To compare the functioning profiles of patients receiving different types of organ transplants using the International Classification of Functioning, Disability, and Health. The patients (n =102) were enrolled between days 5 and 10 after discharge following receipt of an organ transplant,and assessed for sociodemographic variables, the Functional Independence Measure and Barthel Index, and the International Classification of Functioning, Disability,and Health core set for cardiopulmonary conditions in the acute hospital, augmented with three additional categories.Analysis was conducted by grouping the patients as follows: (1) kidney transplants; (2) all other kinds of transplants. Functional Independence Measure/Barthel Index scores were significantly higher in group 1 compared with group 2. Prevalences of 30% or greater for any impairment were noted for seven b factors, one s factor,and one d factor in group 1, whereas the corresponding numbers for group 2 were 14, 2, and 8, respectively. When prevalences of 30% or greater were calculated for severe or total impairment for all factors, there were none for group 1, but six factors for group 2. For the six factors, the prevalence difference between the groups was significant in five after a full Bonferroni correction (P < 0.000002). The factors with the highest barriers were e110 (products or substances for personal consumption, 36%) and e120(products and technology for personal use in daily living,42%) in group 2 (both significant with P < 0.000001 when compared with the respective prevalences in group 1).Although exercise seems to be the most needed rehabilitation function for kidney transplant patients, other transplant patients will require considerably more rehabilitation intervention.
BACKGROUNDSupernumerary phantom limb (SPL) caused by spinal cord injury (SCI) has previously been reported in several studies. However, the mechanisms and management of SPL in SCI patients are still not fully understood. Herein, we report a rare case of SPL in a patient with incomplete SCI.CASE SUMMARYA 46-year-old man complained of four hands 7 d after SCI. He was diagnosed with SPL complicated with actual limb neuropathic pain. Following a period of treatment with neurotrophic agents and Chinese traditional and analgesic medications, SPL symptoms and actual limb pain did not improve. However, his symptoms gradually lessened after combined treatment with high-frequency repetitive transcranial magnetic stimulation (rTMS), a promising neuromodulation technique, over the M1 cortex and visual feedback. After 7 wk of this treatment, SPL disappeared completely and actual limb pain was significantly relieved.CONCLUSIONCerebral plasticity changes may be a mechanism underlying the occurrence of non-painful SPL in SCI patients, and high-frequency rTMS applied to the M1 cortex could be a promising treatment method for SPL.
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