scholarly journals Hip Internal Range Of Motion Correlates With Back And Lower Extremity Pain In Recreational Triathletes

2021 ◽  
Vol 53 (8S) ◽  
pp. 46-46
Author(s):  
John C. Sieverdes ◽  
Bradley E. Johnson ◽  
Rachel Crawford ◽  
Madeline Crawford ◽  
John Rhodes ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Range Of Motion ◽  
Lower Extremity Pain

Spinal Impairment Evaluation: Fifth Edition Changes

2001 ◽  
Vol 6 (1) ◽  
pp. 1-3
Author(s):  
Robert H. Haralson
Keyword(s):  
Spinal Cord ◽  
Lower Extremity ◽  
Range Of Motion ◽  
Upper Extremity ◽  
Spinal Cord Injuries ◽  
Clinical Findings ◽  
Fourth Edition ◽  
Treatment Results ◽  
Standard Terminology ◽  
Made In

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, was published in November 2000 and contains major changes from its predecessor. In the Fourth Edition, all musculoskeletal evaluation and rating was described in a single chapter. In the Fifth Edition, this information has been divided into three separate chapters: Upper Extremity (13), Lower Extremity (14), and Spine (15). This article discusses changes in the spine chapter. The Models for rating spinal impairment now are called Methods. The AMA Guides, Fifth Edition, has reverted to standard terminology for spinal regions in the Diagnosis-related estimates (DRE) Method, and both it and the Range of Motion (ROM) Method now reference cervical, thoracic, and lumbar. Also, the language requiring the use of the DRE, rather than the ROM Method has been strengthened. The biggest change in the DRE Method is that evaluation should include the treatment results. Unfortunately, the Fourth Edition's philosophy regarding when and how to rate impairment using the DRE Model led to a number of problems, including the same rating of all patients with radiculopathy despite some true differences in outcomes. The term differentiator was abandoned and replaced with clinical findings. Significant changes were made in evaluation of patients with spinal cord injuries, and evaluators should become familiar with these and other changes in the Fifth Edition.

scholarly journals Lower Extremity Rehabilitation in Patients with Post-Stroke Sequelae through Virtual Reality Associated with Mirror Therapy

2021 ◽  
Vol 18 (5) ◽  
pp. 2654
Author(s):  
Roxana Steliana Miclaus ◽  
Nadinne Roman ◽  
Ramona Henter ◽  
Silviu Caloian
Keyword(s):  
Virtual Reality ◽  
Muscle Strength ◽  
Lower Extremity ◽  
Range Of Motion ◽  
Control Group ◽  
Mirror Therapy ◽  
Cohen’S D ◽  
Cohen's D ◽  
Experimental Group ◽  
Post Therapy

More innovative technologies are used worldwide in patient’s rehabilitation after stroke, as it represents a significant cause of disability. The majority of the studies use a single type of therapy in therapeutic protocols. We aimed to identify if the association of virtual reality (VR) therapy and mirror therapy (MT) exercises have better outcomes in lower extremity rehabilitation in post-stroke patients compared to standard physiotherapy. Fifty-nine inpatients from 76 initially identified were included in the research. One experimental group (n = 31) received VR therapy and MT, while the control group (n = 28) received standard physiotherapy. Each group performed seventy minutes of therapy per day for ten days. Statistical analysis was performed with nonparametric tests. Wilcoxon Signed-Rank test showed that both groups registered significant differences between pre-and post-therapy clinical status for the range of motion and muscle strength (p < 0.001 and Cohen’s d between 0.324 and 0.645). Motor Fugl Meyer Lower Extremity Assessment also suggested significant differences pre-and post-therapy for both groups (p < 0.05 and Cohen’s d 0.254 for the control group and 0.685 for the experimental group). Mann-Whitney results suggested that VR and MT as a therapeutic intervention have better outcomes than standard physiotherapy in range of motion (p < 0.05, Cohen’s d 0.693), muscle strength (p < 0.05, Cohen’s d 0.924), lower extremity functionality (p < 0.05, Cohen’s d 0.984) and postural balance (p < 0.05, Cohen’s d 0.936). Our research suggests that VR therapy associated with MT may successfully substitute classic physiotherapy in lower extremity rehabilitation after stroke.

scholarly journals Are accelerometer measures of temporal patterns of static standing associated with lower extremity pain among blue-collar workers?

2019 ◽  
Vol 67 ◽  
pp. 166-171 ◽  
Author(s):  
Francisco Locks ◽  
Nidhi Gupta ◽  
Pascal Madeleine ◽  
Marie Birk Jørgensen ◽  
Ana Beatriz Oliveira ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Temporal Patterns ◽  
Blue Collar ◽  
Blue Collar Workers ◽  
Lower Extremity Pain

scholarly journals Distal Lower-Extremity Pain and Work Postures in the Quebec Population

2008 ◽  
Vol 98 (4) ◽  
pp. 705-713 ◽  
Author(s):  
Karen Messing ◽  
France Tissot ◽  
Susan Stock
Keyword(s):  
Lower Extremity ◽  
Lower Extremity Pain

Lower Extremity Pain

2014 ◽  
pp. 81-99
Author(s):  
Krista Howard ◽  
David March ◽  
Haseeb Ikram ◽  
Jenna Lorentsen ◽  
Jeffrey Howard
Keyword(s):  
Lower Extremity ◽  
Lower Extremity Pain

scholarly journals Risk Factor, Job Stress and Quality of Life in Workers With Lower Extremity Pain Who Use Video Display Terminals

2018 ◽  
Vol 42 (1) ◽  
pp. 101 ◽  
Author(s):  
Sehoon Choi ◽  
Seong Ho Jang ◽  
Kyu Hoon Lee ◽  
Mi Jung Kim ◽  
Si-Bog Park ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factor ◽  
Lower Extremity ◽  
Job Stress ◽  
Video Display ◽  
Video Display Terminals ◽  
Lower Extremity Pain

scholarly journals The Effectiveness of Lumbar Interlaminar Epidural Injections in Managing Chronic Low Back and Lower Extremity Pain

2012 ◽  
Vol 4;15 (4;8) ◽  
pp. E363-E404
Author(s):  
Ramsin Benyamin
Keyword(s):  
Lower Extremity ◽  
Spinal Stenosis ◽  
Disc Herniation ◽  
Local Anesthetic ◽  
Chronic Low Back Pain ◽  
Randomized Trials ◽  
Low Back ◽  
Discogenic Pain ◽  
Epidural Injections ◽  
Lower Extremity Pain

Background: Intervertebral disc herniation, spinal stenosis, intervertebral disc degeneration without disc herniation, and post lumbar surgery syndrome are the most common diagnoses of chronic persistent low back and lower extremity symptoms, resulting in significant economic, societal, and health care impact. Epidural injections are one of the most commonly performed interventions in the United States in managing chronic low back pain. However the evidence is highly variable among different techniques utilized – namely interlaminar, caudal, and transforaminal – and for various conditions, namely – intervertebral disc herniation, spinal stenosis, and discogenic pain without disc herniation or radiculitis. Multiple systematic reviews conducted in the evaluation of the effectiveness of interlaminar epidural injections have been marred with controversy. Consequently, the debate continues with regards to the effectiveness, indications, and medical necessity of interlaminar epidural injections. Study Design: A systematic review of lumbar interlaminar epidural injections with or without steroids. Objective: To evaluate the effect of lumbar interlaminar epidural injections with or without steroids in managing various types of chronic low back and lower extremity pain emanating as a result of disc herniation or radiculitis, spinal stenosis, and chronic discogenic pain. Methods: The available literature on lumbar interlaminar epidural injections with or without steroids in managing various types of chronic low back pain with or without lower extremity pain was reviewed. The quality assessment and clinical relevance criteria utilized were the Cochrane Musculoskeletal Review Group criteria as utilized for interventional techniques for randomized trials and the criteria developed by the Newcastle-Ottawa Scale criteria for observational studies. The level of evidence was classified as good, fair, or limited based on the quality of evidence developed by the U.S. Preventive Services Task Force (USPSTF). Data sources included relevant literature identified through searches of PubMed and EMBASE from 1966 to December 2011, and manual searches of the bibliographies of known primary and review articles. Outcome Measures: The primary outcome measure was pain relief (short-term relief = up to 6 months and long-term > 6 months). Secondary outcome measures were improvement in functional status, psychological status, return to work, and reduction in opioid intake. Results: Overall, 82 lumbar interlaminar trials were identified. All non-randomized studies without fluoroscopy and randomized trials not meeting the inclusion criteria were excluded. Overall, 15 randomized trials and 11 non-randomized studies were included in the analysis. Analysis was derived mainly from fluoroscopically-guided randomized trials and non-randomized studies. The evidence is good for radiculitis secondary to disc herniation with local anesthetics and steroids, fair with local anesthetic only; whereas it is fair for radiculitis secondary to spinal stenosis with local anesthetic and steroids, and fair for axial pain without disc herniation with local anesthetic with or without steroids, with fluoroscopically-guided epidural injections. Limitations: The limitations of this study include that we were unable to perform meta-analysis for disc herniation, and the paucity of evidence for discogenic pain and spinal stenosis. Further, methodological criteria have been highly variable along with sample sizes. The studies were heterogenous. Conclusion: The evidence based on this systematic review is good for lumbar epidural injections under fluoroscopy for radiculitis secondary to disc herniation with local anesthetic and steroids, fair with local anesthetic only; whereas it is fair for radiculitis secondary to spinal stenosis with local anesthetic and steroids, and fair for axial pain without disc herniation with local anesthetic with or without steroids. Key words: Chronic low back pain, lower extremity pain, disc herniation, radiculitis, spinal stenosis, discogenic pain, lumbar interlaminar epidural injections, fluoroscopy

scholarly journals Physiotherapy Rehabilitation in Post Operative Tibia- Fibula Fracture with External Fixators

2021 ◽  
pp. 283-288
Author(s):  
Gunjan Ambalkar ◽  
Deepak Jain ◽  
Pratik Phansopkar
Keyword(s):  
Lower Extremity ◽  
Range Of Motion ◽  
Road Traffic ◽  
Severe Trauma ◽  
Long Bone ◽  
External Fixators ◽  
Tibial Shaft ◽  
Fibula Fracture ◽  
Shaft Fractures ◽  
Tibial Shaft Fractures

Introduction: A tibia - fibula fracture occurs when a fall or trauma to the lower extremities puts more tension on the bones than they can tolerate. Diaphyseal tibial fractures are the most common long bone fracture. Lower extremity Tibia and fibula fractures are examples of fractures. Tibial shaft fractures are most typically associated with a history of severe trauma. The tibia is the most commonly fractured bone in the lower extremity. The bone's shaft is in the middle Fibula fractures are usually, but not always, accompanied by tibial shaft fractures. Case Presentation: At the previous 15 days, a 49-year-old male patient accounted in a hospital with a road traffic accident. Discussion: The physiotherapy was given to this patient for muscle energy technique resulting in a high degree of range of motion in the lower extremity, reduce pain, and improves flexibility and strength. Conclusion: Physiotherapy has a significant effect on pain, strength, and range of motion. The result of this case report specifies that it may be effective for pain relief, improvement in strength, and functional ability.

scholarly journals Characteristics of Patients With Complex Limb Pain Evaluated Through an Interdisciplinary Approach Utilizing Magnetic Resonance Neurography

2021 ◽  
Vol 2 ◽  
Author(s):  
Emily M. Johnson ◽  
Daehyun Yoon ◽  
Sandip Biswal ◽  
Catherine Curtin ◽  
Paige Fox ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Lower Extremity ◽  
Case Series ◽  
Interdisciplinary Team ◽  
Limb Pain ◽  
Magnetic Resonance Neurography ◽  
Treatment Pathways ◽  
Lower Extremity Pain ◽  
Patient Reported ◽  
Team Evaluation

Patients with persistent complex limb pain represent a substantial diagnostic challenge. Physical exam, and tests such as nerve conduction, are often normal even though the patient suffers from severe pain. In 2015, we initiated a team-based approach to evaluate such patients. The approach included physicians from several specialties (Anesthesiology/Pain Medicine, Radiology, Plastic Surgery, Neurosurgery) combined with the use of advanced imaging with Magnetic Resonance Neurography (MRN). This preliminary case series discusses MRN findings identified in patients with previously difficult-to-diagnose peripheral limb pain and describes how this combination of approaches influenced our diagnosis and treatment plans. We extracted demographics, patient characteristics, presenting features, diagnostic tests performed, treatments provided, referral diagnosis and the diagnosis after interdisciplinary team evaluation from patient charts. We evaluated MRN and electrodiagnostic studies (EDX) ability to identify injured nerves. We compared abnormal findings from these diagnostics to patient reported outcome after ultrasound-guided nerve block. A total of 58 patients, 17 males and 41 females, were identified. The majority of patients presented with lower extremity pain (75%) and had prior surgery (43%). The most commonly identified abnormality on MRN was nerve signal alteration on fluid sensitive sequences, followed by caliber change and impingement. Comparing the outcome of diagnostic nerve blocks with abnormal nerve findings on MRN or EDX, we found that MRN had a sensitivity of 67% and specificity of 100% while for EDX it was 45 and 0%, respectively. After interdisciplinary discussion and imaging review, a more specific diagnosis was produced in 78% of evaluated cases opening up additional treatment pathways such as nerve-targeted surgery, which was performed in 36% cases. This descriptive case series demonstrates that a majority of patients evaluated by our team for complex limb pain were women with lower extremity pain resulting from surgery. In addition, an interdisciplinary team evaluation and the use of the moderately sensitive but highly specific MRN imaging modality resulted in a change in diagnosis for a majority of patients with complex limb pain. Future studies investigating patient outcomes after diagnosis change are currently underway based on the findings of this preliminary study.

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