physiotherapy rehabilitation

  • 文章类型: Case Reports
    脊髓病表现在儿童时期,可以根据损伤部位(可能导致脊柱综合征)或来源(可能是非创伤性或广泛创伤性)进行临床分类。非创伤性脊髓病可以由炎症引起,传染性,营养,新陈代谢,或缺血因素。它也可能与全身性疾病有关,如脱髓鞘疾病,多发性硬化症,或者系统性狼疮.非故意伤害是创伤性脊髓病的一个重要因素,这通常与额外的伤害有关。MRI和CT摄片有助于识别压迫性脊髓病。我们介绍了一个12岁女孩的情况,她是右手占主导地位。六个月前,她的健康状况良好,但最近开始出现双下肢无力的情况。脑部MRI显示基底内陷伴大孔狭窄,在头椎交界处引起压迫性脊髓病.病人接受了手术,其次是物理治疗康复,以提高功能独立性和生活质量。
    Myelopathy manifests in childhood and can be clinically categorized according to the site of injury (which may result in spinal syndrome) or the source (which may be nontraumatic or widely traumatic). Nontraumatic myelopathy can be caused by inflammatory, infectious, nutritional, metabolic, or ischemic factors. It may also be associated with systemic illnesses such as demyelinating disease, multiple sclerosis, or systemic lupus. Nonintentional harm is a significant factor to take into account in instances of traumatic myelopathy, which can frequently be linked to additional injuries. MRI and CT radiography help identify compressive myelopathy. We present the case of a 12-year-old girl who is right-hand dominant. She was in good health six months ago but recently began experiencing weakness in both of her lower limbs. An MRI of the brain revealed basilar invagination with stenosis of the foramen magnum, causing compressive myelopathy at the cranio-vertebral junction. The patient was operated on, followed by physiotherapy rehabilitation to improve functional independence and quality of life.
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  • 文章类型: Case Reports
    胫骨对骨折的敏感性来自其暴露的位置,使其成为一个普遍受影响的区域。胫骨近端表现出宽的干phy端区域,远端逐渐变窄,形成三角形。延伸的胫骨轴与腓骨铰接,距骨,和股骨远端.我们已经讨论了一名18岁男性在2023年1月7日经历了一起道路交通事故的案例,涉及他的自行车和四轮车之间的碰撞,导致高能力冲击他的左下肢.因此,他失去了左下肢的活动能力。经检查,他被诊断出患有用Ilizarov固定器治疗的3C级复合胫骨近端骨折,伴有神经血管缺陷,导致左侧脚下垂。此外,他以前有一个手术病例,涉及左侧股骨干骨折,这是通过原位植入物进行管理的。结论是康复方法能有效减轻疼痛,提高运动范围,肌肉力量,减少感觉障碍。下肢功能量表和足部和踝关节能力测量的改进结果表明,物理治疗方法已成功帮助患者恢复日常活动的独立性。术后物理治疗极大地影响了康复的成功和患者的康复。
    The susceptibility of the tibia to fractures arises from its exposed position, making it a commonly affected area. The proximal tibia exhibits a wide metaphyseal region that gradually narrows distally, forming a triangular shape. The extended tibia shaft articulates with the fibula, talus, and distal femur. We have discussed the case of an 18-year-old male who experienced a road traffic accident on January 7, 2023, involving a collision between his bike and four-wheeler, resulting in high-energy forces impacting his left lower limb. As a consequence, he lost mobility in the left lower limb. Upon examination, he was diagnosed with a compound grade 3C proximal tibia fracture treated with Ilizarov fixators, accompanied by a neurovascular deficit leading to a foot drop on the left side. Additionally, he had a previous operative case involving a femur shaft fracture on the left side, which was managed with in situ implants. It concluded that the rehabilitation approach was effective in pain reduction, improving range of motion, muscle strength, and reducing sensory impairment. Improved results on the lower extremity functional scale and the foot and ankle ability measures showed that the physiotherapy method had been successful in helping the patient regain independence in everyday activities. The success of rehabilitation and the recovery of patients are greatly influenced by post-operative physical therapy.
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  • 文章类型: Case Reports
    前曲是脊柱中的椎骨相对于其下方的椎骨向前滑动的情况。前滑脱通常根据滑动的方向和受影响的椎骨来描述,如L5-S1前旋,这表示在第五腰椎(L5)和骶骨(S1)之间发生的滑移。环化可能是由各种因素引起的,创伤,或先天性异常。与前旋相关的症状可能包括下背痛,刚度,肌肉紧绷,和神经症状,如果滑动压迫附近的神经。梨状肌,位于臀部深处,在这种情况下发挥着至关重要的作用,因为它的收缩或炎症会加剧坐骨神经的压迫,加剧个人所经历的疼痛和不适。患有L5-S1前裂和双侧梨状肌综合征的患者通常在涉及髋关节运动的日常活动中报告挑战,比如走路,坐着,或长时间站立。椎体滑脱和梨状肌受累的综合作用导致步态模式改变,并可能导致难以保持稳定和无痛姿势。有效的管理往往需要采取全面的方法,包括物理治疗,疼痛管理策略,and,在严重的情况下,手术干预。我们报告了一例75岁的男性,他抱怨背部疼痛放射到双下肢,一个月前在浴室里滑倒和摔倒,背部受伤,并参观了阿查里亚·维诺巴·巴哈乡村医院(AVBRH)的骨科,Sawangi,瓦尔达,在那里进行了调查,X射线显示L5-S1前裂。物理治疗在减轻疼痛方面起着至关重要的作用,提高运动范围和肌肉力量,减少肌肉紧绷,提高生活质量。理疗康复治疗L5-S1前剥离管理的目标是优化功能恢复,减轻疼痛,提高运动范围和肌肉力量,并改善患有这种疾病的个人的整体生活质量。
    Anterolisthesis is a condition where a vertebra in the spine slips forward relative to the vertebra below it. Anterolisthesis is often described in terms of the direction of the slippage and the affected vertebrae, such as L5-S1 anterolisthesis, which indicates the slippage occurring between the fifth lumbar vertebra (L5) and the sacral bone (S1). Anterolisthesis can result from various factors, trauma, or congenital abnormalities. The symptoms associated with anterolisthesis can include lower back pain, stiffness, muscle tightness, and neurological symptoms if the slippage compresses nearby nerves. The piriformis muscle, situated deep within the buttocks, plays a crucial role in this scenario, as its contraction or inflammation can exacerbate the compression of the sciatic nerve, intensifying the pain and discomfort experienced by the individual. Patients with L5-S1 anterolisthesis and bilateral piriformis syndrome commonly report challenges in daily activities involving hip movement, such as walking, sitting, or standing for prolonged periods of time. The combined effects of vertebral slippage and piriformis involvement contribute to altered gait patterns and may lead to difficulties in maintaining a stable and pain-free posture. Effective management often necessitates a comprehensive approach, encompassing physical therapy, pain management strategies, and, in severe cases, surgical intervention. We report a case of a 75-year-old male who complained of pain in his back radiating to both lower limbs with a history of slipping and falling in the bathroom one month prior, sustaining an injury to his back, and who visited the orthopedics department of Acharya Vinoba Bhave Rural Hospital (AVBRH), Sawangi, Wardha, where an investigation was done and an X-ray revealed L5-S1 anterolisthesis. Physiotherapy plays a crucial role in reducing pain, improving the range of motion and muscle strength, decreasing muscle tightness, and enhancing the quality of life. The goal of physiotherapeutic rehabilitation for L5-S1 anterolisthesis management is to optimize functional recovery, reduce pain, improve the range of motion and muscle strength, and improve the overall quality of life for individuals with this condition.
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  • 文章类型: Case Reports
    白质脑病(LE),以影响脑白质的结构变化为特征,提出了一个复杂的临床表现与不同的病因。此案例报告详细介绍了演示文稿,临床发现,1名32岁女性患有集落刺激因子1受体(CSF1R)相关性白质脑病,有糖尿病和高血压病史。她突然停药了,这导致了她病情恶化.她出现了头痛的症状,含糊不清的讲话,视觉障碍,认知障碍,平衡和协调受损,因此,她的日常生活活动受到影响。症状突出了其管理所需的挑战和多学科方法。病人表现出神经功能缺损,认知能力下降,和异常的反射,磁共振成像(MRI)显示白质异常。结果指标表明,认知和功能能力显着改善,强调量身定制的康复治疗在控制集落刺激因子1受体相关白质脑病复杂性方面的有效性。为期六周的物理治疗康复计划涉及各个领域,包括力量训练,特定任务的练习,无差错的学习,面部肌肉再训练,平衡练习,视觉恢复治疗,和流动性培训。所有这些干预措施都有效地改善了她的功能能力,并使患者独立进行日常生活活动。
    Leukoencephalopathy (LE), characterized by structural changes affecting cerebral white matter, presents a complex clinical picture with diverse etiologies. This case report details the presentation, clinical findings, and physiotherapy management of a 32-year-old female with colony-stimulating factor 1 receptor (CSF1R)-related leukoencephalopathy and a history of diabetes and hypertension. She suddenly stopped her medications, which led to the worsening of her condition. She presented with symptoms of headache, slurred speech, visual disturbances, cognitive impairment, and impaired balance and coordination, due to which her activities of daily living were affected. The symptoms highlighted the challenges and multidisciplinary approach required for its management. The patient exhibited neurological deficits, cognitive decline, and abnormal reflexes, with magnetic resonance imaging (MRI) revealing white matter abnormalities. Outcome measures demonstrated significant improvements in cognitive and functional abilities, emphasizing the effectiveness of tailored rehabilitation in managing the complexities of colony-stimulating factor 1 receptor-related leukoencephalopathy. A six-week physiotherapy rehabilitation program addressed various domains, including strength training, task-specific exercises, errorless learning, facial muscle retraining, balance exercises, visual restoration therapy, and mobility training. All these interventions effectively improved her functional capacity and made the patient independent in performing activities of daily living.
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  • 文章类型: Case Reports
    影响大脑后动脉(PCA)的急性缺血性卒中(AIS)代表了独特的临床挑战,需要采取多方面的康复方法。这篇综述旨在全面概述专门为涉及PCA领域的AIS患者量身定制的物理治疗干预措施。PCA提供负责视觉处理的大脑关键区域,记忆,和感觉统合。因此,PCA梗死患者通常表现出一组明显的神经功能缺损,包括视野干扰,认知障碍,和感觉异常。本病例报告重点介绍了基于证据的物理治疗策略,包括一系列干预措施,从早期动员和运动训练到感觉重新融合和认知康复。及早动员,包括卧床活动和直立活动,对于预防与不动相关的并发症至关重要。运动训练干预措施的目标是恢复功能性运动模式,解决偏瘫和平衡障碍。
    Acute ischemic stroke (AIS) affecting the posterior cerebral artery (PCA) represents a unique clinical challenge, necessitating a multifaceted approach to rehabilitation. This review aims to provide a comprehensive overview of physiotherapeutic interventions tailored specifically for individuals with AIS involving the PCA territory. The PCA supplies critical areas of the brain responsible for visual processing, memory, and sensory integration. Consequently, patients with PCA infarcts often exhibit a distinct set of neurological deficits, including visual field disturbances, cognitive impairments, and sensory abnormalities. This case report highlights evidence-based physiotherapy strategies that encompass a spectrum of interventions, ranging from early mobilization and motor training to sensory reintegration and cognitive rehabilitation. Early mobilization, including bed mobility exercises and upright activities, is crucial to prevent complications associated with immobility. Motor training interventions target the restoration of functional movement patterns, addressing hemiparesis and balance impairments.
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  • 文章类型: Case Reports
    类风湿性关节炎(RA)是一种对关节和关节外器官有深远影响的全身性自身免疫性疾病。本病例报告探讨了一名54岁女性患者的复杂治疗方法,该患者患有RA和干燥综合征(SS)的双重诊断。RA主要涉及关节炎症和晨僵,导致严重残疾,而SS,另一种自身免疫性疾病,表现为自身抗体和淋巴细胞浸润影响外分泌腺。患者出现关节和腰痛,随着流动性的降低,描绘复杂的临床表现。物理治疗在解决患者表现出的各种症状中起着至关重要的作用。治疗涉及Mulligan动员靶向骶髂关节功能障碍,激光治疗缓解疼痛,以及专注于关节活动度和肌肉力量的量身定制练习。使用类风湿性关节炎疾病活动指数(RADAI-5)和总体生活质量评估监测进展。康复后观察到显着改善,包括疼痛程度降低,增加关节的运动范围,肌肉力量增强,增强骶髂关节活动能力。这些积极的结果突出了物理治疗在管理自身免疫性风湿性疾病中的功效。医疗保健专业人员特别是风湿病学家和物理治疗师之间的合作对于全面的患者护理至关重要。该案例强调了采用整体方法来管理自身免疫性疾病的重要性。物理治疗是缓解症状和增强身体功能的关键组成部分,强调了其与面临自身免疫性风湿性疾病挑战的个体的多学科护理框架的整合。
    Rheumatoid arthritis (RA) is a systemic autoimmune disease with profound effects on joints and extra-articular organs. This case report explores the complex treatment approach for a 54-year-old female patient who is dealing with the dual diagnosis of RA and Sjogren\'s syndrome (SS). RA primarily involves joint inflammation and morning stiffness leading to significant disability, while SS, another autoimmune condition, manifests with autoantibodies and lymphocytic infiltration affecting exocrine glands. The patient presented with joint and low back pain, alongside reduced mobility, portraying a complex clinical picture. Physiotherapy played a crucial role in addressing the diverse symptoms exhibited by the patient. Treatment involved Mulligan mobilization targeting sacroiliac joint dysfunction, laser therapy for pain relief, and tailored exercises focusing on joint mobility and muscle strength. Progress was monitored using the Rheumatoid Arthritis Disease Activity Index (RADAI-5) and overall quality of life assessments. Significant improvements were observed post-rehabilitation including reduced pain levels, increased joint range of motion, increased muscle strength, and enhanced sacroiliac mobility. These positive outcomes highlight the efficacy of physiotherapy in managing autoimmune rheumatic disorders. Collaboration between healthcare professionals particularly rheumatologists and physiotherapists is essential for comprehensive patient care. This case emphasizes the importance of adopting a holistic approach to managing autoimmune disorders. Physiotherapy emerges as a pivotal component in alleviating symptoms and enhancing physical function underscoring its integration into the multidisciplinary care framework for individuals facing the challenges of autoimmune rheumatic disorders.
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  • 文章类型: Case Reports
    在印度,称为抗胆碱酯酶的有机磷(OP)化学物质会导致大量疾病和死亡。虽然没有确切的数字,来自医院的数据表明,约50%的急性中毒事件归因于有机磷。抗胆碱酯酶,当意外或自杀暴露时,导致三种不同的神经系统疾病。第一种是急性胆碱能危象,可能是致命的,需要在重症监护病房给药;第二种是中间综合征,经常导致颅神经麻痹,近端和呼吸肌无力,和患者的呼吸支持;第三是迟发性有机磷引起的多发性神经病。一起,这些神经行为改变已被确认,被称为"慢性有机磷引起的神经精神障碍"(COPIND).一名40岁的男性患者试图通过吞咽大量OP杀虫剂来自杀。他呼吸沉重,喘气的空气,嘴唇起泡,当他被带到一家私人医院时,他闻到了强烈的农药味。进行了神经传导速度(NCV)等调查,显示了运动性轴索多发性神经病。
    In India, organophosphorus (OP) chemicals known as anticholinesterases cause a considerable amount of disease and mortality. While precise figures are unavailable, data from hospitals indicates that about 50% of acute poisoning episodes are attributed to organophosphates. Anticholinesterases, when accidentally or suicidally exposed, cause three different neurological disorders. The first is an acute cholinergic crisis that can be fatal and necessitates administration in an intensive care unit; the second is an intermediate syndrome that frequently results in cranial nerve palsies, proximal and respiratory muscle weakness, and respiratory support for patients; and the third is a delayed organophosphate-induced polyneuropathy. Together, these neurobehavioral alterations have been identified and are referred to as \"chronic organophosphate-induced neuropsychiatric disorders\" (COPIND). A 40-year-old male patient tried suicide by swallowing a significant dose of OP pesticide. He was breathing heavily, gasping for air, foaming at the lips, and smelled intensely of pesticide when he was brought to a private hospital. Investigations like nerve conduction velocity (NCV) were done, which revealed motor axonal polyneuropathy.
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  • 文章类型: Case Reports
    桥小脑角(CPA)肿瘤患者的听神经瘤切除术由于涉及的小脑和脑干组织的复杂结构而带来了特殊的康复问题。CPA肿瘤(听神经瘤)是由前庭耳蜗神经引起的生长缓慢的肿瘤。手术切除这些肿瘤会导致神经系统异常,损害运动协调,balance,和面部神经功能。该案例研究强调了在听神经瘤切除术后康复患者的综合理疗方法的重要性。专注于特定的CPA肿瘤缺陷。康复方案侧重于通过平衡改善功能成果,本体感受,以及根据患者的需求和不足定制的前庭康复。我们的综合方法旨在改善患者的生活质量,促进神经愈合,并支持CPA肿瘤手术后轻松重返正常活动。
    Acoustic neuroma excision in patients with cerebellopontine angle (CPA) tumours offers particular rehabilitation problems due to the complicated architecture of the cerebellum and brainstem tissues involved. CPA tumours (acoustic neuromas) are slow-growing tumours that arise from the vestibulocochlear nerve. Surgical excision of these tumours can cause neurological abnormalities that compromise motor coordination, balance, and facial nerve function. The case study emphasises the importance of a comprehensive physiotherapeutic approach in rehabilitating a patient following acoustic neuroma excision, with a focus on particular CPA tumour deficits. The rehabilitation programme focuses on improving functional outcomes through balance, proprioception, and vestibular rehabilitation that is customised to the demands and deficiencies of the patient. Our comprehensive approach seeks to improve patients\' quality of life, promote neurological healing, and support easy reintegration into normal activities following CPA tumour surgery.
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  • 文章类型: Case Reports
    帕金森病(PD)患者表现出严重的神经肌肉疾病和低骨质量。这些问题因无所作为和处于主席地位而变得更糟。影响自然老化脊柱的每一个病理和退化过程也影响这些个体。弯腰姿势是疾病的症状,很容易引起脊柱退化。PD与许多身体异常有关,这些异常导致对康复的独特和特定需求。患者的经历凸显了医生在诊断中面临的挑战,治疗,和康复。此病例报告详细介绍了一名67岁的PD患者的康复情况,该患者因椎管狭窄而接受了脊柱内固定术,并抱怨双下肢无力。设计了一个先进的康复计划,主要强调力量训练以增强整体功能。进行了干预前和干预后评估,包括运动范围(ROM),手动肌肉测试(MMT),Oswestry残疾指数,功能独立性度量,下肢功能量表,和Berg平衡量表,所有这些都证明了关节ROM的显着改进,力量,功能独立,balance,和下肢功能。本案例报告强调了康复计划在此类案例中的重要性,强调它们在增强整体功能方面的重要作用。
    Patients with Parkinson\'s disease (PD) exhibit both a severe neuromuscular disorder and low bone quality at presentation. These issues are made worse by inactivity and a chairbound state. Each and every pathologic and degenerative process that affects the naturally aging spine also affects these individuals. Stooped posture is a symptom of a disease and can easily cause spinal degeneration. PD is associated with many physical abnormalities that cause a unique and specific need for rehabilitation. Patients\' experiences highlight the challenges doctors face in diagnosis, treatment, and rehabilitation. This case report details the rehabilitation of a 67-year-old patient with PD who underwent spinal fixation for spinal stenosis and presented with complaints of weakness in both lower limbs. An advanced rehabilitation program was devised, primarily emphasizing strength training to enhance overall functionality. Pre- and post-intervention assessments were conducted, encompassing range of motion (ROM), manual muscle testing (MMT), Oswestry Disability Index, Functional Independence Measure, Lower Limb Functional Scale, and Berg Balance Scale, all of which demonstrated noteworthy improvements in joints ROM, strength, functional independence, balance, and lower limb function. This case report underscores the significance of rehabilitation programs in such cases, highlighting their important role in enhancing overall functioning.
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  • 文章类型: Case Reports
    视神经炎是一种导致炎症和视神经损伤的炎症性疾病,引起视觉障碍和疼痛。它通常与多发性硬化症等疾病有关,通常表现为突发性,单侧视力丧失或视力模糊。这种疾病可以影响任何年龄的个体,并可能导致双眼视力下降,可能导致深度感知和视觉协调方面的困难。物理治疗通过解决疾病的各个方面在治疗视神经炎中起着至关重要的作用。我们报道了一个14岁男性双眼缩小的病例,发病突然,自然无痛,没有跌倒的历史,创伤,或糖尿病。磁共振成像显示短tau倒置恢复(STIR)的高强度,双侧视神经后部(颅内部分)有轻度对比增强,延伸到视神经炎的视交叉。物理治疗师采用一系列的技术来提高病人的整体健康,包括凝视稳定性练习,眼手协调练习,以及旨在改善视觉跟踪和协调的习惯练习。此外,理疗可以帮助减少相关症状,如肌肉无力,平衡问题,和视觉感知受损引起的姿势问题。物理治疗师通过增强功能独立性并有助于更有效的治疗方法来努力提高视神经炎患者的生活质量。值得注意的是,视觉扫描有所改善,空间意识,和眼球运动控制在这种情况下。
    Optic neuritis is an inflammatory condition that leads to inflammation and damage to the optic nerve, causing visual disturbances and pain. It is commonly associated with disorders such as multiple sclerosis and often manifests as sudden, unilateral loss of vision or blurred vision. This disorder can affect individuals of any age and may lead to decreased binocular vision, potentially resulting in difficulties with depth perception and visual coordination. Physiotherapy plays a crucial role in treating optic neuritis by addressing various aspects of the illness. We report the case of a 14-year-old male with diminution in both eyes, which was sudden in onset and painless in nature, with no history of falls, trauma, or diabetes. Magnetic resonance imaging reveals hyperintensity on short-tau inversion recovery (STIR) with mild contrast enhancement in the posterior aspects of the bilateral optic nerves (intracranial part), extending to the optic chiasm in optic neuritis. Physiotherapists employ a range of techniques to enhance the patient\'s overall well-being, including gaze stability exercises, eye-hand coordination exercises, and habituation exercises aimed at improving visual tracking and coordination. Additionally, physiotherapy can help reduce related symptoms such as muscle weakness, balance issues, and posture problems caused by impaired visual perception. Physical therapists endeavor to improve the quality of life for patients with optic neuritis by enhancing functional independence and contributing to a more effective approach to treatment. Notably, there was an improvement in visual scanning, spatial awareness, and eye movement control in this case.
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