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Stem Cell Therapy as an Alternative to Reconstruction of Complete ACL Tears and Associated Physical Therapy Considerations – A Case Report
Get PDFIntroduction: Injury to the anterior cruciate ligament (ACL) is one of the most common injuries in orthopedics and sports medicine. With nearly 200,000 injuries per year in the United States, 100,000 opt for reconstructive surgery. There are a variety of known graft choices including hamstring, patellar tendon, quadriceps tendon, IT band, and allogenous grafts. However, these options do not come without future complications. Regenerative medicine using stem cell therapies is becoming increasingly popular. Thus, the purpose of this case report is to highlight the use of stem cell therapies as an alternative treatment to traditional ACL reconstruction, and to provide insight to its associated physical therapy progression. Case description: The rehabilitation of a 26-year-old female with a grade III ACL tear that was less than one cm retracted with goals of returning to an active lifestyle is described. Outcomes: MR imaging was assessed at three months which indicated healing of the ACL. Lower Extremity Functional Scale (LEFS) scores increased from 23/80 to 68/80 over the course of 7 months. Other potentially useful outcomes measures are discussed. Discussion: Based on the current literature, regenerative medicine using stem cell therapies seems to be a promising alternative to surgical treatment of the ACL. Slight differences exist between rehab of the ACL treated with stem cell therapy vs traditional reconstruction. Although subjective reports of knee pain and function improve over time, more objective measurements to quantify ACL healing are needed. Future research aimed at determining long term effects of stem cell therapies is warranted
Outpatient Neurological and Orthopedic Physical Therapy Management for an Individual Diagnosed with a Cervical Central Spinal Cord Lesion: A Case Report
Get PDFBackground: Geriatric patients commonly present to rehabilitation having multiple co-morbidities. One example occurred in an outpatient clinic where the patient presented with a central cord lesion and knee range of motion deficits. Central cord injuries commonly lead to motor impairment, with the upper extremities being affected more than the lower extremities. The rehabilitation for addressing these two conditions often do not have much overlap. However, for patients with unrelated co-morbidities, therapists need to rely on multiple strategies to optimize patient care. Purpose: The purpose of this case report is to illustrate the outpatient plan of care, including both neurological and orthopedic strategies, for an individual with a cervical central cord lesion and bilateral reduced knee range of motion. Case Description: The patient was a 61-year old male who sustained a cervical central spinal cord lesion at the C1-C4 level. He had a history of bilateral total knee arthroplasties over 10 years ago, with notable knee range of motion and functional limitations. He achieved 40 degrees of knee flexion on the left and 85 degrees of knee flexion on his right at initial evaluation. Intervention: Neurological interventions of task specific repetitive practice along with orthopedic interventions of joint mobilizations and exercise were administered with the patient. Outcomes: Outcomes used included: 10 Meter Walk Test, 5x Sit to Stand, Lower Extremity Functional Scale, and goniometry. Discussion: The patient improved in all outcome measures and reported improvement in home and community function. This is one case outlining a patient with both neurological and orthopedic impairments, thus further research into patients with multiple co-morbidities is warranted to improve clinicians’ evidence-based approach and provide optimal patient care
A Discussion of the Limitations of Standardized Testing in a Pediatric Patient with Neuronal Migration Disorder: A Case Report
Get PDFBackground: Standardized, norm-referenced tests, such as The Bruininks-Oseretsky Test of Motor Proficiency, 2nd edition (BOT-2) and the Pediatric Balance Scale (PBS) are commonly used examination measures to assess progress of gross motor skills in pediatric patients. However, there is limited evidence to support the use of these measures in patients with chronic neurological conditions. Case Description: The patient is an 8-year-old girl. She has a medical diagnosis of Unilateral (left) Perisylvian Syndrome, a variant of neuronal migration disorder. The malformation of the left hemisphere has contributed to the following impairments: cognitive, motor, sensory and the gastrointestinal system, as well as occurrences of petit mal and atonic drop seizures. The patient has demonstrated minimal progressions, as well as regressions, of certain gross motor skills based on standardized testing. Outcome Measures: The main outcome measures utilized to determine patient progress were the BOT-2 and the PBS. A parent reported outcome measure, the Pediatrics Quality of Life Inventory Short Form (PedsQL 4.0 SF15) and parent interviews were also used to determine quality of life and participation levels of the patient. Discussion & Outcome Considerations: The purpose of this case report is to consider the discrepancies of standardized testing of pediatric patients with neurological disorders when compared to observed goal attainment in physical therapy, as well as parent reported participation and quality of life measures
Penitentiaries, Punishment, and Military Prisons: Familiar Responses to an Extraordinary Crisis during the American Civil War, and Crossing the Deadlines: Civil War Prisons Reconsidered
Get PDFReview of: Penitentiaries, Punishment, and Military Prisons: Familiar Responses to an Extraordinary Crisis during the American Civil War, by Angela Zombek and Crossing the Deadlines: Civil War Prisons Reconsidered, edited by Michael P. Gray
Wild Mares: My Lesbian Back-to-the-Land Life
Get PDFReview of: Wild Mares: My Lesbian Back-to-the-Land Life, by Dianna Hunter
Sweat
No full textThis photo features Evan, Jason’s Parole officer with an added mustache to enhance an older look.https://ir.uiowa.edu/makeup_design/1016/thumbnail.jp
Orlando
No full textThe Chorus is adding a ruff collar, cuffs, and shoe rosettes to Orlando’s 16th Century look before meeting the Queen. I designed the look so the additions would make Orlando more formal to meet the Queen.https://ir.uiowa.edu/costume_design/1282/thumbnail.jp
The Wolves
No full textThis photo showcases #14’s mom who comes to speak to the team after her daughter\u27s death, #7 coming to watch the team still on crotches, and #25 cut her hair.https://ir.uiowa.edu/costume_design/1263/thumbnail.jp