Santiago Toledo | Northwestern University (original) (raw)

Papers by Santiago Toledo

Arch Phys Med Rehabil, 2004

Drake DF, Nadler SF, Chou LH, Toledo SD, Akuthota V. Sports and performing arts medicine. 4. Trau... more Drake DF, Nadler SF, Chou LH, Toledo SD, Akuthota V. Sports and performing arts medicine. 4. Traumatic injuries in sports. 2004;85(3 Suppl 1):S67–71.This self-directed learning module focuses on injuries often seen in contact sports. It includes information on trauma to the cervical spine, wrist, shoulder, knee, ankle, foot, and chest and also discusses concussion in sport. It is part of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article specifically focuses on the etiology, differential diagnoses, treatment, and return-to-play criteria for traumatic sports injuries.To summarize the approach to common traumatic sports injuries.

Journal of the American Geriatrics Society, 1992

ABSTRACT To compare the equivalence of infrared tympanic membrane (TM) measure of body temperatur... more ABSTRACT To compare the equivalence of infrared tympanic membrane (TM) measure of body temperature with standard electronic oral (PO) and rectal (R) measures in a nursing home population. Randomized repeated-measurement design. For the study, 82 randomly selected residents (mean age 79 +/- 10 years) of the Nursing Home Care Unit of the VAMC West Los Angeles had PO, R, and TM temperatures measured before arising (6-8 am). An otoscopic exam and the age, sex, presence of neurologic disease, and compliance with thermometry was noted. Also, repeated measures of PO and TM temperatures were performed three times to assess variability. The Pearson's correlation coefficient was determined for PO versus R and for TM versus R temperatures. Stepwise regression analysis was performed with the dependent variable of R temperature and the independent variables of the mean TM temperature, age, sex, presence of neurologic disease, position of the resident, and extent of ear canal occlusion. The correlation of TM versus R (r = .39, P = .004) was better, though not significantly, than of PO versus R (r = .28, P = .04). TM had less variability than PO (pooled standard deviation .38 vs .45 degrees F, respectively) and TM was implemented successfully more often than PO or R (96% vs 81% vs 81%). Therefore, TM was at least equivalent or better than PO measures of temperature in this population. The efficacy of fever detection and the use and durability of long-term use by nursing staff needs to be studied.

Clinics in geriatric medicine, 1992

The high prevalence, morbidity, and mortality of infectious diseases in the geriatric population ... more The high prevalence, morbidity, and mortality of infectious diseases in the geriatric population mandates that clinicians caring for older patients become better acquainted and familiar with the special and unique characteristics and features of this common clinical problem. Only through such awareness and understanding will clinical outcomes, functional capacity, and quality of life be improved in the elderly population.

World journal of gastroenterology : WJG, Jan 21, 2014

To investigate the efficacy of lubiprostone compared to Senna on bowel symptoms and constipation ... more To investigate the efficacy of lubiprostone compared to Senna on bowel symptoms and constipation in post-operative orthopedic patients treated with opioids. In this double blind, randomized, active comparator trial, adults who required opioids for analgesia following orthopedic procedures and who were admitted in inpatient rehabilitation were randomized following baseline assessments to lubiprostone (Amitza(®)), orally twice a day or Senna (generic) two capsules administered daily for six days. Subjects were assessed using the patient assessment of constipation (PAC)-symptoms (PAC-SYM) and the PAC-quality of life (PAC-QOL) scales measured at baseline and Day 7; Subjects were assessed daily for secondary measures included the Bristol stool scale bowel consistency, specific bowel symptom score (Nausea, cramping, straining, completeness, abdominal pain, time per lavatory attempt, assistance needed), adverse events and rescue medications required. Function was measured using the functio...

Improving Care in the Nursing Home: Comprehensive Reviews of Clinical Research, 1993

PM&R, 2013

To assess the effect of exercise training by using the Nintendo Wii Fit video game and balance bo... more To assess the effect of exercise training by using the Nintendo Wii Fit video game and balance board system on balance and gait in adults with Parkinson disease (PD). A prospective interventional cohort study. An outpatient group exercise class. Ten subjects with PD, Hoehn and Yahr stages 2.5 or 3, with a mean age of 67.1 years; 4 men, 6 women. The subjects participated in supervised group exercise sessions 3 times per week for 8 weeks by practicing 3 different Wii balance board games (marble tracking, skiing, and bubble rafting) adjusted for their individualized function level. The subjects trained for 10 minutes per game, a total of 30 minutes training per session. Pre-and postexercise training, a physical therapist evaluated subjects' function by using the Berg Balance Scale, Dynamic Gait Index, and Sharpened Romberg with eyes open and closed. Postural sway was assessed at rest and with tracking tasks by using the Wii balance board. The subjects rated their confidence in balance by using the Activities-specific Balance Confidence scale and depression on the Geriatric Depression Scale. Balance as measured by the Berg Balance Scale improved significantly, with an increase of 3.3 points (P = .016). The Dynamic Gait Index improved as well (mean increase, 2.8; P = .004), as did postural sway measured with the balance board (decreased variance in stance with eyes open by 31%; P = .049). Although the Sharpened Romberg with eyes closed increased by 6.85 points and with eyes opened by 3.3 points, improvements neared significance only for eyes closed (P = .07 versus P = .188). There were no significant changes on patient ratings for the Activities-specific Balance Confidence (mean decrease, -1%; P = .922) or the Geriatric Depression Scale (mean increase, 2.2; P = .188). An 8-week exercise training class by using the Wii Fit balance board improved selective measures of balance and gait in adults with PD. However, no significant changes were seen in mood or confidence regarding balance.

PM&R, 2011

Objective: The purpose of this study is to assess the effect of exercise training using the 10

Frontiers in Neurology, 2012

Mobile phones with built-in accelerometers promise a convenient, objective way to quantify everyd... more Mobile phones with built-in accelerometers promise a convenient, objective way to quantify everyday movements and classify those movements into activities. Using accelerometer data we estimate the following activities of 18 healthy subjects and eight patients with Parkinson's disease: walking, standing, sitting, holding, or not wearing the phone. We use standard machine learning classifiers (support vector machines, regularized logistic regression) to automatically select, weigh, and combine a large set of standard features for time series analysis. Using cross validation across all samples we are able to correctly identify 96.1% of the activities of healthy subjects and 92.2% of the activities of Parkinson's patients. However, when applying the classification parameters derived from the set of healthy subjects to Parkinson's patients, the percent correct lowers to 60.3%, due to different characteristics of movement. For a fairer comparison across populations we also applied subject-wise cross validation, identifying healthy subject activities with 86.0% accuracy and 75.1% accuracy for patients. We discuss the key differences between these populations, and why algorithms designed for and trained with healthy subject data are not reliable for activity recognition in populations with motor disabilities.

Archives of Physical Medicine and Rehabilitation, 2007

Archives of Physical Medicine and Rehabilitation, 2004

This self-directed study module highlights biomechanics unique to dance that predispose to common... more This self-directed study module highlights biomechanics unique to dance that predispose to common injuries of the lower extremity and discusses preventative strategies. It is part of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. To summarize lower-limb and back injuries commonly seen in dancers.

Archives of Physical Medicine and Rehabilitation, 2004

This self-directed learning module discusses classic topics and highlights new advances in this t... more This self-directed learning module discusses classic topics and highlights new advances in this topic area. This article, which discusses upper-limb injuries in musicians, is a section of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article uses case vignettes to elaborate on issues relating to musicians. To summarize overuse injury, nerve entrapment, and focal dystonia in instrumental musicians.

Archives of Physical Medicine and Rehabilitation, 2004

This self-directed learning module focuses on injuries often seen in contact sports. It includes ... more This self-directed learning module focuses on injuries often seen in contact sports. It includes information on trauma to the cervical spine, wrist, shoulder, knee, ankle, foot, and chest and also discusses concussion in sport. It is part of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article specifically focuses on the etiology, differential diagnoses, treatment, and return-to-play criteria for traumatic sports injuries. To summarize the approach to common traumatic sports injuries.

Archives of Physical Medicine and Rehabilitation, 2004

Chou LH, Akuthota V, Drake DF, Toledo SD, Nadler SF. Sports and performing arts medicine. 3. Lowe... more Chou LH, Akuthota V, Drake DF, Toledo SD, Nadler SF. Sports and performing arts medicine. 3. Lower-limb injuries in endurance sports. Arch Phys Med Rehabil 2004;85 (3 Suppl 1):S59-66.

Archives of Physical Medicine and Rehabilitation, 2004

This self-directed learning module discusses classic topics and highlights new advances in this a... more This self-directed learning module discusses classic topics and highlights new advances in this area. This article discusses upper-limb sports injuries as part of a section of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article uses case vignettes as a vehicle to elaborate on shoulder and elbow pain in the athlete. To discuss shoulder and elbow overuse injuries in sports.

Archives of Physical Medicine and Rehabilitation, 2004

This self-directed learning module highlights general considerations in sports and performing art... more This self-directed learning module highlights general considerations in sports and performing arts medicine. It is part of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. To discuss similarities and differences of injuries sustained in sports and performing arts using case vignettes.

American Journal of Physical Medicine & Rehabilitation, 2011

The aim of this study was to assess the impact of cognition, baseline motor function, and co-morb... more The aim of this study was to assess the impact of cognition, baseline motor function, and co-morbid medical conditions on functional change, discharge destination, and discharge needs in patients admitted to acute rehabilitation for Parkinson-related impairments. This retrospective chart review study evaluated the records of patients admitted to acute rehabilitation over a 5-yr period with a primary impairment category of parkinsonism. Functional status was measured at admission and discharge; 3-mo follow-up function was also collected in a sample of discharged patients. Eighty-nine patients (mean age, 74.26 yrs) were admitted over the 5-yr time frame. A more complicated Medicare tier diagnosis (tier 2) was associated with lower total and motor score Functional Independence Measure gains compared with tier 3 (P = 0.009 and P = 0.016, respectively). Cognitive scores at admission were not related to need for caregivers upon discharge. Overall Functional Independence Measure gain (adjusted R(2) = 0.073, P = 0.006) and Functional Independence Measure gain efficiency (adjusted R(2) = 0.142, P < 0.001) inversely correlated with age. At the 3-mo follow-up, a random sample (38%) of patients contacted postdischarge demonstrated continued improvements. Significant improvement may be seen after acute rehabilitation in patients with Parkinson disease, irrespective of cognitive impairment. More complicated medical tier diagnoses result in less Functional Independence Measure gain, and older individuals with Parkinson disease are more likely to show less functional change. However, functional improvements are still statistically significant.

Arch Phys Med Rehabil, 2004

Drake DF, Nadler SF, Chou LH, Toledo SD, Akuthota V. Sports and performing arts medicine. 4. Trau... more Drake DF, Nadler SF, Chou LH, Toledo SD, Akuthota V. Sports and performing arts medicine. 4. Traumatic injuries in sports. 2004;85(3 Suppl 1):S67–71.This self-directed learning module focuses on injuries often seen in contact sports. It includes information on trauma to the cervical spine, wrist, shoulder, knee, ankle, foot, and chest and also discusses concussion in sport. It is part of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article specifically focuses on the etiology, differential diagnoses, treatment, and return-to-play criteria for traumatic sports injuries.To summarize the approach to common traumatic sports injuries.

Journal of the American Geriatrics Society, 1992

ABSTRACT To compare the equivalence of infrared tympanic membrane (TM) measure of body temperatur... more ABSTRACT To compare the equivalence of infrared tympanic membrane (TM) measure of body temperature with standard electronic oral (PO) and rectal (R) measures in a nursing home population. Randomized repeated-measurement design. For the study, 82 randomly selected residents (mean age 79 +/- 10 years) of the Nursing Home Care Unit of the VAMC West Los Angeles had PO, R, and TM temperatures measured before arising (6-8 am). An otoscopic exam and the age, sex, presence of neurologic disease, and compliance with thermometry was noted. Also, repeated measures of PO and TM temperatures were performed three times to assess variability. The Pearson's correlation coefficient was determined for PO versus R and for TM versus R temperatures. Stepwise regression analysis was performed with the dependent variable of R temperature and the independent variables of the mean TM temperature, age, sex, presence of neurologic disease, position of the resident, and extent of ear canal occlusion. The correlation of TM versus R (r = .39, P = .004) was better, though not significantly, than of PO versus R (r = .28, P = .04). TM had less variability than PO (pooled standard deviation .38 vs .45 degrees F, respectively) and TM was implemented successfully more often than PO or R (96% vs 81% vs 81%). Therefore, TM was at least equivalent or better than PO measures of temperature in this population. The efficacy of fever detection and the use and durability of long-term use by nursing staff needs to be studied.

Clinics in geriatric medicine, 1992

The high prevalence, morbidity, and mortality of infectious diseases in the geriatric population ... more The high prevalence, morbidity, and mortality of infectious diseases in the geriatric population mandates that clinicians caring for older patients become better acquainted and familiar with the special and unique characteristics and features of this common clinical problem. Only through such awareness and understanding will clinical outcomes, functional capacity, and quality of life be improved in the elderly population.

World journal of gastroenterology : WJG, Jan 21, 2014

To investigate the efficacy of lubiprostone compared to Senna on bowel symptoms and constipation ... more To investigate the efficacy of lubiprostone compared to Senna on bowel symptoms and constipation in post-operative orthopedic patients treated with opioids. In this double blind, randomized, active comparator trial, adults who required opioids for analgesia following orthopedic procedures and who were admitted in inpatient rehabilitation were randomized following baseline assessments to lubiprostone (Amitza(®)), orally twice a day or Senna (generic) two capsules administered daily for six days. Subjects were assessed using the patient assessment of constipation (PAC)-symptoms (PAC-SYM) and the PAC-quality of life (PAC-QOL) scales measured at baseline and Day 7; Subjects were assessed daily for secondary measures included the Bristol stool scale bowel consistency, specific bowel symptom score (Nausea, cramping, straining, completeness, abdominal pain, time per lavatory attempt, assistance needed), adverse events and rescue medications required. Function was measured using the functio...

Improving Care in the Nursing Home: Comprehensive Reviews of Clinical Research, 1993

PM&R, 2013

To assess the effect of exercise training by using the Nintendo Wii Fit video game and balance bo... more To assess the effect of exercise training by using the Nintendo Wii Fit video game and balance board system on balance and gait in adults with Parkinson disease (PD). A prospective interventional cohort study. An outpatient group exercise class. Ten subjects with PD, Hoehn and Yahr stages 2.5 or 3, with a mean age of 67.1 years; 4 men, 6 women. The subjects participated in supervised group exercise sessions 3 times per week for 8 weeks by practicing 3 different Wii balance board games (marble tracking, skiing, and bubble rafting) adjusted for their individualized function level. The subjects trained for 10 minutes per game, a total of 30 minutes training per session. Pre-and postexercise training, a physical therapist evaluated subjects' function by using the Berg Balance Scale, Dynamic Gait Index, and Sharpened Romberg with eyes open and closed. Postural sway was assessed at rest and with tracking tasks by using the Wii balance board. The subjects rated their confidence in balance by using the Activities-specific Balance Confidence scale and depression on the Geriatric Depression Scale. Balance as measured by the Berg Balance Scale improved significantly, with an increase of 3.3 points (P = .016). The Dynamic Gait Index improved as well (mean increase, 2.8; P = .004), as did postural sway measured with the balance board (decreased variance in stance with eyes open by 31%; P = .049). Although the Sharpened Romberg with eyes closed increased by 6.85 points and with eyes opened by 3.3 points, improvements neared significance only for eyes closed (P = .07 versus P = .188). There were no significant changes on patient ratings for the Activities-specific Balance Confidence (mean decrease, -1%; P = .922) or the Geriatric Depression Scale (mean increase, 2.2; P = .188). An 8-week exercise training class by using the Wii Fit balance board improved selective measures of balance and gait in adults with PD. However, no significant changes were seen in mood or confidence regarding balance.

PM&R, 2011

Objective: The purpose of this study is to assess the effect of exercise training using the 10

Frontiers in Neurology, 2012

Mobile phones with built-in accelerometers promise a convenient, objective way to quantify everyd... more Mobile phones with built-in accelerometers promise a convenient, objective way to quantify everyday movements and classify those movements into activities. Using accelerometer data we estimate the following activities of 18 healthy subjects and eight patients with Parkinson's disease: walking, standing, sitting, holding, or not wearing the phone. We use standard machine learning classifiers (support vector machines, regularized logistic regression) to automatically select, weigh, and combine a large set of standard features for time series analysis. Using cross validation across all samples we are able to correctly identify 96.1% of the activities of healthy subjects and 92.2% of the activities of Parkinson's patients. However, when applying the classification parameters derived from the set of healthy subjects to Parkinson's patients, the percent correct lowers to 60.3%, due to different characteristics of movement. For a fairer comparison across populations we also applied subject-wise cross validation, identifying healthy subject activities with 86.0% accuracy and 75.1% accuracy for patients. We discuss the key differences between these populations, and why algorithms designed for and trained with healthy subject data are not reliable for activity recognition in populations with motor disabilities.

Archives of Physical Medicine and Rehabilitation, 2007

Archives of Physical Medicine and Rehabilitation, 2004

This self-directed study module highlights biomechanics unique to dance that predispose to common... more This self-directed study module highlights biomechanics unique to dance that predispose to common injuries of the lower extremity and discusses preventative strategies. It is part of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. To summarize lower-limb and back injuries commonly seen in dancers.

Archives of Physical Medicine and Rehabilitation, 2004

This self-directed learning module discusses classic topics and highlights new advances in this t... more This self-directed learning module discusses classic topics and highlights new advances in this topic area. This article, which discusses upper-limb injuries in musicians, is a section of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article uses case vignettes to elaborate on issues relating to musicians. To summarize overuse injury, nerve entrapment, and focal dystonia in instrumental musicians.

Archives of Physical Medicine and Rehabilitation, 2004

This self-directed learning module focuses on injuries often seen in contact sports. It includes ... more This self-directed learning module focuses on injuries often seen in contact sports. It includes information on trauma to the cervical spine, wrist, shoulder, knee, ankle, foot, and chest and also discusses concussion in sport. It is part of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article specifically focuses on the etiology, differential diagnoses, treatment, and return-to-play criteria for traumatic sports injuries. To summarize the approach to common traumatic sports injuries.

Archives of Physical Medicine and Rehabilitation, 2004

Chou LH, Akuthota V, Drake DF, Toledo SD, Nadler SF. Sports and performing arts medicine. 3. Lowe... more Chou LH, Akuthota V, Drake DF, Toledo SD, Nadler SF. Sports and performing arts medicine. 3. Lower-limb injuries in endurance sports. Arch Phys Med Rehabil 2004;85 (3 Suppl 1):S59-66.

Archives of Physical Medicine and Rehabilitation, 2004

This self-directed learning module discusses classic topics and highlights new advances in this a... more This self-directed learning module discusses classic topics and highlights new advances in this area. This article discusses upper-limb sports injuries as part of a section of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article uses case vignettes as a vehicle to elaborate on shoulder and elbow pain in the athlete. To discuss shoulder and elbow overuse injuries in sports.

Archives of Physical Medicine and Rehabilitation, 2004

This self-directed learning module highlights general considerations in sports and performing art... more This self-directed learning module highlights general considerations in sports and performing arts medicine. It is part of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. To discuss similarities and differences of injuries sustained in sports and performing arts using case vignettes.

American Journal of Physical Medicine & Rehabilitation, 2011

The aim of this study was to assess the impact of cognition, baseline motor function, and co-morb... more The aim of this study was to assess the impact of cognition, baseline motor function, and co-morbid medical conditions on functional change, discharge destination, and discharge needs in patients admitted to acute rehabilitation for Parkinson-related impairments. This retrospective chart review study evaluated the records of patients admitted to acute rehabilitation over a 5-yr period with a primary impairment category of parkinsonism. Functional status was measured at admission and discharge; 3-mo follow-up function was also collected in a sample of discharged patients. Eighty-nine patients (mean age, 74.26 yrs) were admitted over the 5-yr time frame. A more complicated Medicare tier diagnosis (tier 2) was associated with lower total and motor score Functional Independence Measure gains compared with tier 3 (P = 0.009 and P = 0.016, respectively). Cognitive scores at admission were not related to need for caregivers upon discharge. Overall Functional Independence Measure gain (adjusted R(2) = 0.073, P = 0.006) and Functional Independence Measure gain efficiency (adjusted R(2) = 0.142, P < 0.001) inversely correlated with age. At the 3-mo follow-up, a random sample (38%) of patients contacted postdischarge demonstrated continued improvements. Significant improvement may be seen after acute rehabilitation in patients with Parkinson disease, irrespective of cognitive impairment. More complicated medical tier diagnoses result in less Functional Independence Measure gain, and older individuals with Parkinson disease are more likely to show less functional change. However, functional improvements are still statistically significant.