ReviewPositioning in Radiography, ClarkK. C., M.B.E., Fourth Edition, London, Ilford Ltd., William Heinemann (Medical Books) Ltd., 1945.

Purpose The purpose of this study was to assess the perceptions of stuttering of school-age children who stutter and those of adults who stutter through the use of the same tools that could be commonly used by clinicians. Method Twenty-three participants across various ages and stuttering severity were administered both the Stuttering Severity Instrument–Fourth Edition (SSI-4; Riley, 2009 ) and the Wright & Ayre Stuttering Self-Rating Profile ( Wright & Ayre, 2000 ). Comparisons were made between severity of behavioral measures of stuttering made by the SSI-4 and by age (child/adult). Results Significant differences were obtained for the age comparison but not for the severity comparison. Results are explained in terms of the correlation between severity equivalents of the SSI-4 and the Wright & Ayre Stuttering Self-Rating Profile scores, with clinical implications justifying multi-aspect assessment. Conclusions Clinical implications indicate that self-perception and impact of stuttering must not be assumed and should be evaluated for individual participants. Research implications include further study with a larger subject pool and various levels of stuttering severity.

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Use of the AMA Guides in State Workers' Compensation Systems: 2009 Update

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2009.marapr02 ◽

2009 ◽

Vol 14 (2) ◽

pp. 13-16

Author(s):

Christopher R. Brigham ◽

Jenny Walker

Keyword(s):

New York ◽

North Carolina ◽

South Carolina ◽

South Dakota ◽

Rhode Island ◽

Workers Compensation ◽

Fourth Edition ◽

Sixth Edition ◽

Specific Guideline ◽

Compensation Systems

Abstract The AMAGuides to the Evaluation of Permanent Impairment (AMA Guides) is the most widely used basis for determining impairment and is used in state workers’ compensation systems, federal systems, automobile casualty, and personal injury, as well as by the majority of state workers’ compensation jurisdictions. Two tables summarize the edition of the AMA Guides used and provide information by state. The fifth edition (2000) is the most commonly used edition: California, Delaware, Georgia, Hawaii, Kentucky, New Hampshire, Idaho, Indiana, Iowa, Kentucky, Massachusetts, Nevada, North Dakota, Ohio, Vermont, and Washington. Eleven states use the sixth edition (2007): Alaska, Arizona, Louisiana, Mississippi, Montana, New Mexico, Oklahoma, Pennsylvania, Rhode Island, Tennessee, and Wyoming. Eight states still commonly make use of the fourth edition (1993): Alabama, Arkansas, Kansas, Maine, Maryland, South Dakota, Texas, and West Virginia. Two states use the Third Edition, Revised (1990): Colorado and Oregon. Connecticut does not stipulate which edition of the AMA Guides to use. Six states use their own state specific guidelines (Florida, Illinois, Minnesota, New York, North Carolina, and Wisconsin), and six states do not specify a specific guideline (Michigan, Missouri, Nebraska, New Jersey, South Carolina, and Virginia). Statutes may or may not specify which edition of the AMA Guides to use. Some states use their own guidelines for specific problems and use the Guides for other issues.

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Impairment Tutorial: Recurrent Radioculpathy: Recurrent Radioculpathy and Apportionment

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2002.julaug03 ◽

2002 ◽

Vol 7 (4) ◽

pp. 8-10

Author(s):

Christopher R. Brigham ◽

Leon H. Ensalada

Keyword(s):

Lumbar Spine ◽

Range Of Motion ◽

Disk Herniation ◽

Fourth Edition ◽

Recurrent Injury ◽

Injury Model ◽

Whole Person ◽

Spinal Region

Abstract Recurrent radiculopathy is evaluated by a different approach in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, compared to that in the Fourth Edition. The AMA Guides, Fifth Edition, specifies several occasions on which the range-of-motion (ROM), not the Diagnosis-related estimates (DRE) method, is used to rate spinal impairments. For example, the AMA Guides, Fifth Edition, clarifies that ROM is used only for radiculopathy caused by a recurrent injury, including when there is new (recurrent) disk herniation or a recurrent injury in the same spinal region. In the AMA Guides, Fourth Edition, radiculopathy was rated using the Injury Model, which is termed the DRE method in the Fifth Edition. Also, in the Fourth Edition, for the lumbar spine all radiculopathies resulted in the same impairment (10% whole person permanent impairment), based on that edition's philosophy that radiculopathy is not quantifiable and, once present, is permanent. A rating of recurrent radiculopathy suggests the presence of a previous impairment rating and may require apportionment, which is the process of allocating causation among two or more factors that caused or significantly contributed to an injury and resulting impairment. A case example shows the divergent results following evaluation using the Injury Model (Fourth Edition) and the ROM Method (Fifth Edition) and concludes that revisions to the latter for rating permanent impairments of the spine often will lead to different results compared to using the Fourth Edition.

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Rating Post-Operative Backs (Part I)

Guides Newsletter ◽

10.1001/amaguidesnewsletters.1997.julaug01 ◽

1997 ◽

Vol 2 (4) ◽

pp. 1-3

Author(s):

James B. Talmage

Keyword(s):

Spinal Stenosis ◽

Foot Drop ◽

Neurogenic Claudication ◽

Root Damage ◽

Fourth Edition ◽

Minor Strain ◽

Injury Model ◽

Strain Type ◽

A Minor ◽

Anterior Tibialis

Abstract The AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition, uses the Injury Model to rate impairment in people who have experienced back injuries. Injured individuals who have not required surgery can be rated using differentiators. Challenges arise when assessing patients whose injuries have been treated surgically before the patient is rated for impairment. This article discusses five of the most common situations: 1) What is the impairment rating for an individual who has had an injury resulting in sciatica and who has been treated surgically, either with chemonucleolysis or with discectomy? 2) What is the impairment rating for an individual who has a back strain and is operated on without reasonable indications? 3) What is the impairment rating of an individual with sciatica and a foot drop (major anterior tibialis weakness) from L5 root damage? 4) What is the rating for an individual who is injured, has true radiculopathy, undergoes a discectomy, and is rated as Category III but later has another injury and, ultimately, a second disc operation? 5) What is the impairment rating for an older individual who was asymptomatic until a minor strain-type injury but subsequently has neurogenic claudication with severe surgical spinal stenosis on MRI/myelography? [Continued in the September/October 1997 The Guides Newsletter]

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Fifth Edition: the New Standard

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2000.novdec01 ◽

2000 ◽

Vol 5 (6) ◽

pp. 1-7

Author(s):

Christopher R. Brigham ◽

James B. Talmage ◽

Leon H. Ensalada

Keyword(s):

Musculoskeletal System ◽

Medical Information ◽

Objective Assessment ◽

Scientific Data ◽

Practical Application ◽

Fourth Edition ◽

Appropriate Use ◽

Medical Evaluation ◽

Single Set

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, is available and includes numerous changes that will affect both evaluators who and systems that use the AMA Guides. The Fifth Edition is nearly twice the size of its predecessor (613 pages vs 339 pages) and contains three additional chapters (the musculoskeletal system now is split into three chapters and the cardiovascular system into two). Table 1 shows how chapters in the Fifth Edition were reorganized from the Fourth Edition. In addition, each of the chapters is presented in a consistent format, as shown in Table 2. This article and subsequent issues of The Guides Newsletter will examine these changes, and the present discussion focuses on major revisions, particularly those in the first two chapters. (See Table 3 for a summary of the revisions to the musculoskeletal and pain chapters.) Chapter 1, Philosophy, Purpose, and Appropriate Use of the AMA Guides, emphasizes objective assessment necessitating a medical evaluation. Most impairment percentages in the Fifth Edition are unchanged from the Fourth because the majority of ratings currently are accepted, there is limited scientific data to support changes, and ratings should not be changed arbitrarily. Chapter 2, Practical Application of the AMA Guides, describes how to use the AMA Guides for consistent and reliable acquisition, analysis, communication, and utilization of medical information through a single set of standards.

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