Objective-To investigate the efficacy of wheelchair tilt-in-space and recline on enhancing skin perfusion over the ischial tuberosity in wheelchair users with spinal cord injury (SCI). Design-Repeated measures, intervention and outcomes measure design. Setting-A university research laboratory.Participants-11 wheelchair users with SCI (9 men, 2 women; mean age ± standard deviation, 37.7±14.2 years; body mass index 24.7±2.6 kg/m 2 ; and duration of injury 8.1±7.5 years).Interventions-6 protocols of various wheelchair tilt-in-space and recline angles were randomly assigned to the participants. Each protocol consisted of a 5-min sitting-induced ischemic period and a 5-min wheelchair tilt-in-space and recline pressure relieving period. A participant sat in a position without tilt or recline for 5 minutes and then sat in one of 6 wheelchair tiled and reclined positions, including (1) 15° tilt-in-space and 100° recline, (2) 25° tilt-in-space and 100° recline, (3) 35° tilt-in-space and 100° recline, (4) 15° tilt-in-space and 120° recline, (5) 25° tilt-in-space and 120° recline, and (6) 35° tilt-in-space and 120° recline. A 5-min washout period (at 35° tilt-inspace and 120° recline) was allowed between protocols.Main Outcome Measures-Laser Doppler flowmetry was used to measure skin perfusion over the ischial tuberosity in response to the changes of body positions caused by performing wheelchair tilt-in-space and recline. Skin perfusion response to wheelchair tilt-in-space and recline was normalized to skin perfusion of the upright seated position (no tilt/recline).Results-When combined with 100° recline, wheelchair tilt-in-space at 35° resulted in a significant increase in skin perfusion as compared with upright seated position (no tilt/recline) © 2010 The American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.Correspondence to Yih-Kuen Jan, PT, PhD, Dept of Rehabilitation Sciences, University of Oklahoma Health Sciences Center, 1200 N Stonewall Ave, Room 3135, Oklahoma City, OK 73117, yjan@ouhsc.edu. Reprints are not available from the author. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated. (p<0.05), while there was no significant increase in skin perfusion at 15° and 25° tilt-in-space( non significance). When combined with 120° recline, wheelchair tilt-in-space at 15°, 25°, and 35° tiltin-space all showed a significant inc...

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The increased popularity of contact sports worldwide exposes a large number of participants to both acute and chronic traumatic brain injury. Chronic traumatic brain injury (CTBI) represents the cumulative, long-term neurological consequences of repetitive concussive and subconcussive blows to the brain. Although this condition has been described primarily in boxing, it may be anticipated in other contact sports such as soccer, football, ice hockey, and the martial arts. Since treatment options in CTBI are relatively limited, the prevention of CTBI is of paramount importance. Minimizing the frequency and severity of acute brain injury in sport will be instrumental in accomplishing this goal. The prevention of CTBI will need to be sport specific and will undoubtedly rely on limiting the exposure of high-risk athletes, utilizing of protective equipment, enforcing strict rule adherence, training and supervising athletes, and increasing medical surveillance.

Intensive nutritional supplementation, using readily available commercial preparations, improves motor recovery in previously undernourished patients receiving intensive in-patient rehabilitation after stroke.