A 6 Week Balance And Gait Training Program Using The AlterG For A Patient With Cervical Myelopathy After Spinal Decompression Surgery: A Case Report
Spinal stenosis is the narrowing of the spinal canal which can cause radiculopathy or myelopathy symptoms due to compression of the spinal cord. About 80% of patients of 70 years old have some level of stenosis. There is limited research on prognosis for patients with cervical myelopathy and subsequent spinal decompression surgery. AlterG treadmill (AlterG Anti-Gravity Treadmill M320/F320, Fremont, CA) is an antigravity treadmill that is considered a body weight support system used in progressive gait retraining. The purpose of this case report is to assess the effectiveness of balance and gait training on the AlterG in a geriatric patient with sever cervical myelopathy who underwent spinal decompression surgery.
Gianna G. Pezzano and Amy J. Litterini
The purpose of this case study was to describe a palliative care physical therapy (PT) plan for maintenance of functional mobility and fall risk reduction for a patient with ALS. Ice Bucket Challenge began in 2014 to increase public awareness and funding for ALS. Need for further research was highlighted, in the campaign, for medical treatment and rehabilitation. Typical Presentation for Amyotrophic Lateral Sclerosis (ALS) is male, 60 years old, limb onset. This patient was female, 82 years old, with bulbar onset, limb weakness, and fall risk.
Inpatient Rehabilitation Of A 99-Year-Old Following A High-Impact Unstable Pelvic Ring Fracture: A Case Report
The purpose of this case report was to describe the outcomes of PT interventions for a nonagenarian patient following an unstable pelvic ring fracture and to provide an overview for a plan of care supported by research. Unstable pelvic ring fractures are defined by the displacement and deformity of the pelvic bones. Pelvic fractures are rare and only make up 3% of all skeletal injuries; however, the mortality rate of unstable pelvic fractures is extremely high, ranging from 20-50%. Most pelvic fractures are caused by motor vehicle accidents (MVA) in which patients suffer multiple traumas. When patients suffer multiple traumas including a pelvic fracture, their mortality rate increases by 10%, and their ability to return home after treatment decreases by 33%.
Relieving Low Back Pain And Improving Mobility For An Adult Patient With Progressive Multifocal Leukoencephalopathy: A Case Report
Derek Schwaiger and Matthew Somma
Progressive Multifocal Leukoencephalopathy (PML) is a progressive demyelinating disease caused by the John Cunningham Virus (JCV). There is no FDA approved JCV- specific treatment. This case report examines interventions administered to address low back pain (LBP) and functional mobility deficits.
Natalie Slattery and Kirsten Buchanan
93% of patients who have a total hip arthroplasty (THA) are due to end-stage osteoarthritis. 15-30% of patients who survive a stroke continue to live with a long-term disability. The most common abnormal gait pattern after surviving a stroke is due to hemiparesis. Patients who are deaf require greater visual and tactile cueing during gait training. Gait training has been shown to normalize gait patterns and increase functional mobility in patients after a total hip replacement (THR), THA revision and/or stroke. There is a lack of research investigating the optimal gait training plan of care (POC) for a patient with a THR, THA revision, stroke and deafness. The purpose of this case report was to investigate a comprehensive POC for a patient who is deaf and had a THR, a THA revision and a subacute stroke.
Lumbar radiculopathy is compression of a spinal nerve root, typically due to a herniated nucleus pulposus. It can present as low back pain (LBP) that radiates to one lower extremity (LE) and may be associated with diminished sensation, strength and reflexes on the affected side. The McKenzie approach is an evaluation and treatment technique that focuses on the movement of the nucleus pulposus within the intervertebral disc during trunk movement. This approach involves having a patient perform repeated motions, while monitoring their symptoms for centralization. Centralization refers to the concept that radiating symptoms into the lower extremities can move proximally toward the spine. The purpose of this case report was to evaluate the efficacy of the McKenzie method, along with manual therapy, strengthening and stretching exercises, modalities, patient education and a home exercise program (HEP) for a patient with lumbar radiculopathy. The setting of this episode of care was outpatient orthopedics.
Cameron Vallie and Matthew Somma
The number of Americans who practice yoga jumped to 16.5 million between 2004 and 2008 (87% increase), making it a top 10 modality in alternative medicine according to the National Institutes of Health. Medical Therapeutic Yoga is the practice of yoga in medicine, rehabilitation, and wellness settings by a licensed health care professional credentialed by the Professional Yoga Therapy Institute. Shoulder pain has been found to be the third most common site of musculoskeletal pain in the community. Adhesive capsulitis (AC) is a particularly disabling condition whose incidence is estimated to be between 2% and 5% of the general population and up to 38% in those with systemic diseases such as diabetes, Parkinson’s disease and thyroid disease. The purpose of this case report was to detail the use of yoga therapy in conjunction with joint mobilization and therapeutic exercise on a patient with AC.
Subacute Rehabilitation Following An Hypoxic Ischemic Brain Injury Resulting In Severe Ataxia: A Case Report
The purpose of this case report is to provide physical therapy interventions that were utilized in an inpatient rehabilitation hospital setting for a patient who experienced a hypoxic brain injury. Hypoxic/anoxic brain injuries result from global lack of oxygen to the brain from events such as drowning, choking, and cardiac or respiratory arrest. Certain areas of the brain have more devastating effects when deprived of oxygen as they have a higher metabolic activity and increased utilization of oxygen. One area in particular is the basal ganglia. Anoxic brain injuries involving infarcts of the basal ganglia (containing globus pallidus) can result in involuntary movement disorders such as: Myoclonic jerks, Ataxia, Akinetic-rigid movements, Difficulties in learning new motor skills. Ataxic gait is characterized by: Difficulties with inter- and intra-limb coordination, Decreased speed of ambulation, Irregular stepping pattern, Impaired postural stability, An increased risk of falls.
The purpose of this case study was to assess conservative management of a complete rupture of the long head of the biceps over a six-week period. The long head of the biceps (LHB) stabilizes the shoulder by reducing anteroposterior and superior inferior translation of the humeral head in the glenoid fossa. A tear of the LHB most commonly occurs when the biceps is suddenly loaded against flexion and supination of the elbow. Surgical repair of the LHB has seen 94% satisfaction rates, but with complications. Fifty-six percent of patients who initially chose conservative methods ultimately choose surgery. There is a currently a lack of evidence supporting conservative management of a complete rupture of the LHB.
Blood Flow Restriction Exercises Following An ACL Reconstruction In A 17-Year-Old Female Athlete: A Case Report
Andrew Anich and Kirsten Buchanan
Anterior cruciate ligament (ACL) reconstructions account for over 50% of all sports-related knee surgeries. Due to graft healing, rehab protocols do not allow for high resistance training for several months. Blood flow restriction (BFR) therapy with low load exercise has been suggested to improve quadriceps and hamstring strength and hypertrophy in adults. There is currently a lack of research on the effects of BFR therapy on hamstring strength and hypertrophy following an ACL reconstruction in high school athletes. The purpose of this case report was to assess how BFR therapy affects hamstring and quadriceps strength and hypertrophy in a 17-year-old athlete following ACL reconstruction.
Physical Therapy For Low Back Pain With A Focus On McKenzie Method For Diagnosis And Treatment: A Case Report
Low back pain (LBP) is thought to affect 80% of the population. It decreases work attendance, affects daily activity, and decreases quality of life. Physical Therapy (PT) is a noninvasive form of treatment that may include manual therapy, physical exercise, deep heat modalities, or a combination. The purpose of this case report was to review a multifaceted approach to LBP, including a focus on the McKenzie method and paired with conventional PT for a patient with a recurring episode of chronic LBP.
Gait and Functional Training for a Patient Post-Stroke with a History of Substance Abuse and Psychiatric Disorders: A Case Report
Morgan Costa and Amy J. Litterini
The opioid crisis is the largest drug epidemic in recorded history, resulting in over 500,000 deaths between the years of 2000 and 2015. The abuse of and addiction to opioids are serious global health problems that affect the social and economic well-being of all societies. Drug abusers have a 6.5 times increased risk of stroke. Strokes contribute to the disability and morbidity associated with drug abuse. Drug abuse is a frequent cause of stroke in areas with a high prevalence of comorbidity between drug abuse disorders and mental illness. The purpose of this case study was to outline physical therapy (PT) rehabilitation that utilized task-oriented and gait training in an inpatient rehabilitation facility (IRF) to address gait and functional mobility in a patient following a stroke combined with both substance abuse and psychiatric disorders.
High Intensity Intervals And Gait Training For A Patient With Heart Failure And Parkinson Disease In A Skilled Nursing Facility: A Case Report
The primary impairments of congestive heart failure (CHF) and Parkinson disease (PD) interact and present a unique challenge to rehabilitation. There is limited evidence on the PT management of both CHF and PD in the literature. The purpose of this case report is to present the PT management and outcomes of cardiovascular endurance training, gait training, therapeutic exercise, and balance activities for a patient with acute CHF and PD.
Erin Fusting and Kirsten Buchanan
The most common reason for lower extremity amputation (LEA) is from complications from Diabetes Mellitus (DM). Patients with DM are 10x more likely to have an amputation than someone without the disease. 50% of those with DM with an LEA will have an opposite foot or leg amputated in approximately 3 years or less. Transtibial amputations (TTAs), also known as below knee amputations, are the most common amputation. There is good evidence that physical therapy (PT) can help patients with one LEA to regain strength and functional independence, but there is limited information on the most effective PT plan of care for patients with two amputations. The purpose of this case report was to investigate a comprehensive physical therapy plan of care for a patient with bilateral transtibial amputations.
Outpatient Vestibular Rehabilitation For A Patient Three Months Post Acoustic Neuroma Resection: A Case Report
An acoustic neuroma is a benign and slow growing intracranial tumor that originates from cells of the vestibular nerve within the inner ear. Acoustic neuromas are estimated to occur in 10-20 individuals per 1,000,000 in the US. The tumor and subsequent surgery frequently lead to vestibular impairment. The vestibular system functions to coordinate head and eye movement through the vestibulo-ocular reflex (VOR), maintain postural stability, and provide input for spatial orientation. Common signs and symptoms of vestibular dysfunction include dizziness, headaches, oscillopsia, and disequilibrium. The purpose of this case report is to describe the outpatient PT management of a patient with chronic symptoms of UVH three months after surgical removal of an acoustic neuroma.
Comprehensive Physical Therapy Management Of A Patient With Motor Control Deficits And Idiopathic Toe-Walking: A Case Report
Chelsey Hoglund and Kirsten Buchanan
Idiopathic toe-walking (ITW) describes patients who walk bearing most weight through their forefoot, in the absence of any known cause. Developmental coordination disorder (DCD) is a chronic condition involving impairments in gross motor, postural, and/or fine motor performance and affects the performance of movements necessary for daily living and academic tasks. Physical therapy intervention has been shown to result in improvements for patients with ITW and DCD, however, there are no known studies that investigate physical therapy intervention for patients with a diagnosis of both ITW and DCD. The purpose of this case report was to describe the comprehensive physical therapy management of a patient with a clinical diagnosis of DCD and ITW.
Outpatient Physical Therapy Management Of A Total Knee Arthroplasty With Severe Contralateral Knee Osteoarthritis: A Case Report
Knee osteoarthritis (OA) is a common cause of severe pain, disability within the community, and dependence on others. In the U.S., a total knee arthroplasty (TKA) is one of the most commonly performed orthopedic procedures and 95% of them are attributed to OA. Following a TKA, pain and walking ability are the most important factors that need to be addressed. The purpose of this case report is to describe comprehensive PT management for a patient following a TKA with severe OA of the contralateral knee and report the outcomes.
Elizabeth Inscore and Kirsten Buchanan
The psychological effects of an injury have the potential to be more debilitating than the physical ailments themselves. Physical therapy (PT) rehabilitation programs that incorporate both physical and psychological interventions have demonstrated successful outcomes but have not been widely studied. The purpose of this case report was to investigate both the physical and psychological outcomes after a comprehensive PT rehabilitation program for a patient who sustained multiple foot and ankle injuries.
Balance & Fall Prevention Rehabilitation Program For A 77-Year-Old Patient Following A Trimalleolar Fracture: A Case Report
Kathryn Judd and Kirsten Buchanan
Balance and fall prevention are typical components of a rehab program in the elderly, however, there is limited research investigating the effects of the combination of balance and fall prevention in an elderly person with a trimalleolar fracture. The purpose of this case report was to describe a comprehensive physical therapy program combining balance training and fall prevention strategies for a 77-year-old patient after a trimalleolar fracture.
Esaam Kamareddine and Kirsten Buchanan
There is limited research on the most effective conservative PT plan of care (POC) for a young athlete with a superior labrum anterior and posterior (SLAP) tear. The purpose of this case report was to investigate a comprehensive conservative PT rehab program for a 13-year-old softball player with a SLAP lesion.
Adult Scoliosis And Chronic Low Back Pain With Land And Aquatic Based Physical Therapy: A Case Report
Scoliosis is defined as a spinal angulation of greater than 10 degrees in the frontal plane with spinal torsion. Incidence of idiopathic scoliosis is 2- 3%. Symptoms associated with scoliosis include pulmonary dysfunction and spinal pain. Cobb angle greater than 25° requires physical therapy to stop progression of curve. Cobb angle greater than 45° requires surgical intervention. The purpose of this case report was to evaluate the effects of an aquatic and land based exercise program on an adult who presented with severe, untreated scoliosis.
The Use Of Therapeutic Exercise And Manual Therapy For A Patient Following Simultaneous Bilateral Total Knee Arthroplasty: A Case Report
Osteoarthritis (OA) is the most common joint disorder in the United States (US) and is the most common cause for a total knee arthroplasty (TKA) surgery. Approximately 670,000 TKA surgeries are performed annually in the US and it is estimated that one third are bilateral TKAs (BTKA) due to bilateral OA. Simultaneously, BTKA procedures consist of replacing both knees consecutively, in one operation, under one anesthesia. The purpose of this case report is to describe PT management, specifically therapeutic exercise and manual therapy, utilized for a patient who underwent simultaneous BTKA. This case report is needed based on the high prevalence of bilateral knee OA and the need for BTKA procedures in the US.
The Comprehensive PT Management Of A Patient With Chronic Low Back Pain And Lumbar Radiculopathy: A Case Report
Lumbar radiculopathy is pain originating from nerve root compression in the lumbar spine. Patient presentation is chronic, recurring low back pain with associated radiating pain and potential sensory, strength, or reflex deficits in the involved lower extremity. The purpose of this case report was to describe a comprehensive approach for a patient with chronic low back pain and lumbar radiculopathy using the following interventions: therapeutic exercises using directional preference, IFC, and manual traction.
Chelsea Paul, Emily Gall, Kristina Jamo, and Shannon Bergeland
Maine Adaptive Sports & Recreation (MASR) is an adaptive sporting program that relies on volunteers to instruct participants of varying abilities. In order to effectively instruct, volunteers should firmly understand the health condition their participant has. Previously, MASR lacked a formal curriculum to educate their volunteers. The aim of this research project was to create online learning modules & determine whether a massed or distributed learning schedule resulted in better long term retention and confidence. MASR volunteers were placed into two non-randomized groups of eleven. Six video training modules were created to educate volunteers on the most common conditions encountered. Group A watched all of their modules at one time while Group B followed a distributed schedule. Competence was assessed prior, immediately after, and 2 weeks after completion of the learning modules. Confidence regarding the subject matter was also assessed after 2 weeks.
Task-Oriented Training To Restore Independence In A Patient With Encephalitis In The Intensive Care Unit: A Case Report
Bacterial meningitis is a serious disease that causes acute inflammation of the meninges, the lining of the brain and spinal cord, which can result in significant morbidity and mortality. There are 15,000 to 25,000 cases in the US yearly and it is one of the top 10 causes of infection-related deaths worldwide. Bacterial meningitis is commonly complicated by encephalitis, inflammation of the brain parenchyma. 30% to 50% of survivors of bacterial encephalitis sustain neurological sequelae, which include memory loss, behavioral disorders, speech disorders, difficulty concentrating. The purpose of this case report was to investigate the use of task-oriented training to restore independence in a patient with encephalitis in the intensive care unit.
Printing is not supported at the primary Gallery Thumbnail page. Please first navigate to a specific Image before printing.