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Integrating Art into Instruction
Get PDFAlthough integrating art into instruction is commonly overlooked in elementary education, it is proven to improve student achievement. Pre-service elementary teachers should learn in college how to effectively teach students with arts integration. This literature review will discuss strategies to integrating art into instruction and the benefits to doing so. This study will confirm that arts integration is not frequently taught in education, but teachers are still expected to do so in their own classrooms even though they are not familiar with the strategies. Arts integration is key to student achievement and should be taught and used in the college of education curriculum
Vestibular Rehabilitation in a Pediatric Patient with Sensory Dysfunction of the Vestibular System: A Case Report
Get PDFBackground: Descriptions of children with sensory dysfunction of the vestibular system are sparsely cited in the literature. Notable improvements in vestibular dysfunction have been seen in adults with physical therapy interventions. Case Description: The patient was a 2-year-old child with notable vestibular dysfunction, a history of recurrent ear infections and child neglect. Examination procedures were limited by lack of vestibular outcomes specifically in this young population. Interventions consisted of balance activities, improving tolerance to multidirectional perturbations and gross motor skills. Outcomes: Vestibular outcome measures were unable to be used due to the child’s speech delay. Objective observations and tolerance to activities were used to determine improvements. Discussion: The purpose of this case study was to highlight the use of physical therapy interventions and the successful progress after 20 sessions in a pediatric patient with sensory dysfunction of the vestibular system. Conclusion: There are limited metrics of vestibular outcomes, particularly in this young population due to limited speech, thus assessments are limited to indirect measures of vestibular function (i.e. symptoms). Exercise interventions that focus on the enhancement of sensory integrative postural control abilities in children could be effective for the arrest of the progressive motor development delay with vestibular impairment
Combined Use of Vestibular and Aerobic Exercise to Treat a Patient with Post-Concussion Syndrome Following a Mild Traumatic Brain injury: A Case Report
Get PDFBackground: Prolonged Concussive symptoms following an acute injury, known as Post-Concussion Syndrome (PCS) are beginning to be discussed in literature. There has been recent evidence produced on the benefits of aerobic exercise and vestibular rehabilitation to assess and manage this unique patient population. Purpose: The purpose of this case study is to describe a protracted recovery of a patient experiencing PCS and provide specific assessment tools as well as interventions to help guide rehabilitation strategies following a concussion. Case Description: A 33-year-old female arrived at physical therapy 3-weeks after experiencing a mild traumatic brain injury (mTBI), following a motor vehicle accident (MVA). She was experiencing constant headaches, dizziness, nausea, right-sided neck pain, difficulty sleeping, decreased concentration, fatigue, increased irritability and frustration, and decreased function in daily responsibilities. Interventions: The patient received 22 sessions of physical therapy over a 12-week period, while also receiving psychological services. The interventions included functional strengthening, manual therapy, sub-symptom aerobic exercise, vestibular and oculomotor training, balance interventions, and work simulated tasks. Outcomes: The patient was evaluated using the Vestibular/ Ocular Motor Screening (VOMS) assessment tool. The patient improved from symptomatic with all items of the VOMS to mild headache symptoms with 3 items of the assessment. In addition, on initial evaluation the patient reported 7 on a 0-10 cm on a visual analog scale (VAS) for neck pain, which was reduced to 0/10. The patient returned to previous level of employment following physical therapy rehabilitation demonstrating improvement in overall function. Discussion: Through the physical therapy plan of care the patient demonstrated improvements with reduced frequency and severity of headaches with accompanying dizziness, increased tolerance to activity, and decreased neck pain, and improved concentration. This case study provides an example of a positive outcome following outpatient physical therapy for a patient with prolonged PCS, with full return to work and pre-injury activity
Physical Therapy Management of Bilateral Knee Contractures Using Serial Casting in a Medically-Complex Rehabilitation Patient: A Case Report
Get PDFBackground: Serial casting is a technique that is used to improve muscle length and increase range of motion in joints that are limited by contractures. While it is typically utilized in pediatric populations including but not limited to cerebral palsy, club foot, and idiopathic toe walking, serial casting can also be used to treat adults with brain injury, spinal cord injury, and stroke. The purpose of this case report is to highlight the use of serial casting as part of a comprehensive rehabilitation process to treat a medically-complex adult. Case Description: Patient A was a 50-year old male who was admitted to inpatient rehabilitation following a series of multifaceted medical events. His diagnoses included both neurological and orthopedic components, including a brain injury, spinal cord involvement, and a total hip arthroplasty. Intervention: Patient A was seen by a physical therapist for 30-60 minutes, five days per week for six-and-a-half months. During this extensive rehabilitation period, the patient was treated with a variety of interventions, including serial casting. The primary goal of serial casting was to increase his bilateral knee range of motion (ROM) to improve his ability to perform functional activities, including walking and negotiating stairs. Outcome Measures: The outcome measures used to monitor progress included measuring range of motion, the 6 Minute Walk Test (6MWT), the Timed Up and Go (TUG), and the Modified Ashworth Scale. Discussion: The serial casting intervention was performed unilaterally with the goal of increasing the patient’s ability to participate in therapy and functional activities. We found that the patient improved knee extension ROM bilaterally even though only one leg was casted using this technique, suggesting that stretching and positioning alone also likely significantly influence ROM
Physical Therapy Management of Newly Diagnosed Neuromyelitis Optica: A Case Report
Get PDFBackground: Neuromyelitis opticans (NMO) is an immune-mediated inflammatory disorder of the central nervous system, characterized by neuron demyelination that primarily targets the spinal cord and optic nerves. Diagnostic features of NMO include presence of a serum NMO-immunoglobulin G (IgG) antibody that binds to aquaporin-4 (AQP-4) and acute flare-ups of bilateral optic neuritis and myelitis. Purpose: Due to limited research about NMO, the purpose of this case report is to describe the clinical decision-making process used to create an inpatient rehabilitation treatment plan for a patient with newly diagnosed neuromyelitis optica. Case Description: A 45-year-old African American female presented to the emergency department with progressive weakness of her bilateral lower extremities, which had advanced to a point where she was no longer able to walk or move her legs during her initial hospital stay. Following her diagnosis of NMO, she was transferred to an inpatient rehabilitation department, where she spent the next four weeks working with physical and occupational therapy. Discussion: NMO remains a very rare, poorly understood diagnosis with very little evidence to support effective physical therapy interventions. The available research was accessed and utilized in an effective manner, allowing the patient to achieve significant functional gains prior to returning home
Clinical Decision Making Associated with Persistent Lateral Elbow Pain: A Case Study
Get PDFBackground: Lateral elbow pain is a common musculoskeletal condition of the upper extremity. It can lead to marked dysfunction and decreased productivity at work. Persistent lateral elbow pain is often challenging to treat due to numerous treatment options with limited evidence to prove which is more efficacious. Purpose: The purpose of this case study is to outline the clinical decision making associated with treating persistent lateral elbow pain in a patient that displayed variable responses to care. Case Description: This case study examines a 33-year-old male with lateral elbow pain who was initially diagnosed with lateral epicondylalgia. His pain lasted over ten physical therapy visits despite conventional treatment interventions including manual therapy, trigger point dry needling, and various forms of therapeutic exercises including concentrics, eccentrics, and isometrics. Outcome Measures: The Quick Disabilities of Arm, Shoulder, and Hand (QuickDASH) was used to assess this patient’s outcome. Discussion: Various treatments were performed with the patient discussed in this study due to changing symptoms and lasting pain. This case study presents the clinical reasoning behind treatment decisions based on patient response. While often therapeutic interventions have gradually positive outcomes, it is important to recognize and evaluate cases which show less clear immediate improvement
Physical Therapy Management of a Patient with Guillain-Barré Syndrome During Inpatient Rehabilitation Stay: A Case Report
No full textBackground: Guillain-Barré syndrome is a rare condition characterized by demyelination of the peripheral nervous system resulting from an erroneous attack by the immune system. Symptoms and complications develop rapidly and often result in significant functional impairments, which may persist beyond the acute phase of the condition. There is a currently a lack of evidence supporting the most effective early treatment interventions to facilitate a timelier return to function and decrease in long-term effects. Purpose: The purpose of this case report is to outline treatment interventions implemented within the inpatient rehabilitation setting to influence functional independence of a patient diagnosed with Guillain-Barré syndrome. Case Description: A 49-year-old male was admitted to an inpatient rehabilitation facility two weeks after being diagnosed with Guillain-Barré syndrome. He presented with decreased functional status, fatigue, lower extremity weakness, impaired fine motor skills, and difficulty walking. The patient’s physical therapy goals were to increase strength, improve balance, and normalize walking so he could return to work. Interventions: Physical therapy interventions were focused on addressing functional mobility, cardiovascular endurance, gait training, balance, lower extremity strengthening, and patient/family education. Outcome Measures: The Functional Independence Measure was utilized to assess the patient’s level of assistance required to perform activities of daily living. Manual muscle testing was performed to measure the patient’s lower extremity strength improvement during physical therapy. Discussion: This case provides one example of notable improvements in strength, endurance, and functional abilities that occurred following four weeks of intensive inpatient rehab. Although the patient demonstrated progress and did not experience worsening symptoms during his inpatient stay, further research is needed to determine the most effective treatment interventions to facilitate return to function and diminution of associated sequelae