Agreement Between a Physical Therapist and an Orthopedic Surgeon in Children Referred for Gait Abnormalities

2016 ◽  
Vol 28 (1) ◽  
pp. 85-92 ◽  
Author(s):  
Stacey Miller ◽  
Susan R. Harris ◽  
Kishore Mulpuri
Keyword(s):  
Physical Therapist ◽  
Orthopedic Surgeon ◽  
Gait Abnormalities

scholarly journals Undetected Pectoralis Major Tendon Rupture in a Patient Referred to a Physical Therapist in a Combat Environment: A Case Report

2013 ◽  
Vol 93 (9) ◽  
pp. 1225-1233 ◽  
Author(s):  
Carrie W. Hoppes ◽  
Michael D. Ross ◽  
Josef H. Moore
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Physical Examination ◽  
Tendon Rupture ◽  
Surgical Repair ◽  
Physical Therapist ◽  
The United States ◽  
Pectoralis Major ◽  
Orthopedic Surgeon ◽  
Combat Environment

Background and Purpose This case report describes a patient who was referred to a physical therapist for treatment of a shoulder strain and was eventually diagnosed with a rupture of the pectoralis major tendon that required surgical repair. The purpose of this case report is to highlight the management of this injury within the unique constraints of a combat environment. Case Description A 29-year-old man, currently serving as an active duty soldier in the US Army in Iraq, had a sudden onset of right shoulder pain during the concentric portion of a bench press. He was seen by a physician immediately after the injury, diagnosed with a shoulder strain, and referred to a physical therapist for a sling and exercise instruction. On the basis of the history and physical examination findings, which were consistent with a pectoralis major tendon rupture, the physical therapist placed a consult to an orthopedic surgeon in the United States through teleconsultation because orthopedic surgeons were not easily accessible in Iraq for nonemergency musculoskeletal referrals. Subsequently, the orthopedic surgeon advised evacuating the patient out of Iraq for surgical treatment. Outcomes By means of magnetic resonance imaging, the patient was diagnosed as having a rupture of the pectoralis major tendon at the musculotendinous junction near its insertion into the greater tubercle of the humerus that required surgical repair. At 3 months after surgery, the patient had full pain-free shoulder active range of motion and had progressed well through his strengthening program in a manner that allowed return to full duty. At 6 months after surgery, the patient maintained full duty status, was performing a routine of strength training 3 times per week, and had met all of his rehabilitation and personal goals. Discussion Successful treatment of this patient depended on analysis of the history and physical examination findings by the physical therapist to form an accurate diagnosis. In addition, timely medical evacuation and referral to an orthopedic surgeon for surgical treatment were coordinated in a combat environment. Completion of a progressive rehabilitation program after pectoralis major tendon repair also contributed to this patient's full recovery and return to duty. Had the physical therapist only followed the initial referral request, given this patient's military duties and sports and recreational activities, this case probably would have resulted in suboptimal outcomes.

Impairment Tutorial: Functionally Limiting Upper Extremity Pain: Controversies in Impairment Rating

2003 ◽  
Vol 8 (5) ◽  
pp. 4-12
Author(s):  
Lorne Direnfeld ◽  
James Talmage ◽  
Christopher Brigham
Keyword(s):  
Upper Extremity ◽  
Radicular Pain ◽  
Illness Behavior ◽  
Orthopedic Surgeon ◽  
First Case ◽  
Clinical Presentations ◽  
Whole Person ◽  
Physical Examinations ◽  
Upper Extremity Impairment ◽  
The Individual

Abstract This article was prompted by the submission of two challenging cases that exemplify the decision processes involved in using the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides). In both cases, the physical examinations were normal with no evidence of illness behavior, but, based on their histories and clinical presentations, the patients reported credible symptoms attributable to specific significant injuries. The dilemma for evaluators was whether to adhere to the AMA Guides, as written, or to attempt to rate impairment in these rare cases. In the first case, the evaluating neurologist used alternative approaches to define impairment based on the presence of thoracic outlet syndrome and upper extremity pain, as if there were a nerve injury. An orthopedic surgeon who evaluated the case did not base impairment on pain and used the upper extremity chapters in the AMA Guides. The impairment ratings determined using either the nervous system or upper extremity chapters of the AMA Guides resulted in almost the same rating (9% vs 8% upper extremity impairment), and either value converted to 5% whole person permanent impairment. In the second case, the neurologist evaluated the individual for neuropathic pain (9% WPI), and the orthopedic surgeon rated the patient as Diagnosis-related estimates Cervical Category II for nonverifiable radicular pain (5% to 8% WPI).

scholarly journals The Physical Therapist in a Nuclear Disaster

1964 ◽  
Vol 44 (4) ◽  
pp. 251-255
Author(s):  
Bernice R. Krumhansl
Keyword(s):  
Physical Therapist ◽  
Nuclear Disaster

Implant Complications in 20 Triple Pelvic Osteotomies

1993 ◽  
Vol 06 (04) ◽  
pp. 202-207 ◽  
Author(s):  
Cindy Fries ◽  
Audrey Remedios
Keyword(s):  
Postoperative Complication ◽  
Hip Dysplasia ◽  
Pelvic Osteotomy ◽  
Implant Failure ◽  
Screw Loosening ◽  
Common Complication ◽  
Implant Complications ◽  
Gait Abnormalities

SummaryIn 12 dogs with hip dysplasia, 20 triple pelvic osteotomies (eight bilateral and four unilateral) were performed. Screw loosening, occurring in six of 12 dogs (seven of 20 osteotomies), was the most common complication after surgery. Implants loosened from the cranial ilium in six hemipelvises (30%) and from both fragments in one hemipelvis, two to six weeks (mean — three) after the operation. Medial acetabular displace-ment caused pelvic narrowing (6 to 9%, mean = 8%) in three of four dogs. Medial ischial displacement decreased pelvic diameter (11 to 21%, mean = 17%) in four of seven osteotomies. All of the dogs with implant failure were treated conservatively with cage rest and in two cases Ehmer slings were used. Although none were lame, gait abnormalities were evident in three of seven dogs on follow-up examinations four to 12 months (mean = six) later.Screw loosening, occurring in seven of 20 hemipelvises, was the most common postoperative complication associated with triple pelvic osteotomy. Fixation failures were managed conservatively. Despite decreased pelvic diameter in four of seven animals, none were lame or showed signs of pelvic obstruction at follow-up examinations four to 12 months later.

scholarly journals Automatically evaluating balance using machine learning and data from a single inertial measurement unit

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Fahad Kamran ◽  
Kathryn Harrold ◽  
Jonathan Zwier ◽  
Wendy Carender ◽  
Tian Bao ◽  
...  
Keyword(s):  
Machine Learning ◽  
Inertial Measurement Unit ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Model Performance ◽  
Machine Learning Techniques ◽  
Measurement Unit ◽  
Balance Performance ◽  
Inertial Measurement ◽  
Self Assessments

Abstract Background Recently, machine learning techniques have been applied to data collected from inertial measurement units to automatically assess balance, but rely on hand-engineered features. We explore the utility of machine learning to automatically extract important features from inertial measurement unit data for balance assessment. Findings Ten participants with balance concerns performed multiple balance exercises in a laboratory setting while wearing an inertial measurement unit on their lower back. Physical therapists watched video recordings of participants performing the exercises and rated balance on a 5-point scale. We trained machine learning models using different representations of the unprocessed inertial measurement unit data to estimate physical therapist ratings. On a held-out test set, we compared these learned models to one another, to participants’ self-assessments of balance, and to models trained using hand-engineered features. Utilizing the unprocessed kinematic data from the inertial measurement unit provided significant improvements over both self-assessments and models using hand-engineered features (AUROC of 0.806 vs. 0.768, 0.665). Conclusions Unprocessed data from an inertial measurement unit used as input to a machine learning model produced accurate estimates of balance performance. The ability to learn from unprocessed data presents a potentially generalizable approach for assessing balance without the need for labor-intensive feature engineering, while maintaining comparable model performance.

scholarly journals Rethinking Telerehabilitation: Attitudes of Physical Therapists and Patients

2021 ◽  
Vol 8 ◽  
pp. 237437352110343
Author(s):  
Fereshteh Saaei ◽  
Susan G Klappa
Keyword(s):  
Patient Population ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Patient Survey ◽  
Patient Perspectives ◽  
Remote Care ◽  
Virtual Therapy ◽  
Therapy Sessions

COVID-19 has accelerated the adoption of telehealth among various specialties, including rehabilitation. The fast-paced implementation of telerehabilitation has laid bare its challenges, providing an opportunity for innovation in order to enhance the experience of remote care. The purpose of this study sought to understand the attitudes toward telerehabilitation from physical therapist (PT) and patient perspectives. Two surveys administered to PTs, and the general patient population explored beliefs regarding telerehabilitation. There were a total of 289 participant responses in this study. There were 228 PT respondents and 61 patients who responded to the patient survey. Qualitative results describe current attitudes toward telerehabilitation. Results indicated both groups were receptive to virtual therapy sessions; however, some challenges were also reported. Current challenges and trends in utilizing telerehabilitation are further discussed.

scholarly journals How can the orthopedic surgeon ensure optimal vitamin D status in patients operated for an osteoporotic fracture?

2021 ◽  
Author(s):  
T. Chevalley ◽  
M.L. Brandi ◽  
E. Cavalier ◽  
N.C. Harvey ◽  
G. Iolascon ◽  
...  
Keyword(s):  
Vitamin D ◽  
Osteoporotic Fracture ◽  
Vitamin D Status ◽  
Orthopedic Surgeon
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