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The utilization of an isometric protocol during the early intervention of chronic gluteus Medius tendinopathy: case report
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Background and Purpose: Chronic hip pain is just a way of life for many Americans. Of those individuals experiencing hip pain, many are due to Greater Trochanteric Pain Syndrome (GTPS). GTPS is often caused by a tendinopathy of the Gluteus Medius tendon. This case study follows the evaluation and treatment of a patient with hip pain consistent with GTPS.
Case Description: The patient’s main concerns are chronic hip pain that limits her participation in daily activities such as her walking routine or climbing stairs. She presents with weakness of hip stabilizers and is at increased risk of falls. The primary intervention used to manage her tendinopathy symptoms is an isometric protocol outlined by other studies.
Outcomes: The patient experienced positive outcomes and responded well to the treatments. The outcome measures used were Manual Muscle Testing, the Lower Extremity Functional Scale, and a Single Leg Stance time. Her muscle strength increased and she was able to score better on the outcome measures used to determine her impairment level.
Discussion: The patient’s positive response to the isometric protocol suggests the protocol can be effective for the treatment of GTPS. When considering this treatment option for a patient it is important to remember further research is needed to confirm the efficacy of the protocol. At this time it is uncertain if this protocol is more effective than other physical therapy interventions
Outcome measures and interventions of a balance training program
Get PDFBackground and Purpose:
Falls are currently considered a public health concern due to their increasing prevalence in the aging population (1). The purpose of this case study is to examine and discuss outcome measures and interventions for a patient being treated in an outpatient setting for balance deficits.
Case Description:
The patient discussed in this article was attending outpatient physical therapy for balance training. A very complex medical history presented challenges in forming a concise prognosis. The interventions provided were all based on the six domains of balance.
Outcomes:
The patient showed improved scores in all outcome measures over the course of her treatments. Not only did she make improvements quantitatively in outcome measures, but her self-reported improvements showed a positive impact on her ability to safely perform daily tasks.
Discussion:
When balance training, it is important to take into consideration all the contributing factors of balance. The patients present medical conditions and vision impairments can both have a very negative impact on balance. The interventions provided to this patient yielded improvements in balance. Research has shown a strong correlation between proprioception and balance, leading to the conclusion that if you target improvement in proprioception, it will lead to an overall improvement in balance (2)
A critical appraisal of "Neuromuscular electrical stimulation superimposed on movement early after acl surgery"
Get PDFThis paper appraises a 2018 article published in the American College of Sports Medicine about the effectiveness of neuromuscular electrical stimulation (NMES) treatment on the quadriceps muscles on anterior collateral ligament reconstruction (ACLR) patients. The introduction contains background information that helped formulate the clinical question which is then followed by a description of methods used to select the article. The following results section has a summary of the article along with the appraisal of study's introduction, methods, results, and discussion. In the discussion the significance and main findings of the articles are reviewed and the relevance to clinical practice is presented. Lastly, there is a discussion about the use of NMES intervention being applied to future rehabilitation protocols
Diastasis recti abdominis in a 42-year-old woman: case report
Get PDFBackground and Purpose: The space between the transverse abdominis fibers, known as diastasis rectus abdominis, is commonly seen postpartum. This case is significant because there is limited research about interventions for DRA.
Case Description: The patient is a 42-year-old Hispanic female who had one vaginal delivery 4 years ago and another 2 years ago. The patient presented to therapy after coming through direct access with a chief complaint of abdominal instability when side-lying. The patient reported that there is a “gapping” in their abdomen when they attempt bed mobility and transfers.
Outcomes: The patient decreased their DRA from 5 cm to 3.2 cm at the umbilicus and improved transverse and rectus abdominis strength from 3+/5 to 4-/5. These improvements allowed the patient to increase their abdominal stability during functional activities.
Discussion: The most important finding from this study was that conservative treatment for DRA can be effective in reducing the distance between the transverse abdominal muscles. More research needs to be performed to create a universal clinical practice guideline since DRA is a prevalent condition that occurs in many women post-partum. This case report can provide insight into potential treatment interventions for patients with DRA
Diagnosis of spina bifida and symptoms of bilateral foot pain: a case report
Get PDFSpina bifida is a rare neural tube defect in which malformation of the posterior arch of vertebra leaves the spinal column open. Signs and symptoms of spina bifida include but are not limited to back and lower extremity pain, bowel and bladder dysfunction, and lower extremity weakness and deformity. My goal of the case report is to provide a unique report of a patient who had significant clinical improvement and developed a new belief in the positive impact of physical therapy. The patient is a 34-year-old logistic analyst who presented to physical therapy with a chief complaint of bilateral foot pain causing limited standing and walking tolerance. The onset of pain was insidious approximately 3 years ago. The patient was diagnosed with spina bifida occulta and tethered cord syndrome and had corrective surgery about 1 year ago. Previous treatment for their condition included bilateral tarsal tunnel decompression surgery 1 year ago. Primary interventions include pain neuroscience education, gastrocnemius stretching, and strengthening. The patient present had improvement in ankle dorsiflexion and a slight improvement in plantar flexion range of motion. The patient had improvement in plantar flexion strength with no increase in pain with inversion during manual muscle testing. The patient’s pain scale improved during the time of the progress note and in their reporting of the worst pain in the past 2 weeks. The patient also improved on their LEFS and the single leg balance test. An important finding from the case report is the positive effect of pain neuroscience education on a patient with chronic pain. A primary lesson to take away is to look at the biological, psychological, and social aspects of a person to provide the best care to the patient
A critical appraisal of "Efficacy of quadriceps vastus medialis dry needling in a rehabilitation protocol after surgical reconstruction of complete anterior cruciate ligament rupture."
Get PDFA critical appraisal of the "Efficacy of quadriceps vastus medialis dry needling in a rehabilitation protocol after surgical reconstruction of complete anterior cruciate ligament rupture."� This appraisal aims to evaluate the goals, methods, and results of the associated research article and determine the state of applicability of its findings to the scope of physical therapy
A critical appraisal of "Effects of treadmill training with the eyes closed on gait and balance ability of chronic stroke patients"
Get PDFAs a physical therapist, it is important that our treatment plans are based on solid research, which we need to be able to identify. This critical appraisal is a first step in learning what makes an article a credible source that can be applied in the clinical setting. After pinpointing a research question, the article was chosen through PubMed database based on the inclusion criteria against other articles. In order to determine its authority, the strengths and weaknesses of each section of the article were assessed. Overall, the paper was well written and drew strong conclusions from its results, however it was missing a lot of elements that calls into question its credibility as a source. Based on these missing elements, it can be concluded that the article should not be used as evidence for an intervention in a clinical setting