 106posthospital phase, 858–859resistance to, 850short-term counseling in, 848–850for spinal cord injured patients, 179–180, 195, 856for upper extremity amputees, 38, 41–42, 47, 52, 54, 71–73Veterans Affairs program, 858–859Vietnam War case study, 847–848See also Occupational therapy

Vocational Rehabilitation Act Amendments, 6Vocational rehabilitation counselors

role in interdisciplinary team, 833Vogel, Emma, 21–23Voicaid, 620–621Voice impairments, 332Volar wrist flexion control orthosis, 709–710Volume of maximum oxygen consumption (VO2max)

and cardiac output, 790definition, 790in immobilized patients, 765measurement, 799–800and muscle fatigue, 786and oxygen transport variables, 792, 801response to aerobic training, 809values for elite athletes, 799See also Aerobic capacity

VO2maxSee Volume of maximum oxygen consumption (VO2max)

“V” strapsfor above-elbow prostheses, 57–58

W

Waist belt suspensionfor above-knee prostheses, 131for below-knee prostheses, 97–100, 110–111

Walkers

for above-knee amputees, 127for musculoskeletal injuries, 357overhead, 604–605

WalkingSee Ambulation; Gait pattern

Wallerian degeneration, 431–434electrodiagnostic findings, 460initiation, 432–433

Walter Reed Army Medical Center, 7, 10, 21, 28, 34–35, 80Warm-up period

and muscle injury avoidance, 356War-related injuries

emotional reaction to, 846–848Water beds, 637Watershed infarctions, 211WDR neurons

See Wide dynamic range (WDR) neuronsWeber’s syndrome, 296Weber’s test, 320Webril, 615, 630, 667Wechsler Adult Intelligence Scale, 195Wechsler Memory Scale-Local Memory subtest, 243Weighing

hydrostatic (underwater), 797–799Weight

of burn patient, 602, 688and immobilization, 752measurement, 793, 797–799military control programs, 793and muscle mass, 793use for resistance training, 812

Weight bearingafter above-knee amputations, 126after below-knee amputations, 98–99, 102–103after Syme’s amputations, 91–92and musculoskeletal injuries, 357in spinal cord injured patients, 189

Weight-bearing orthosesischial, 734–735

Weight control programsmilitary services, 793, 795–797physical training in, 793–794

Weightsfor training, 812

Wernicke’s syndrome, 296Western Neurosensory Stimulation Profile, 224Wet-bulb globe temperature (WBGT), 819Wheatstone bridge circuit

wire strain gauge with, 802Wheelchair, 682

controls, 177manual, 177power, 177pressure sores caused by, 196reclining, 175, 177selection, 177

Wheelchair cushions, 611Wheelchair locomotion

energy expenditure for, 731Wheelchair skills

patient education, 102–103, 175–177WHFO

See Wrist, hand, finger orthosis (WHFO)Whiplash, 171, 208, 230White matter, 165–166

damage, 165–166White phosphorus

burns caused by, 577–578


lxx Volume 1: Pages 1–416; Volume 2: Pages 417–886

Widdowson, E. M., 742Wide dynamic range (WDR) neurons, 484Wide Range Achievement Test, 195Wilbur, Ray Lyman, 5Williams flexion exercises, 383–384, 391Wire strain gauge

with Wheatstone bridge circuit, 802Women

Korean War service, 23military body fat standards, 796, 798percent body fat values, 794physical capacity for exercise, 803–804reference body composition values, 792World War II service, 22

Women’s Medical Specialist Corps (WMSC), 23See also Army Medical Specialist Corps (AMSC)

Word deafness, 320Word discrimination test, 320Work hardening, 858Work hardening programs, 637World War I

amputations, 35, 81, 93, 95, 134cranial neuropathies, 332, 339disability retirement laws, 864musculoskeletal injuries, 11, 354peripheral nerve injuries, 420–421, 447physical reconstruction services, 4–5, 7–8physical therapy, 20–28, 830spinal cord injuries, 162trenchfoot, 443–446

World War IIamputation centers, 7, 34–35, 52, 80–81, 149amputations, 34–35, 46, 71–72, 80, 93–95, 134causalgia, 481–482disability retirement laws, 864hand injuries, 35, 38immersion foot, 443–446immobility complications, 742musculoskeletal injuries, 11peripheral nerve injuries, 420–422, 447physical therapy, 21–22, 831rehabilitation services, 5–10spinal cord injuries, 162stress fractures, 817

Worth Four Dot flashlight, 299Wound breakdown

and immediate postoperative prostheses, 99, 102Wound care

burns, 596–607skin grafts, 590–591

Wound cleansingburns, 597–598, 627

Wound closureburns, 587

Wound contaminationin lower extremity amputee, 81–83, 94–95, 134in upper extremity amputee, 46

Wound debridementSee Debridement; Excision

Wound dehiscence

after amputation, 135Wound healing

delayed, 102phases, 595–596

Wound maturation phase, 595–596, 631–684Wound protection

for lower extremity amputations, 87for upper extremity amputations, 48–50

Wright Linear Pump, 606–607, 665, 682Wrist

contracture reduction, 709, 746positioning for burn injuries, 610scar compression, 672strengthening exercises, 374ulnar neuropathy at, 519–522

Wrist, hand, finger orthosis (WHFO), 611–613, 630–631Wrist disarticulation, 44

prostheses, 44, 52and residual limb problems, 61surgical procedures, 46

Wrist disorders, 376–378See also Carpal tunnel syndrome (CTS); specific disorder

Wrist extension assist, 710Wrist extensor-driven flexor hinge orthosis, 707–709Wrist-flexion units, 54Wrist-hand orthosis, 492, 746

for carpal tunnel syndrome, 513for posterior interosseous nerve entrapment, 505for radial neuropathy, 504

Wrist orthoses, 709–710extension assist, 710volar flexion control, 709–710

Wrist units, 53–55, 57quick change, 54thin friction, 54variable-friction, 54

Writingadaptive devices, 621

X

Xeroform, 616, 638, 650

Y

Yohimbine, 222Yom Kippur War, 15“Y” strap

for below-elbow prostheses, 55

Z

Zeiter, Walter J., 5Zero-shear recline wheelchair, 177Zimmer mesher, 590Zinc oxide, 656Zone of injury recovery, 167, 172–173Zone of partial preservation, 169Z-plasty, 691“Z” strap attachment

for above-elbow prostheses, 58–59

Documents

Rehabilitation of the Injured Combatant Vol 1 IndexREHABILITATION OF THE INJURED COMBATANT, Volumes 1 and 2 A AAEM ... and spinal cord injured patients, 179 and traumatic brain injuries,