BACKGROUND: Total pelvic exenteration is the ultimate solution for rectovesicovaginal fistula caused by radiation therapy, yet total pelvic exenteration frequently causes intraoperative complications and postoperative complications. These complications are responsible for the dysfunction of lower extremities, impaired quality of life, and even the high long-term morbidity rate, thus multidisciplinary cooperation and early intervention for prevention of complications are necessary. Physical therapy was found to reduce the postoperative complications and promote rehabilitation, yet the effect on how physiotherapy prevents and treats complications after total pelvic exenteration and pelvic lymphadenectomy remains unclear.
METHODS: A 50-year-old Chinese woman gradually developed perianal and pelvic floor pain and discomfort, right lower limb numbness, and involuntary vaginal discharge owing to recurrence and metastasis of cervical cancer more than half a year ago. Diagnosed as rectovesicovaginal fistula caused by radiation, she received total pelvic exenteration and subsequently developed severe lower limb edema, swelling pain, obturator nerve injury, and motor dysfunction. The patient was referred to a physiotherapist who performed rehabilitation evaluation and found edema in both lower extremities, right inguinal region pain (numeric pain rate scale 5/10), decreased temperature sensation and light touch in the medial thigh of the right lower limb, decreased right hip adductor muscle strength (manual muscle test 1/5) and right hip flexor muscle strength (manual muscle test 1/5), inability actively to adduct and flex the right hip with knee extension, low de Morton mobility Index score (0/100), and low Modified Barthel Index score (35/100). Routine physiotherapy was performed in 2 weeks, including therapeutic exercises, mechanical stimulation and electrical stimulation as well as manual therapy. The outcomes showed that physiotherapy significantly reduced lower limb pain and swelling, and improved hip range of motion, motor function, and activities of daily living, but still did not prevent thrombosis.
CONCLUSIONS: Standardized physical therapy demonstrates the effect on postoperative complications after total pelvic exenteration and pelvic lymphadenectomy. This supports the necessity of multidisciplinary cooperation and early physiotherapy intervention. Further research is needed to determine the causes of thrombosis after standardized intervention, and more randomized controlled trials are needed to investigate the efficacy of physical therapy after total pelvic exenteration.

BACKGROUND: Physical therapy (PT) academic institutions are called upon to strengthen their transformative role in developing more socially responsible graduates. Study objectives were to explore faculty perspectives on educating PT students for social responsibility (SR) and to identify strategies for improvement.
METHODS: Adopting a \"curriculum as praxis\" orientation for curriculum development supports educating for SR because of its focus on transforming self and the world through recurring critical reflection and action. To complement the curriculum, ensuring SR in the entire academic environment, including institutional structures and capable educators, will enrich student development.
METHODS: Six PT educators from a Philippine university with distinct SR mandates were purposively invited to participate based on their key involvements in various aspects of educating for SR.
METHODS: A participatory approach guided the methods to encourage collaborative creation of practical knowledge. Participant perspectives were gathered through focus group discussions, which were informed by research on SR in Philippine PT. Discussions were transcribed and then subjected to thematic analysis.
RESULTS: Three themes highlighted main areas for practice improvement: 1) strengthening curricular focus on SR through a whole-of-curriculum approach to incorporating opportunities for cognitive learning on SR and praxis (reflection and action); 2) maximizing institutional programs by helping students recognize them as further opportunities for developing SR; 3) and ensuring faculty has the capacity to educate for SR.
CONCLUSIONS: Educating for SR requires a transformative curriculum supported by aligned institutional programs and capable educators. This study enjoins PT educators to ensure a strong SR agenda in their PT programs by analyzing and acting on the transformative purpose of their curricula, including the influence of institutional structures, and support needed by educators to enable students to respond to the needs of the society they serve.

OBJECTIVE: The aim was to evaluate the efficacy of ultrasound-guided erector spinae plane (ESP) block and compare with the conventional physical therapy in chronic low back pain (LBP).
METHODS: This prospective case-controlled study included patients with chronic LBP. Their clinical and demographic data were obtained, and they were divided into two groups for conventional physical therapy and ESP blocks. Prior to treatment, on the first day, the second week, and the third month, the Oswestry Disability Index (ODI) and visual analog scale (VAS) pain score were evaluated.
RESULTS: The study included 43 patients, 21 in the ESP block group and 22 in the conventional physical therapy group. The VAS in movement was higher in the ESP block group at baseline (p = 0.047). On the first day after the treatments, the ESP block group showed lower resting (p < 0.001) and movement (p = 0.001) VAS values than the conventional physical therapy group. At the end of 3 months, both groups had improved VAS and ODI scores (all p < 0.001).
CONCLUSIONS: US-guided ESP block might be considered a successful, safe, and technically simple alternative treatment in patients with chronic LBP to control pain and reduce the cost of physical therapy and lost workdays.

UNASSIGNED: Differential diagnosis of pediatric neck pain requires age-appropriate communication and assessment tools. Recognizing these age-related nuances is critical, emphasizing the role of physical therapists in assessing and managing pediatric patients while ruling out severe pathologies.
UNASSIGNED: A 10-year-old male presented to physical therapy with a five-week history of increasing neck pain. A thorough history and segmental cervical examination considering the patient\'s age and development, led to patient referral to the emergency department. This case underscores the significance of comprehensive evaluation in pediatric neck pain management.
UNASSIGNED: The patient was diagnosed with Langerhans Cell Histiocytosis (LCH). LCH primarily affects children and is treated with chemotherapy. Chemotherapy reduced the tumor, revealing C2 vertebral body damage. The patient underwent C1-C3 fusion surgery, a standard procedure for atlanto-occipital region stabilization in children. The patient was advised to restrict motion for 6 months while monitoring for tumor growth.
UNASSIGNED: Pediatric neck cancer presents diagnostic challenges due to varied symptoms, but research highlights specific indicators to assist with differential diagnosis. This case emphasizes the need to recognize the complexities of pediatric neck pain and perform a thorough age-appropriate evaluation.

Conjoined twins are identical twins joined in utero and are a rare phenomenon. This report discusses a case of female thoraco-omphalo-ischiopagus tripus conjoined twins. The twins were separated at age two, and once medically stable, spent one month in inpatient rehabilitation to improve their sitting balance and gross motor skills. This was followed by outpatient physical therapy. The twins initially had customized ZipZac seats, which they were able to wheel independently. After six months of therapy, the girls began walking with posterior walkers and prostheses. The hemipelvectomy prosthesis included a customized thoracolumbosacral orthosis component and was directly attached to a non-articulated pylon. A manual-locking hip joint was added to accommodate sitting. An articulated ankle-foot orthosis was used for the intact leg. Care of formerly conjoined twins requires comprehensive care from a multidisciplinary team involving, but not limited to, a physiatrist, orthopaedic surgeon, physical therapist, and orthotist/prosthetist. Complex congenital limb deficiencies are often a major undertaking for the rehabilitation team as continuous treatment and management are needed throughout the patient\'s lifetime due to growth, development, and evolving physical demands. Anatomic variations must be examined on a case-by-case basis but often include limb deficiencies, orthopedic abnormalities, and organ comorbidities.

METHODS: This is the first documented case of an isolated traumatic vastus medialis rupture that occurred in a 14-year-old athlete after direct impact during play. Imaging confirmed a rare mid-substance rupture. The patient underwent conservative management with physical therapy augmented by blood flow restriction therapy (BFRT) and platelet-poor plasma (PPP) injection to regain full function.
CONCLUSIONS: Isolated quadriceps mid-substance tears are rare. Determining an appropriate treatment technique for mid-substance tears is complex. This case documents the use of nonoperative management with BFRT and PPP to achieve full recovery and early return to play in a young athlete.

OBJECTIVE: The purposes of this case report were to (1) highlight the use and efficacy of the Tubular Orthosis for Torticollis (TOT) Collar in a prolonged and complex episode of care for an infant with congenital muscular torticollis (CMT) and (2) describe an infant with CMT receiving a physical therapy episode of care interrupted by the COVID-19 pandemic, leading to use of supplemental interventions.
CONCLUSIONS: The patient presented was an infant with CMT who received physical therapy treatment, including the TOT Collar, to resolve all symptoms.
CONCLUSIONS: The TOT Collar helped achieve midline head position after all treatment options were exhausted at the end of a lengthy episode of care impacted by the COVID-19 pandemic.
UNASSIGNED: The TOT Collar may be an appropriate supplemental intervention choice for infants with CMT whose symptoms do not resolve with first-choice interventions.

BACKGROUND: A 14-year-old adolescent girl with spastic diplegic cerebral palsy underwent bilateral distal femur extension osteotomy and patellar tendon plication. Two and a half months after surgery, during physiotherapy, she sustained mid-substance tear of the left patellar tendon. The girl was successfully managed with patellar tendon repair and augmentation with tensor fascia lata autograft.
CONCLUSIONS: Patellar tendon rupture during rehabilitative physiotherapy after patellar tendon plication surgery is rare. Postoperative protocols in patients with cerebral palsy are crucial and should progress gradually to improve knee range of motion. This report highlights that patellar tendon repair with fascia lata augmentation yields good outcome.

OBJECTIVE: The purpose of this report was to describe an example of how to incorporate infographics as a group assignment in the entry-level physical therapy classroom to integrate course content and translate knowledge of research evidence.
METHODS: This was a retrospective case report. Students developed their own infographics as a group assignment to present in the classroom. During course orientation and at the end of the course, students were asked to complete an optional survey about infographics.
RESULTS: Fifty students completed the survey. All students (n=50) reported that they were attracted to visual information, and 74% (n=37) had used an infographic as an educational/informative tool. 74% (n=37) completed the post-intervention survey and found infographics valuable in reviewing course content. 95% (n=35) would consider using infographics as a learning and knowledge translation (KT) tool in the future.
CONCLUSIONS: These data validated students\' interest in visual information and awareness about the use of infographics as an educational/informative tool. Health care educators may use innovative KT strategies, such as infographics, in the classroom to encourage students to develop competency in KT and dissemination of information.

This report introduces a young adult who has been in bed for more than ten years with end-stage hemophilic arthropathy. He didn\'t have access to factor VIII (FVIII) in the early stage of hemophilia due to the high costs of clotting replacement therapy. As a result, he is experiencing some difficulties, such as joint contracture, muscular atrophy, severe pain, and poor function of cardiopulmonary. He came to visit us for a comprehensive rehabilitation program, and, finally, he achieved the basic goal of self-care in daily life.