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Archives of Physical Medicine and Rehabilitation Volume 88, Issue 11, Pages , 1369-1545 (November 2007) Masthead 1. Page A2 Editorial Board 2. Page A3 Table of Contents 3. Pages A9-A10 ORIGINAL ARTICLES Somatosensory Stimulation Enhances the Effects of Training Functional 4. Hand Tasks in Patients With Chronic Stroke Pages 1369-1376 Pablo Celnik, Friedhelm Hummel, Michelle Harris-Love, Rebecca Wolk and Leonardo G. Cohen Electromyographic Activity in the Immobilized Shoulder Girdle 5. Musculature During Ipsilateral Kinetic Chain Exercises Pages 1377-1383 Jay Smith, Diane L. Dahm, Brian R. Kotajarvi, Andrea J. Boon, Edward R. Laskowski, David J. Jacofsky and Kenton R. Kaufman Clinical Correlates of Elevated Serum Concentrations of Cytokines and 6. Autoantibodies in Patients With Spinal Cord Injury Pages 1384-1393 Andrew L. Davies, Keith C. Hayes and Gregory A. Dekaban Smoking Among Veterans With Multiple Sclerosis: Prevalence 7. Correlates, Quit Attempts, and Unmet Need for Services Pages 1394-1399 Aaron P. Turner, Daniel R. Kivlahan, Lewis E. Kazis and Jodie K. Haselkorn Employment After Traumatic Brain Injury: Differences Between Men 8. and Women Pages 1400-1409 John D. Corrigan, Lee A. Lineberry, Eugene Komaroff, Jean A. Langlois, Anbesaw W. Selassie and Kenneth D. Wood Reliability and Validity of the Dynamic Gait Index in Persons With 9. Chronic Stroke Pages 1410-1415 Johanna Jonsdottir and Davide Cattaneo Exercise Prevents Fatigue and Improves Quality of Life in Prostate 10. Cancer Patients Undergoing Radiotherapy Pages 1416-1422 Uma Monga, Susan L. Garber, John Thornby, Carlos Vallbona, Anthony J. Kerrigan, Trilok N. Monga and Kuno P. Zimmermann The Segway Personal Transporter as an Alternative Mobility Device for 11. People With Disabilities: A Pilot Study Pages 1423-1428 Bonita Sawatzky, Ian Denison, Shauna Langrish, Shonna Richardson, Kelly Hiller and Bronwyn Slobogean Efficacy of a Fabricated Customized Splint and Tendon and Nerve 12. Gliding Exercises for the Treatment of Carpal Tunnel Syndrome: A Randomized Controlled Trial Pages 1429-1435 Teresa L. Brininger, Joan C. Rogers, Margo B. Holm, Nancy A. Baker, Zong-Ming Li and Robert J. Goitz Reliability of the Family Impact of Assistive Technology Scale for 13. Families of Young Children With Cerebral Palsy Pages 1436-1440 Stephen E. Ryan, Kent A. Campbell and Patricia J. Rigby Differences in Isometric Neck Muscle Strength Between Healthy 14. Controls and Women With Chronic Neck Pain: The Use of a Reliable Measurement Pages 1441-1445 Barbara Cagnie, Ann Cools, Veerle De Loose, Dirk Cambier and Lieven Danneels Normalizing Lower-Extremity Strength Data for Children Without 15. Disability Using Allometric Scaling Pages 1446-1451 Tishya A. Wren and Jack R. Engsberg Review Article Exercise Therapy and Other Types of Physical Therapy for Patients 16. With Neuromuscular Diseases: A Systematic Review Pages 1452-1464 Edith H. Cup, Allan J. Pieterse, Jessica M. ten Broek-Pastoor, Marten Munneke, Baziel G. van Engelen, Henk T. Hendricks, Gert J. van der Wilt and Rob A. Oostendorp Clinical Notes Allergic Reactions to Gadodiamide Following Interventional Spinal 17. Procedures: A Report of 4 Cases Pages 1465-1467 Casey J. O’Donnell and William G. Cano Prolonged, Severe Intrathecal Baclofen Withdrawal Syndrome: A Case 18. Report Pages 1468-1471 Colby R. Hansen, Judith L. Gooch and Teresa Such-Neibar Development of Spontaneous Intracranial Hypotension Concurrent 19. With Grade IV Mobilization of the Cervical and Thoracic Spine: A Case Report Pages 1472-1473 J. Skye Donovan, Charles W. Kerber, William H. Donovan and Lawrence F. Marshall Refusal to Eat, Capacity, and Ethics in Stroke Patients: A Report of 3 20. Cases Pages 1474-1477 Hillel M. Finestone and Jeff Blackmer Special Section State-of-the-Science on Postacute Rehabilitation: Setting a Research 21. Agenda and Developing an Evidence Base for Practice and Public Policy. An Introduction Pages 1478-1481 Allen W. Heinemann State-of-the-Science on Postacute Rehabilitation: Measurement and 22. Methodologies for Assessing Quality and Establishing Policy for Postacute Care Pages 1482-1487 Pamela W. Duncan and Craig A. Velozo Access to Postacute Rehabilitation 23. Pages 1488-1493 Melinda Beeuwkes Buntin Growth and Payment Adequacy of Medicare Postacute Care 24. Rehabilitation Pages 1494-1499 Sally J. Kaplan Assessing the Effectiveness of Postacute Care Rehabilitation 25. Pages 1500-1504 Robert L. Kane The Uniform Postacute Assessment Tool: Systematically Evaluating the 26. Quality of Measurement Evidence Pages 1505-1512 Mark V. Johnston, Daniel Graves and Maureen Greene The State-of-the-Science: Access to Postacute Care Rehabilitation 27. Services. A Review Pages 1513-1521 Kenneth J. Ottenbacher and James E. Graham The State-of-the-Science: Challenges in Designing Postacute Care 28. Payment Policy Pages 1522-1525 Leighton Chan Effectiveness of Multidisciplinary Rehabilitation Services in Postacute 29. Care: State-of-the-Science. A Review Pages 1526-1534 Janet A. Prvu Bettger and Margaret G. Stineman Postacute Rehabilitation Research and Policy Recommendations 30. Pages 1535-1541 Dexanne B. Clohan, Elizabeth M. Durkin, Joy Hammel, Patrick Murray, John Whyte, Marcel Dijkers, Bruce M. Gans, Daniel E. Graves, Allen W. Heinemann and Greg Worsowicz Departments Letters to the Editor Reduced Longitudinal Excursion of the Median Nerve in Carpal Tunnel 31. Syndrome Page 1542 Myron M. LaBan Saphenous Nerve Conduction Study Techniques 32. Page 1542 Seyed Mansoor Rayegani The author responds 33. Page 1543 Anthony Chiodo Organizational News--AAPM &R Journal-Based CME Evaluation and Application 34. Page 1544 CME Processing Fees and Application 35. Page 1545 OfficialJournaloftheAmericanCongressofRehabilitationMedicineandtheAmericanAcademyofPhysicalMedicineandRehabilitation ArchivesofPhysicalMedicineandRehabilitation(ISSN0003-9993)ispublishedmonthlybyElsevierInc.,360ParkAvenue South, New York, NY 10010-1710. Business and Editorial Office: 1600 John F. Kennedy Blvd., Ste. 1800, Philadelphia, PA 19103-2899.CustomerServiceOffice:6277SeaHarborDrive,Orlando,FL32887-4800.PeriodicalspostagepaidatNewYork,NY andadditionalmailingoffices. POSTMASTER:SendaddresschangestoArchivesofPhysicalMedicineandRehabilitation,ElsevierCustomerService,6277 SeaHarborDrive,Orlando,FL32887-4800. 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TheideasandopinionsexpressedinArchivesofPhysicalMedicineandRehabilitationdonotnecessarilyreflectthoseofthe AmericanAcademyofPhysicalMedicineandRehabilitation,theAmericanCongressofRehabilitationMedicine,theEditor,or thePublisher.PublicationofanadvertisementorotherproductmentioninArchivesofPhysicalMedicineandRehabilitation shouldnotbeconstruedasanendorsementoftheproductorthemanufacturer’sclaims.Readersareencouragedtocontact themanufacturerwithanyquestionsaboutthefeaturesorlimitationsoftheproductsmentioned.TheAmericanAcademyof PhysicalMedicineandRehabilitation,theAmericanCongressofRehabilitationMedicine,andthePublisherdonotassumeany responsibilityforanyinjuryand/ordamagetopersonsorpropertyarisingoutoforrelatedtoanyuseofthematerialcontained in this periodical. The reader is advised to check the appropriate medical literature and the product information currently providedbythemanufacturerofeachdrugtobeadministeredtoverifythedosage,themethodanddurationofadministration, orcontraindications.Itistheresponsibilityofthetreatingphysicianorotherhealthcareprofessional,relyingonindependent experienceandknowledgeofthepatient,todeterminedrugdosagesandthebesttreatmentforthepatient. ThecontentsofArchivesofPhysicalMedicineandRehabilitationareindexedinIndexMedicus/MEDLINE,ExcerptaMedica/ EMBASE,CurrentContents/ClinicalMedicine,ScienceCitationIndex,CitationAlert,BIOSIS,andCINAHL. Official Journal of the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation MISSION STATEMENT: The mission of the Archives of Physical Medicine and Rehabilitation is to disseminate information, with the ultimate goal of furthering the art and science of the practice of physical medicine and rehabilitation and interdisciplinary rehabilitation, and improving thehealthandwelfareofpersonswithdisabilities. EDITOR-IN-CHIEF Jeffrey R. Basford, MD, PhD (Academy) Rochester,MN ACADEMY EDITOR CONGRESS EDITOR Leighton Chan, MD, MPH Allen W. Heinemann, PhD, ABPP Bethesda,MD Chicago,IL PublicationsDirector EditorialCoordinators MichaelA.Vasko,MA CarolJ.Manow EditorialAssistant Lupe Soto KristenR.Golem EditorialAdministrator KarenK.Parks Editorial Board MichaelL.Boninger,MD(Academy) PatrickK.Murray,MD(Academy) Pittsburgh,PA Cleveland,OH BruceCaplan,PhD,ABPP(Congress) MaryM.Rodgers,PhD,PT(Congress) Wynnewood,PA Baltimore,MD MartinD.Hoffman,MD(Academy) ElliotJ.Roth,MD(Congress) Mather,CA Chicago,IL KennethM.Jaffe,MD(Congress) DaleC.Strasser,MD(Academy) Seattle,WA Atlanta,GA DavidD.Kilmer,MD(Academy) DeniseG.Tate,PhD,ABPP(Congress) Sacramento,CA AnnArbor,MI DavidE.Krebs,DPT,PhD(Congress) RobertA.Werner,MD(Academy) Boston,MA AnnArbor,MI JayM.Meythaler,MD,JD(Congress) Detroit,MI Associate Board JonathanF.Bean,MD,MS(Academy) MarkS.Kaplan,MD(Academy) Boston,MA Boston,MA BrendaJ.Brouwer,PhD(Congress) ChristinaM.Marciniak,MD(Academy) Kingston,ON Chicago,IL JohnChae,MD(Academy) JulieD.Moreland,MSc(Congress) Cleveland,OH Hamilton,ON JohnDeLuca,PhD,ABPP(Congress) MichaelW.O’Dell,MD(Congress) WestOrange,NJ NewYork,NY AlbertoEsquenazi,MD(Academy) JeffreyB.Palmer,MD(Congress) Philadelphia,PA Baltimore,MD RobertG.Frank,PhD,ABClinP(Congress) ThomasD.RizzoJr,MD(AcademyCMEEditor) Gainesville,FL Jacksonville,FL JannaFriedly,MD(Academy) JoanC.Rogers,PhD,OTR/L(Congress) Seattle,WA Pittsburgh,PA LynnH.Gerber,MD(Academy) BruceShapiro,MD(Academy) Fairfax,VA Baltimore,MD HelenHoenig,MD,MPH,OT(Congress) RobertW.Teasell,MD,FRCPC(Academy) Durham,NC London,ON MarkP.Jensen,PhD(Congress) RichardD.Zorowitz,MD(Academy) Seattle,WA Baltimore,MD Editorial Office: Suite 2510, 330 North Wabash Avenue, Chicago, Illinois 60611-7617. Phone: (312) 245-3992. Fax: (312) 464-9554.E-mail:[email protected]:www.archives-pmr.org Volume 88 No 11 November 2007 Table of Contents ORIGINAL ARTICLES 1369 SomatosensoryStimulationEnhancestheEffectsofTrainingFunctionalHandTasksin PatientsWithChronicStroke PabloCelnik,MD,FriedhelmHummel,MD,MichelleHarris-Love,PhD,RebeccaWolk,BA,LeonardoG.Cohen,MD 1377 ElectromyographicActivityintheImmobilizedShoulderGirdleMusculature CMECredit DuringIpsilateralKineticChainExercises JaySmith,MD,DianeL.Dahm,MD,BrianR.Kotajarvi,PT,AndreaJ.Boon,MD,EdwardR.Laskowski,MD, DavidJ.Jacofsky,MD,KentonR.Kaufman,PhD 1384 ClinicalCorrelatesofElevatedSerumConcentrationsofCytokinesand CMECredit AutoantibodiesinPatientsWithSpinalCordInjury AndrewL.Davies,MSc,KeithC.Hayes,PhD,GregoryA.Dekaban,PhD 1394 SmokingAmongVeteransWithMultipleSclerosis:PrevalenceCorrelates,QuitAttempts,and UnmetNeedforServices AaronP.Turner,PhD,DanielR.Kivlahan,PhD,LewisE.Kazis,ScD,JodieK.Haselkorn,MD,MPH 1400 EmploymentAfterTraumaticBrainInjury:DifferencesBetweenMenandWomen JohnD.Corrigan,PhD,LeeA.Lineberry,MS,EugeneKomaroff,PhD,JeanA.Langlois,ScD,MPH, AnbesawW.Selassie,DrPH,KennethD.Wood,PhD 1410 ReliabilityandValidityoftheDynamicGaitIndexinPersonsWithChronicStroke CMECredit JohannaJonsdottir,ScD,DavideCattaneo,PT 1416 ExercisePreventsFatigueandImprovesQualityofLifeinProstateCancerPatientsUndergoing Radiotherapy UmaMonga,MD,SusanL.Garber,MA,OTR,JohnThornby,PhD,CarlosVallbona,MD,AnthonyJ.Kerrigan,PhD, TrilokN.Monga,MD,KunoP.Zimmermann,DO,PhD 1423 TheSegwayPersonalTransporterasanAlternativeMobilityDeviceforPeopleWith Disabilities:APilotStudy BonitaSawatzky,PhD,IanDenison,BPT,ShaunaLangrish,MOT,ShonnaRichardson,MOT,KellyHiller,BPT, BronwynSlobogean,BA 1429 EfficacyofaFabricatedCustomizedSplintandTendonandNerveGlidingExercisesforthe TreatmentofCarpalTunnelSyndrome:ARandomizedControlledTrial MAJTeresaL.Brininger,SP,USA,JoanC.Rogers,PhD,MargoB.Holm,PhD,NancyA.Baker,ScD,Zong-MingLi,PhD, RobertJ.Goitz,MD 1436 ReliabilityoftheFamilyImpactofAssistiveTechnologyScaleforFamiliesofYoungChildren WithCerebralPalsy StephenE.Ryan,BESc,PEng,KentA.Campbell,PhD,PatriciaJ.Rigby,MHSc,OTReg(Ont) 1441 DifferencesinIsometricNeckMuscleStrengthBetweenHealthyControlsandWomenWith ChronicNeckPain:TheUseofaReliableMeasurement BarbaraCagnie,PT,PhD,AnnCools,PT,PhD,VeerleDeLoose,PT,DirkCambier,PT,PhD,LievenDanneels,PT,PhD 1446 NormalizingLower-ExtremityStrengthDataforChildrenWithoutDisabilityUsingAllometric Scaling TishyaA.Wren,PhD,JackR.Engsberg,PhD REVIEW ARTICLE 1452 ExerciseTherapyandOtherTypesofPhysicalTherapyforPatientsWithNeuromuscular Diseases:ASystematicReview EdithH.Cup,MSc,OT,AllanJ.Pieterse,PT,JessicaM.tenBroek-Pastoor,MSc,PT,MartenMunneke,PhD,PT, BazielG.vanEngelen,MD,PhD,HenkT.Hendricks,MD,PhD,GertJ.vanderWilt,PhD,RobA.Oostendorp,PhD,PT Volume 88 No 11 November 2007 Table of Contents (continued) CLINICAL NOTES 1465 AllergicReactionstoGadodiamideFollowingInterventionalSpinalProcedures:AReportof 4Cases CaseyJ.O’Donnell,DO,WilliamG.Cano,MD 1468 Prolonged,SevereIntrathecalBaclofenWithdrawalSyndrome:ACaseReport ColbyR.Hansen,MD,JudithL.Gooch,MD,TeresaSuch-Neibar,DO 1472 DevelopmentofSpontaneousIntracranialHypotensionConcurrentWithGradeIV MobilizationoftheCervicalandThoracicSpine:ACaseReport J.SkyeDonovan,PT,PhD,OCS,CharlesW.Kerber,MD,WilliamH.Donovan,MD,LawrenceF.Marshall,MD 1474 RefusaltoEat,Capacity,andEthicsinStrokePatients:AReportof3Cases HillelM.Finestone,MD,CM,FRCPC,JeffBlackmer,MD,MHSc,FRCPC SPECIAL SECTION 1478 State-of-the-ScienceonPostacuteRehabilitation:SettingaResearchAgendaandDevelopingan EvidenceBaseforPracticeandPublicPolicy.AnIntroduction AllenW.Heinemann,PhD 1482 State-of-the-ScienceonPostacuteRehabilitation:MeasurementandMethodologiesfor AssessingQualityandEstablishingPolicyforPostacuteCare PamelaW.Duncan,PhD,PT,CraigA.Velozo,PhD,OT 1488 AccesstoPostacuteRehabilitation MelindaBeeuwkesBuntin,PhD 1494 GrowthandPaymentAdequacyofMedicarePostacuteCareRehabilitation SallyJ.Kaplan,PhD 1500 AssessingtheEffectivenessofPostacuteCareRehabilitation RobertL.Kane,MD 1505 TheUniformPostacuteAssessmentTool:SystematicallyEvaluatingtheQualityof MeasurementEvidence MarkV.Johnston,PhD,DanielGraves,PhD,MaureenGreene,MS 1513 TheState-of-the-Science:AccesstoPostacuteCareRehabilitationServices.AReview KennethJ.Ottenbacher,PhD,OTR,JamesE.Graham,PhD,DC 1522 TheState-of-the-Science:ChallengesinDesigningPostacuteCarePaymentPolicy LeightonChan,MD,MPH 1526 EffectivenessofMultidisciplinaryRehabilitationServicesinPostacuteCare:State-of-the- Science.AReview JanetA.PrvuBettger,ScD,MargaretG.Stineman,MD 1535 PostacuteRehabilitationResearchandPolicyRecommendations DexanneB.Clohan,MD,ElizabethM.Durkin,PhD,JoyHammel,PhD,PatrickMurray,MD,MS,JohnWhyte,MD,PhD, MarcelDijkers,PhD,BruceM.Gans,MD,DanielE.Graves,PhD,AllenW.Heinemann,PhD,GregWorsowicz,MD DEPARTMENTS 1542 LetterstotheEditor ReducedLongitudinalExcursionoftheMedianNerveinCarpalTunnelSyndrome SaphenousNerveConductionStudyTechniques ORGANIZATION NEWS—AAPM&R 1544 Journal-BasedCMEEvaluationandApplication 1369 ORIGINAL ARTICLE Somatosensory Stimulation Enhances the Effects of Training Functional Hand Tasks in Patients With Chronic Stroke Pablo Celnik, MD, Friedhelm Hummel, MD, Michelle Harris-Love, PhD, Rebecca Wolk, BA, Leonardo G. Cohen, MD ABSTRACT.CelnikP,HummelF,Harris-LoveM,WolkR, advancesinourunderstandingofmoreeffectiveschedulesand CohenLG.Somatosensorystimulationenhancestheeffectsof structureoftrainingprotocols,3,4motorimpairmentrepresents training functional hand tasks in patients with chronic stroke. a frequent sequela. Somatosensory input is required for accu- Arch Phys Med Rehabil 2007;88:1369-76. ratemotorperformance5,6andformoreeffectivemotorlearn- ing.6 As predicted by these data, patients with intact somato- Objective: To test the hypothesis that somatosensory stim- sensory function experience more satisfactory response to ulation would enhance the effects of training functional hand rehabilitation interventions,7 and recovery of sensation in pa- tasks immediately after practice and 1 day later in chronic tients with sensory deficits is associated with improvement in subcortical stroke patients. motor control.8 Design: Single-blinded and randomized, crossover study. In healthy subjects, relatively brief application of somato- Setting: Human research laboratory. sensorystimulationintheformofperipheralnervestimulation Participants: Nine chronic subcortical stroke patients. (PNS) results in enhanced activation of the contralateral pri- Interventions: Three separate sessions of motor training marysensorimotorcortex(SM1)9,10andincreasedcontralateral preceded by (1) synchronous peripheral nerve stimulation motorcorticalexcitability.11-15Inpatientswithchronicstroke, (PNS), (2) no stimulation, or (3) asynchronous PNS. somatosensory stimulation applied to peripheral nerves inner- Main Outcome Measures: Time to complete the Jebsen- vating weak body parts transiently enhances motor perfor- Taylor Hand Function Test (JTHFT time) and corticomotor mance.16-18 Although most of these studies14,16-18 measured excitability tested with transcranial magnetic stimulation. performance immediately after the end of stimulation, little is Results: After familiarization practice, during which all known about the mechanisms and ability of PNS to modulate patients reached a performance plateau, training under the the effects of motor training in chronic subcortical stroke effectsofPNSreducedJTHFTtimeby10%beyondthepost- patients.Recently,astudy19investigatedtheeffectsofmedian familiarizationplateau.Thisbehavioralgainwasaccompanied nervestimulationontheperformanceoffunctionalhandtasks by a specific reduction in GABAergically mediated intracorti- in cortical stroke patients and found improvement and better cal inhibition in the motor cortex. These findings were not retentionafterPNSrelativetocontrolstimulation.Thisstudy, observedaftersimilarpracticeundertheinfluenceofnostim- however, did not investigate the effects on subcortical stroke ulation or asynchronous PNS sessions. patients who may have different mechanisms of motor recov- Conclusions:Somatosensorystimulationmayenhancethe ery20anddidnotdeterminetheneuroplasticchangesassociated training of functional hand tasks in patients with chronic to PNS. stroke, possibly through modulation of intracortical GABAergic In this study, we tested the hypothesis that PNS would pathways. enhance the effects of training functional hand tasks immedi- Key Words: Electric stimulation; Motor skills; Rehabilita- atelyand1dayafterpractice,inagroupofsubcorticalstroke tion; Stroke. patients. In addition, using transcranial magnetic stimulation © 2007 by the American Congress of Rehabilitation Medi- (TMS),weinvestigatedtheunderlyingmechanismsassociated cine and the American Academy of Physical Medicine and with PNS and motor training effects. Rehabilitation METHODS MOTOR TRAINING IS EXTENSIVELY used as part of rehabilitative treatments to facilitate relearning of activ- Participants ities of daily living (ADLs) after stroke.1,2 Despite recent Werecruited9patientsthroughtheStrokeNeurorehabilita- tion Clinic of the National Institutes of Health (table 1). All participantshadahistoryofsinglesubcorticalischemicstroke, at least 1 year prior to participation in the study, leading to From the Human Cortical Physiology Section and Stroke Neurorehabilitation Clinic,NationalInstituteofNeurologicalDisordersandStroke,NationalInstitutesof initial severe upper arm motor pareses (Medical Research Health,Bethesda,MD(Celnik,Hummel,Harris-Love,Wolk,Cohen);Departmentsof Council scale score (cid:1)2) with subsequent good recovery of Physical Medicine and Rehabilitation and Neurology, Johns Hopkins University, function to the point of being able to complete the Jebsen- Baltimore,MD(Celnik);andDepartmentofNeurology,HamburgUniversityMedical TaylorHandFunctionTest(JTHFT).Theyallsignedinformed Center,Hamburg,Germany(Hummel). SupportedbytheIntramuralResearchProgramoftheNationalInstituteofNeu- consent according to the Declaration of Helsinki and the Na- rological Disorders and Stroke, National Institutes of Health; the Rehabilitation tional Institute of Neurological Disorders and Stroke Institu- Medicine Scientist Training Program (grant no. 5K12HD001097); and the A. v. tional Review Board approved the experimental protocol. HumboldtFoundation(Feodor-Lynengrant). Nocommercialpartyhavingadirectfinancialinterestintheresultsoftheresearch supporting this article has or will confer a benefit upon the authors or upon any Experimental Design organizationwithwhichtheauthorsareassociated. All subjects participated in this single-blinded randomized, RequestreprintstoLeonardoG.Cohen,MD,HumanCorticalPhysiologySection, NINDS,NIH,Bethesda,MD20817,e-mail:[email protected]. counterbalanced crossover study. Initially, all subjects partici- patedinafamiliarizationsessioninwhichtheytrainedwiththe 0003-9993/07/8811-11566$32.00/0 doi:10.1016/j.apmr.2007.08.001 JTHFT 30 times (3 blocks of 10 repetitions, separated by ArchPhysMedRehabilVol88,November2007

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State-of-the-Science on Postacute Rehabilitation: Measurement and . contact: Keida Spurlock, Tel: 212-633-3986, fax: 212-633-3820, e-mail, [email protected]. manual muscle testing positions, each subject was given in- .. LabView 6.1; National Instruments Corp, 11500 N Mopac Expwy,.
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