RESUMEN

Patellofemoral pain syndrome (PFPS) is a major concern in the field of orthopedic medicine, affecting a substantial portion of the population and significantly impacting the quality of life. This condition, characterized by anterior knee pain increasing with various activities, shows higher susceptibility in certain demographic groups, such as women and adolescents. PFPS arises from a multifactorial etiology involving anatomical, biomechanical, psychological, and social factors, making it a complex condition to manage. Despite numerous therapeutic interventions available, including strengthening exercises, manual therapy, and patellar realignment techniques, the long-term efficacy of these interventions remains debated. This case report describes the case of a 21-year-old female recreational long-distance runner with bilateral knee pain diagnosed with PFPS. Through a comprehensive intervention plan targeting strength, function, flexibility, proprioception, and pain management, significant improvements were observed in pain levels and functional outcomes after physiotherapy intervention. This case underscores the importance of a holistic approach in managing PFPS and highlights the need for further research to optimize treatment strategies and improve patient outcomes.

RESUMEN

Background Lumbosacral radiculopathy (LSR) due to lumbar disc herniation (LDH) is a condition caused by mechanical compression of nerve roots. Various physical therapy interventions have been proposed for the conservative management of LSR due to LDH. However, the study of physical therapy interventions in a multimodal form is lacking. Additionally, the effect of physical therapy on diffusion tensor imaging (DTI) parameters of the compressed nerve root has not been studied. This study aimed to investigate the effects of multimodal physical therapy (MPT) on pain, disability, soleus H-reflex, and DTI parameters of the compressed nerve root in patients with chronic unilateral LSR due to LDH. Methods A prospective preliminary pre-post clinical trial with a convenience sample was conducted. A total of 14 patients with chronic unilateral LSR due to paracentral L4-L5 or L5-S1 LDH were recruited for the study. Participants received a total of 18 sessions of a six-week MPT program that consisted of electrophysical agents, manual therapy interventions, and core stability exercises. Electrophysical agents involved interferential current and hot pack. Manual therapy interventions included myofascial release, side posture positional distraction, passive spinal rotation mobilization, and high-velocity low-amplitude manipulation. Visual analog scale (VAS), Roland-Morris Disability Questionnaire (RMDQ), soleus H-reflex amplitude, side-to-side amplitude (H/H) ratio, fractional anisotropy (FA), and apparent diffusion coefficient (ADC) of the compressed nerve root were measured at baseline and post-intervention. Results There were significant improvements in VAS, RMDQ, H/H ratio, FA, and ADC of the compressed nerve root. Furthermore, significant improvement was found in the affected side compared with the contralateral side in H-reflex amplitude. Conclusions The observations of this preliminary trial suggest that MPT is a successful intervention in patients with chronic unilateral LSR due to LDH. Regarding DTI parameters of the compressed nerve root, FA increased and ADC decreased. Future studies with a control group, large sample sizes, and longer follow-up periods are needed.

RESUMEN

This case report presents the physiotherapy intervention of a one-year-old male child diagnosed with non-communicating hydrocephalus primary to developmental delay. Hydrocephalus is marked by an accumulation of cerebrospinal fluid and often leads to significant developmental delays and neurological impairments in affected infants. The physiotherapy intervention aimed to achieve head and trunk control, improve sensory awareness, and enhance overall body coordination and balance. Various techniques, including neurodevelopmental techniques, sensory stimulation, hippotherapy, and sensory integration therapy, were utilized to target specific developmental milestones and functional abilities. Outcome measures, including the Gross Motor Function Measure, Infant Neurological International Battery, Hammersmith Infant Neurological Examination, and New Ballard Score, were used to assess the patient's progress pre- and post-intervention. Significant improvements were observed across all outcome measures following four months of physiotherapy rehabilitation. The patient demonstrated substantial gains in gross motor function, neurological examination scores, and overall developmental milestones. These findings underscore the effectiveness of physiotherapy rehabilitation in addressing developmental delays associated with non-communicating hydrocephalus. This case underscores the significance of early physiotherapy intervention, which plays a vital role in enhancing outcomes and improving the quality of life for affected children.

RESUMEN

As a type of aseptic osteonecrosis, femoral head avascular necrosis (AVN) is characterized by abnormal blood flow that results in osteocyte death and femoral head degradation. Trauma, alcohol abuse, corticosteroid usage, and a few underlying medical disorders are common reasons. A 46-year-old farmer who had acute femoral head damage and left hip pain is described in this case study as having undergone total hip arthroplasty (THA). The systematic plan of the physiotherapy intervention included patient education, joint restoration, pain management, prevention of complications, strengthening, proprioception, endurance, and task-oriented motor relearning activities. Over the course of four weeks, the patient demonstrated improvements in functional outcomes and pain levels, highlighting the significance of a thorough physiotherapy approach in the management of AVN following THA. For the best possible patient results, this case study emphasizes the importance of early detection, diagnosis, and a well-coordinated rehabilitation program.

RESUMEN

This case report describes the rehabilitation of a 54-year-old female patient with a left knee dislocation and multiligament injury after surgery. The patient experienced persistent pain and difficulty with weight-bearing, leading to the need for surgical repair. The rehabilitation protocol included three phases: pain management, range-of-motion (ROM) restoration, muscle strength improvement, proprioception, and equilibrium promotion. Modalities like cryotherapy, compression, manual therapy, and a tailored exercise regimen were used. The patient's outcomes showed significant improvements post-rehabilitation, emphasizing the importance of structured physiotherapy interventions in recovery and functional restoration. The aim of the case report is to highlight the efficacy of a structured physiotherapy intervention protocol in facilitating recovery and functional restoration for patients with knee dislocation and multiligament injury post-surgery. Further research and evidence-based rehabilitation strategies are needed to improve outcomes in similar cases.

RESUMEN

PURPOSE: Long Covid syndrome is a multiorgan condition with multiple sequelae affecting quality of life, capacity to work and daily activities. The advantages that new technologies can offer are presented as an opportunity in the current healthcare framework. OBJECTIVE: This research aimed to explore people with Long Covid's experiences with a digital physiotherapy practice intervention, during four weeks. METHODS: Qualitative semistructured interviews were conducted by video call. Thirty-two Long Covid participants were invited to join an in-depth interview once the intervention was completed. Participants were queried on their intervention experiences and perceptions, as well as any lifestyle changes made, as a result of receiving digital physiotherapy practice. The interviews were transcribed and analysed using inductive qualitative content analysis. RESULTS: In-depth qualitative analysis has revealed four themes that reflect participants' perceptions of digital physiotherapy intervention. The helpfulness of the exercises, interaction with the physiotherapist, the domestic use of technology and the future of digital health practice were the topics highlighted by Long Covid participants. Some improvements have been suggested including video sounds and the need to introduce face-to-face sessions. Participants stated that interventions were helpful and superior to printed exercise sheets, mobile phone apps and usual care received. This intervention did not present major barriers, highlighting the importance of personalized care and continuity in the provision of health services. CONCLUSION: The digital physiotherapy practice is perceived by people with Long Covid as an appropriate method for the care of their health needs. Participants stated the need for this type of intervention in the public health system, where it would eliminate waiting lists, facilitate accessibility and improve existing care. PATIENT AND PUBLIC CONTRIBUTION: Participants contributed to the interpretation of the data acquired in the interview. CLINICAL TRIAL REGISTRATION: Trial registration NCT04742946.

Asunto(s)

RESUMEN

Pneumonia is an infection that causes inflammation in the air sacs of the lungs. Coronary artery disease is a condition characterized by the buildup of plaque in the coronary arteries, which supply blood to the heart. This obstruction restricts blood flow, resulting in chest pain (angina) and, in extreme cases, heart attacks. An important part of successfully treating diseases like peripheral artery disease and coronary artery disease is balloon angioplasty, a commonly used medical procedure for treating narrowed or clogged arteries. An 83-year-old man who had pneumonia after angioplasty was the subject of this case study. The patient had pneumonia after angioplasty, which was managed by proper medications and cardio-respiratory physiotherapy. The patient was intubated and referred for cardio-respiratory physiotherapy. Physiotherapy treatments like mild chest vibrations, suctioning, and bed mobility exercises were given initially. After extubation, physiotherapy treatment continued with deep breathing exercises, coughing techniques, relaxation techniques, and mobility exercises for the upper limbs and lower limbs. Effective physical rehabilitation was necessary in order to minimize complications following angioplasty and allow him to resume his daily activities. Several outcome measures, like the ICU mobility scale, CURB-65 score, and chest X-ray grading scores, were used to monitor the patient's progress during rehabilitation. The benefits of pulmonary rehabilitation programs emphasize the need for tailored approaches in addressing individual patient needs for comprehensive recovery.

RESUMEN

BACKGROUND: Exercise induced laryngeal obstruction (EILO) causes inspiratory distress in the upper airway in many adolescent athletes. The nature of EILO is not fully understood, and effective management strategies are lacking. This study aimed to assess the effectiveness of a multidimensional individually tailored intervention, including Norwegian Psychomotor Physiotherapy (NPMP), elements of cognitive behavioural therapy and a rehabilitation plan, in reducing inspiratory distress and dysfunctional breathing in adolescent athletes with EILO. METHODS: A mixed methods design, which combined qualitative and quantitative research, was used. Data, including subjective experiences of respiratory distress, findings from body examinations and objective measurements of lung function and aerobic capacity were gathered before and after a five month intervention involving 18 participants. RESULTS: Following the intervention, the participants showed a reduction in respiratory distress and anxiousness associated with their breathing difficulties. Furthermore, the participants reported to be more in control of their breathing. The body assessments revealed a more functional breathing motion and improved posture, which imply that the breathing was less thoracic and more diaphragmatic in rest and exercise in all participants after the intervention. CONCLUSIONS: Our results suggest that a multidimensional individually tailored intervention, including NPMP based physiotherapy, cognitive behavioural therapy elements, and a rehabilitation plan may reduce inspiratory distress and dysfunctional breathing in athletes with EILO. TRIAL REGISTRATION: ClinicalTrials.gov Protocol Registration and Results system NCT06033755, date of registration: September12, 2023. Retrospectively registered.

RESUMEN

Necrotizing fasciitis is defined as a highly progressive microbial infection. The diagnosis of necrotizing fasciitis is mostly based on clinical signs, and early diagnosis is key. There are several difficulties that patients confront following surgery. Physical therapy helps to regain the functional range of motion, enhance muscle strength, reduce stiffness and make the patient self-independent. We presented a case of a 54-year-old male with presenting complaints of pain over right lower limb while doing movements and difficulty in performing daily activities. The patient was diagnosed with necrotizing fasciitis of the right leg which was managed surgically by a skin-split graft but later the patient developed post-operative stiffness and pain for which physiotherapy was advised. A goal-oriented tailored rehabilitation approach was planned for the patient for four weeks. The patient and his family were informed about their present condition. Positioning was given to reduce edema. Wound healing was enhanced by the use of ultrasound and low-level laser therapy. In order to mobilize scar myofascial release technique and massage were applied. To increase functional range and strength, a mobility and strengthening exercise was performed. To make the patient functionally independent balance and gait exercise was given. The outcome measures included a numerical pain rating scale (NPRS), range of motion, manual must testing, and lower extremity functional scale. There was an improvement in all the outcome measures taken. The treatment protocol proved to be beneficial for the patient.

RESUMEN

Chronic pain is a very common problem in patients with spinal cord injury (SCI) as it affects 80% of these patients, which negatively affects their quality of life. Despite many advantages that exist in the management of any type of pain (neuropathic, nociceptive, mixed) in these patients, there is no cure, and the analgesic effect of some treatments is inadequate. This study aims to conduct an evidence-based systematic review regarding the various interventions used for the management of pain after SCI. The PubMed, Physiotherapy Evidence Database (PEDro), and Cochrane Library databases were searched from 1969 to 2023. The risk of bias was assessed using the PEDro scoring system. A total of 57 studies met the inclusion criteria and were included in this systematic review. Among the different interventions at present, 18 studies examined the role of oral medications, 11 studies examined the role of minimally invasive methods (injection and infusion), 16 studies investigated physiotherapy and alternative treatments, and 12 studies examined the role of repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), and cranial electrotherapy stimulation (CES) in the management of pain in patients after SCI. Gabapentin and pregabalin are very effective in managing chronic neuropathic pain after SCI, and pregabalin also seems to reduce anxiety and sleep disturbances in the patients. It is noteworthy that lamotrigine, valproate, and carbamazepine do not have an analgesic effect, but mirogabalin is a novel and promising drug. Antidepressants (selective serotonin reuptake inhibitors and serotonin and noradrenaline reuptake inhibitors) did not reduce the pain of the patients, although some studies showed an efficacy of amitriptyline especially in depressed patients and tramadol should be considered short-term with caution. Also, tDCS and rTMS reduced pain. Moreover, botulinum toxin type A, lidocaine, ketamine, and intrathecal baclofen significantly reduced pain intensity, although the sample of the studies was small. Physiotherapy and alternative treatments seem to relieve pain, and transcutaneous electrical nerve stimulation had the greatest reduction of pain intensity. In conclusion, several pharmaceutical and non-pharmaceutical methods exist, which can reduce pain in patients after SCI. The type of intervention can be considered by the physician depending on the patients' preference, age, medical history, type of pain, and associated symptoms. However, more studies with greater samples and with better methodological quality should be conducted.

RESUMEN

PURPOSE: To evaluate the feasibility of an active behavioural physiotherapy intervention (ABPI) and procedures to prevent the transition to chronicity in patients with acute non-specific neck pain (ANSNP). MATERIALS AND METHODS: A cluster-randomised double-blind (assessors and participants), parallel 2-arm (ABPI versus standard physiotherapy intervention [SPI]) pilot and feasibility clinical trial was conducted owing to a pre-specified published protocol. Six public hospitals were recruited and cluster-randomised (computer-generated randomisation with block sampling). Sixty participants (30 in each arm, 10 per hospital) were assessed at baseline and 3 months following baseline for neck disability index, numerical pain rating scale, cervical range-of-motion, fear-avoidance beliefs questionnaire and EuroQol 5-dimension 5-level. RESULTS: All procedures worked well. The participants' median age was 36.5 (range 21-59, interquartile range: 20.75) years. Participants in the ABPI demonstrated better improvement in all outcomes compared to SPI. Furthermore, the number of fully recovered participants following ABPI (27/30, 90.00%) was higher than SPI (16/30, 53.33%) with fewer treatment sessions and lower costs of management. CONCLUSIONS: The findings suggest that the ABPI is feasible and valuable (e.g. a high number of fully recovered participants, fewer treatment sessions and reduced management costs compared to the SPI) in conducting a future definitive trial to evaluate the effectiveness of the ANSNP management. TRIAL REGISTRATION: TCTR20180607001Implications for RehabilitationAn active behavioural physiotherapy intervention (ABPI) is feasible to manage acute non-specific neck pain.The ABPI demonstrated a high number of fully recovered participants, fewer treatment sessions and reduced management costs compared to the standard physiotherapy intervention.The ABPI is valuable to conduct a future definitive trial to evaluate the effectiveness of acute non-specific neck pain management.

RESUMEN

Background and objective Upper trapezius can cause neck pain, and restrict functional activities and cervical range of motion (ROM), and hence its management should be part of a global rehabilitation program. Owing to the heterogeneity of the existing trials, various techniques of manual physical therapy might be potent, though the scope of their efficacy is currently unspecified. The reciprocal inhibition technique of the muscle energy technique (MET) works on both agonist as well antagonist muscles for the reduction of pain and to improve overall functional activities. The aim of this study was to analyze the effect of the reciprocal inhibition technique of MET on pain, cervical ROM, and functional activities in patients with upper trapezitis. Methods An interventional cross-sectional study involving 30 patients with neck pain due to upper trapezitis was conducted. The outcome measures were as follows: numerical pain rating scale (NPRS) score for pain intensity, universal goniometer for cervical ROM, and neck disability index (NDI) score for functional activities. The reciprocal inhibition technique involved a five-second hold, five-second rest, followed by stretching with a 10-60-second hold, with five repetitions. Patients were treated for five sessions a week for two weeks. Results Paired t-test was used to compare the group's mean values before and after therapy. Our findings revealed that NPRS score, cervical ROM, and NDI score notably improved (p=0.001). Conclusion The reciprocal inhibition technique of MET in patients with upper trapezitis showed significant improvement in neck pain, cervical movement, and functional activities. Further studies with larger sample sizes are warranted to validate our findings.

RESUMEN

The granulomatous disease tuberculosis (TB) is brought on by the bacteria Mycobacterium tuberculosis. Skeletal TB is involved in 10-35% of extra-pulmonary reported cases worldwide, with the most common kind being tuberculous spondylitis (Pott's disease). Depending upon the extent of spinal engagement, the clinical presentation may include back pain, discomfort, neurological abnormalities, as well as other clinical signs like temperature, malaise, and loss of weight. The multidisciplinary therapeutic care of Pott's illness is centered on a particular medicinal therapy, on-demand surgery, and a customized rehabilitation regimen. A 20-year-old female was diagnosed with Pott's disease following investigations in Acharya Vinoba Bhave Rural Hospital (AVBRH), Sawangi (Meghe), Wardha, India. A tailored physiotherapy (PT) program was started and continued for six weeks, after which improvement in the mobility of the spine, pain relief, increased respiratory function, improved sensory function, and overall improvement in functional independence was markedly seen in the patient. The protocol included mobility, strengthening of lower limbs and core musculature, breathing, and postural correction exercises. Sensory re-education was done. Thus rehabilitation showed a great improvement in the patient and helped ease the patient's discomfort.

RESUMEN

The earliest stages of osteosarcomas are primitive mesenchymal cells. It generally occurs close to the long bones' metaphysis and typically affects the long bones, such as the arm and leg. This case report underscores the pivotal role of physiotherapy in the rehabilitation of a 14-year-old male diagnosed with osteosarcoma, who underwent above-knee amputation. The structured six-week rehabilitation program, encompassing passive, active-assisted, and active exercises for the affected limb, alongside strength training for unaffected joints, produced notable gains in the pain rating scale and the lower-extremity functional scale in just 15 days. These outcomes underscore the significance of early and targeted physiotherapy interventions in optimizing functional outcomes and quality of life for young patients with osteosarcoma after surgery.

RESUMEN

This case report reports the effects of an 18-week physiotherapy program in children with mitochondrial membrane protein-associated neurodegeneration (MPAN). The study involved two brothers, aged 11 and 12, who had been diagnosed with MPAN. The physiotherapy program was divided into three phases and consisted of 18 weeks of training with a pediatric physiotherapist, including balance, coordination, and strengthening exercises. Muscle strength was assessed using pediatric manual muscle testing, functional balance using the Pediatric Berg Balance Test (PBBT), static balance using the Single-Leg Stance Test, dynamic balance using the Functional Reach Test, postural control using the 5-Time Sit-to-Stand Test, and independence using the Functional Independence Measure for Children (WeeFIM). Positive changes were observed in muscle strength, balance, and independence. After Phase I, PBBT scores (younger sibling +4, 8.1%; older +3, 6.8%) were higher than the minimal clinically important difference (MCID=3.66-5.83). After Phase III, although the PBBT scores improved (younger +2, 4.05%; older +1, 2.3%), the older sibling's score was not higher than the MCID. Thus, the two children showed visible improvements in both body structure and function, as well as activity and participation levels.

RESUMEN

A diaphysis fracture that occurs between 5 cm distal to the lesser trochanter and 5 cm proximal to the adductor tubercle is recognized as a femoral shaft fracture and is prevalent in runners and military personnel. A patient's ability to carry out activities of daily living effectively and efficiently post-surgery is hampered by a variety of obstacles. We present a case of a 21-year-old male who came to the hospital with a complaint of pain and swelling in his right leg. The patient was diagnosed with a proximal femur fracture. Physiotherapy procedures commenced with the purpose of alleviating pain and establishing a normal range of motion. As a result of the physiotherapy regimens, the patient was aided in his recovery.

RESUMEN

Pleural effusion is the accumulation of extra fluid between the layers of the pleura outside the lungs, also known as water on the lungs. Pleura are thin membranes that lubricate and aid breathing by lining the lungs and the inside of the chest cavity. The pleural space typically contains only a few teaspoons of watery fluid, which enables the lungs to move easily inside the chest cavity when breathing. Several barriers limited the patient's capacity to carry out daily activities successfully and efficiently. Loculated effusions are most frequently associated with diseases such as empyema, hemothorax, or tuberculosis that result in severe pleural inflammation. Hence, a physiotherapy program is started to help improve the patient's symptoms. A 59-year-old male presented to the hospital with the chief complaint of left-sided chest pain, fever, and breathlessness. On the Modified Medical Research Council dyspnea scale, breathlessness was grade 3.

RESUMEN

Gamification is a novel interventional approach to functional recovery and rehabilitation. We present a novel gamification rehabilitation case of a 38-year-old female referred to the physiotherapy department for post-distal radial fracture rehabilitation. She was managed with closed reduction and internal fixation (CRIF) using two Kirschner wires (K-wires) after falling on an outstretched hand in a road traffic accident with a two-wheeler. Gamification intervention was provided to the patient for four weeks. We used pre- and post-intervention outcome measures for pain, range of motion, grip strength, and hand function. There was a substantial improvement in all outcome measures after four weeks of gamification intervention.

RESUMEN

It has been suggested that regular physical activity has become a part of rehabilitation in controlling blood glucose levels in type 2 diabetes mellitus patients. In type 2 diabetes mellitus the cells become resistant to insulin, which leads to elevated blood glucose over time and leads to prediabetes and type 2 diabetes mellitus (T2DM). The typical adult's blood contains about 5-10 grams of glucose when their blood glucose content is 100 milligrams per decilitre. About half a billion individuals are at risk for diabetes worldwide. Physical exercise has been proved to be better therapy for controlling blood glucose in persons at risk for diabetes, preventing further body complications. Three significant interests in exercising to delay the onset of T2DM. First, increased blood flow into the muscle is triggered by skeletal muscle activity, which promotes glucose absorption from the bloodstream. Second, it reduces abdominal adipose tissue, a well-known risk of metabolic disease. Third, physical exercise with moderate intensity has been proven to boost glucose uptake by 40 percent. Globally and in developing nations like India, the burden of diabetes is expanding, attributable to a rise in overweight/obesity and sedentary lifestyles. It is difficult to provide healthcare for diseases like diabetes since it requires a consistent commitment to the prescribed course of treatment. Based on the correlation between fasting plasma glucose (FPG) or hemoglobin A1c (HbA1c) and retinopathy, cut-off values for glucose and HbA1c are estimated.

RESUMEN

In the elderly population, the proximal femoral fracture is a major health concern. Surgical treatment of this fracture, combined with postoperative physical therapy, is used to reduce morbidity. The primary goal of this study was to investigate tibial and femoral neck fractures. It was managed by physiotherapy post-operatively and had the patient perform activities of daily living with no resistance. In this case, a 45-year-old male patient was traveling when he was involved in a traffic accident, causing injury to his left lower limb. He was operated on with open reduction and internal fixation with a tibia interlocked nail for a segmental tibia fracture on the left side, as well as cannulated screw fixation for a femoral neck fracture. Physiotherapy management was done, focusing on his occupational needs and rehabilitation for the betterment of activities of daily living.