A strategic physical therapy approach to restore function and maintain quality of life for a patient with multiple myeloma and vertebral fracture: A case report

Author(s):  
Amanda Jacobs ◽  
Ellen Perlow
2019 ◽  
Vol 4 (2) ◽  
pp. 24 ◽  
Author(s):  
Sarah Mottram ◽  
Martin Warner ◽  
Nadine Booysen ◽  
Katie Bahain-Steenman ◽  
Maria Stokes

Athletes with femoroacetabular impingement syndrome (FAIS) managed arthroscopically do not always return to sport. Inability to control back/pelvis, hip and lower limb movements may contribute to the onset and recurrence of symptoms. Our hypothesis is that results from a battery of cognitive movement control tests can inform a cognitive movement control (neuromuscular) retraining programme for improving the clinical presentation and quality of life in an athlete with FAIS. This case report presents a female elite rower with persistent left-sided anterior hip pain, four years post-arthroscopic surgery for FAIS, whose symptoms failed to respond to conventional physical therapy. Hip and groin outcome score (HAGOS), passive and active hip flexion range of motion (ROM) workload (time training on water), hip and pelvic kinematics (3-D motion analysis) and electromyography during a seated hip flexion movement control test, and a movement control test battery to identify movement control impairments (The Foundation Matrix), were assessed pre-intervention (week 0) and immediately post-intervention (week 16). Impaired movement control was targeted in a tailored 16-week cognitive movement control retraining exercise program. All measures improved: HAGOS (all 6 sub-scales); symptoms (61/100 pre-training to 96/100 post-training); physical activities participation (13/100 to 75/100); and active hip flexion ROM increased (78 to 116 and 98 to 118 degrees, respectively); workload increased from 4 to 18 h/week; and movement control impairment reduced (25/50 to 9/50). Pelvic motion on kinematic analysis were altered, and delayed activation onset of tensor fascia latae and rectus femoris muscles reduced. This proof-of-concept case report supports the hypothesis that cognitive movement control tests can inform a targeted cognitive movement control retraining program to improve symptoms, function and quality of life, in an elite rower with persistent hip pain. This training offers an alternative approach to conventional physical therapy, which has failed to restore function in FAIS, and the present study illustrates how specific cognitive movement control assessment can direct individual training programmes.


Author(s):  
Raysa Silva Venâncio ◽  
Tamiris Beppler Martins ◽  
Keyla Mara Dos Santos ◽  
Gilmar Moraes Santos

Introduction: Osteosarcoma is the most common malignancy among musculoskeletal tumors. It can be treated for preservation member or amputation. The cases treated for preservation member have improved functionality and quality of life, however, patients with oncologic diseases exhibit symptoms of anxiety and depression. The aim of this study is to describe the role of physiotherapy in the hip endoprosthesis after surgery for osteosarcoma of a patient treated at the Clinic Physiotherapy School of the University of the State of Santa Catarina (CEFID / UDESC) and verify their quality of life, functionality and symptoms of anxiety and depression. Materials and Methods: A descriptive study through case report. The subject was assessed before and after 10 sessions of physiotherapy on the quality of life, functionality and symptoms of anxiety and depression using a standardized assessment form, the Quality of Life Assessment Questionnaire (WHOQOL-BREF), the system Functional assessment (Musculoskeletal Tumor Society Rating Scale - MSTS); of Lower Limb Function Scale (EFMI) and the Hospital Anxiety and Depression Scale (Hospital Anxiety and Depression Scale - HADS); Results and Conclusions: Physical therapy treatment proposed to the patient allowed the increase of muscle strength; increased muscle tropism; improved member functionality (65% of EFMI); possible reduction of anxiety or depressive symptoms in HADS; presenting score (67.31%) of the WHOQOL-BREF and (56%) in MSTS. Thus, based on the functional, emotional and psychological outcomes, the proposed physical therapy had a positive influence on a patient's quality of life osteosarcoma at the proximal end of the left femur, underwent resection and reconstruction member with endoprosthesis.


2020 ◽  
Vol 1 (1) ◽  
pp. 14-18
Author(s):  
Bobby Nourani ◽  
Ross Gilbert ◽  
David Rabago

Abstract Coccydynia is debilitating pain of the coccyx that substantially impacts quality of life. Although most cases resolve with conservative therapy, pain can become chronic and involve other anatomical areas. Treatment options include physical therapy, manual medicine, injection, and surgery with mixed results. Manual medicine options vary depending on provider and physical exam findings. Little is known about transrectal therapy. We present a case of a 21-year-old female with coccydynia and subsequent headaches that failed conventional work-up and conservative therapy but resolved with osteopathic manipulative treatment (OMT).


2020 ◽  
Vol 29 (4) ◽  
pp. 685-690
Author(s):  
C. S. Vanaja ◽  
Miriam Soni Abigail

Purpose Misophonia is a sound tolerance disorder condition in certain sounds that trigger intense emotional or physiological responses. While some persons may experience misophonia, a few patients suffer from misophonia. However, there is a dearth of literature on audiological assessment and management of persons with misophonia. The purpose of this report is to discuss the assessment of misophonia and highlight the management option that helped a patient with misophonia. Method A case study of a 26-year-old woman with the complaint of decreased tolerance to specific sounds affecting quality of life is reported. Audiological assessment differentiated misophonia from hyperacusis. Management included retraining counseling as well as desensitization and habituation therapy based on the principles described by P. J. Jastreboff and Jastreboff (2014). A misophonia questionnaire was administered at regular intervals to monitor the effectiveness of therapy. Results A detailed case history and audiological evaluations including pure-tone audiogram and Johnson Hyperacusis Index revealed the presence of misophonia. The patient benefitted from intervention, and the scores of the misophonia questionnaire indicated a decrease in the severity of the problem. Conclusions It is important to differentially diagnose misophonia and hyperacusis in persons with sound tolerance disorders. Retraining counseling as well as desensitization and habituation therapy can help patients who suffer from misophonia.


2019 ◽  
Author(s):  
M. Graça Pereira ◽  
Gabriela Ferreira ◽  
Marta Pereira ◽  
Sara Faria ◽  
Rosário Bacalhau ◽  
...  

Author(s):  
Ganapathi Rao ◽  
Vijay Kumar ◽  
Ashok Naikar ◽  
Chandrakanth Halli

A standard Ksharasutra is practiced in treatment of Bhagandara (fistula-in-ano) with high success rate and minimum recurrence rate. In previous research it was noted that Pittaja Prakruti patients sometime might cause more perianal irritation due to Apamarga Ksharasutra. So in this study Palasha Ksharasutra prepared in Arkaksheera was prepared by Palasha Kshara (Ash of Butea monosperma), Arka Ksheera (Calotropis gigantic) and turmeric powder (Curcuma longa). This Ksharasutra was prepared as per the API guidelines and preserved in air tight tube. A patient of Pittaja predominant Prakruti with fistula-in ano having two external opening at 6 and 7 O’ clock position of anus was treated with application of Ksharasutra. The Palasha Ksharasutra prepared in Arkaksheera was applied in these two opening under spinal anesthesia. Then Ksharasutra was changed by weekly interval under local xylocaine jelly 2%. The length of thread was measured weekly and noted in the case to assess the unit cutting time (UCT). The unit cutting time (UCT) of first thread was 7.5 days/cm and second one had UCT 6.8 days/cm. During the treatment patient was doing his job regularly without hampering the quality of life. After 2 months patient was free from all symptoms of fistula with normal scar and without any complications. This case study demonstrated the utility of Palasha Ksharasutra prepared in Arkaksheera in multiple fistula-in ano.


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