Pelvic pain in Maigne’s syndrome—a multi-segmental approach

Background Maigne’s syndrome is a poorly understood condition that affects the thoracolumbar junction. The symptoms can range from pain in the low back, pelvis, hip, lower abdomen, and groin. These symptoms can have bio-mechanical and neurophysiological attributions due to the complexity of spinal mechanics. Thoraco-lumbar junction (T12-L1) is a transitional zone with a higher degree of mean angular motion and a mean translation motion than T10-T11 and T11-T12. This higher degree of translational and rotation mobility predisposes these segments to a higher degree of stress, making them more prone to biomechanical faults such as dysfunctions and positional faults. These altered static and dynamic mechanics can create a cascade of problems along the biomechanical chain. The co-existence of thoracolumbar junction problems with pelvic pain and dysfunctions strengthens the idea of regional interdependence. Case presentation The patient is a 44-year-old Caucasian male who reported pain in the low back with symptoms radiating to the right hip, iliac region, lower abdomen, and gluteal region. The patient tested positive for Sacroiliac joint dysfunction with both Laslett’s cluster testing and palpatory sacroiliac examination. In addition, the segmental examination showed restriction in thoracolumbar junction with positive skin rolling test and hypomobility in manual segmental testing. Thus, the manual therapy treatment targeted the thoracolumbar junction and sacroiliac joint to address the underlying biomechanical dysfunctions. Conclusions The manual therapy targeting both sacroiliac and thoracolumbar spine can improve pelvic and thoracic spine mobility. In addition, therapeutic exercises can focus on enhancing anterior and posterior chain force generation capacity. This combined approach helped improve functional outcomes with a significant decrease in the Modified Oswestry Disability index and significant improvement on Visual analog scale.

efficacy of the therapeutic exercises on Evminov board with use of the Glisson loop in patients with degenerative spine diseases

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Low Molecular Weight Hyaluronic Acid (500–730 Kda) Injections in Tendinopathies—A Narrative Review

Tendinopathies are common causes of pain and disability in general population and athletes. Conservative treatment is largely preferred, and eccentric exercise or other modalities of therapeutic exercises are recommended. However, this approach requests several weeks of consecutive treatment and could be discouraging. In the last years, injections of different formulations were evaluated to accelerate functional recovery in combination with usual therapy. Hyaluronic acid (HA) preparations were proposed, in particular LMW-HA (500–730 kDa) for its unique molecular characteristics in favored extracellular matrix homeostasis and tenocyte viability. The purpose of our review is to evaluate the state-of-the-art about the role of 500–730 kDa in tendinopathies considering both preclinical and clinical findings and encourage further research on this emerging topic.

Effectiveness of Physical Therapy in the Correction of the Functional Status of the Temporomandibular Joint in Arthrosis

The purpose of the study was to evaluate the effect of a physical therapy program on the state of functioning of the maxillofacial region in patients with arthrosis of the temporomandibular joint. Materials and methods. The study involved 33 people with arthrosis of the temporomandibular joint of the II-III degrees, which were divided into 2 groups – control and main. The control group consisted of 18 people who received arthrosis therapy only with non-steroidal anti-inflammatory drugs. The main group consisted of 15 people who additionally underwent the developed program of physical therapy (therapeutic exercises, massage, post-isometric relaxation, kinesiotaping of the masticatory muscles, neck muscles, cervical-collar zone; paraffin therapy course for the temporomandibular joint area, patient education). Complaints of patients, the intensity of pain in the temporomandibular joint on a visual analogue scale, the amount of mouth opening were determined, and auscultation of the joint was performed. Results and discussion. After the completion of the treatment course (for patients of the control group) and physical therapy (for the patients of the main group), pain in the temporomandibular joint did not manifest itself at rest and during movement. This is explained, in particular, by the fact that the basis of conservative treatment of arthrosis is the use of non-steroidal anti-inflammatory drugs with analgesic effects. At the same time, the usage of physical therapy, in comparison with medications, in the main group was statistically significant (p <0.05) in relation to control patients, it improved the functional activity of the jaw area and the functioning of the temporomandibular joint, which was manifested by a decrease in the number of persons with complaints of pathological sounds during jaw movements and their auscultatory detection, discomfort when chewing, as well as an increase in the magnitude of opening the mouth. Restoration of the condition of patients with diseases of the maxillofacial region, and, in particular, the temporomandibular joint, is an urgent problem not only for dentists, but also for specialists in the field of rehabilitation, in particular, physical therapists. The objectives of physical therapy in patients with arthrosis of the temporomandibular joint are to reduce the load on the joint, eliminate and reduce pain, synovitis, myalgia, improve joint function, stimulate and activate metabolic processes in cartilaginous and bone tissues, normalize blood flow, and thus improve quality of life. Conclusion. Physical therapy means improve the functional ability of the temporomandibular joint in the complex recovery of patients with arthrosis statistically significantly better than monotherapy with non-steroidal anti-inflammatory drugs

The Influence of Approaches to Early Mobilization of Cardiosurgical Patients on the Duration of Hospitalization

The purpose of the study was to compare the impact of approaches to early mobilization of cardiac surgery patients on the duration of hospitalization. Materials and methods. Early mobilization of patients after cardiac surgery and study of its effectiveness is an important issue of physical therapy. The beginning of the development of cardiac surgery was characterized by the fact that patients after surgery were in the intensive care unit on a bed rest for several days to improve recovery and prevent complications. The benefits of early mobilization were later recognized, and patient verticalization began earlier. The study involved 90 patients (over 18 years old). Patients were divided into two groups. The first group of mobilization (GM1, n = 49) included patients who underwent surgery on Monday or Tuesday, performed standing and if possible walking on the spot on the first postoperative day with a physical therapist. The second group of mobilization (GM2, n = 41) included patients who underwent surgery on Friday, were mobilized to sit in bed on the first postoperative day; performed standing and walking on the spot on the second or third postoperative day with the participation of medical staff. In addition, other early mobilization points (chamber walking and corridor walking) were performed statistically later in GM2. Patients did not differ in other features of physical therapy. All patients were told during the preoperative consultation with a physical therapist that if they were operated on Friday, they would perform mobilization and therapeutic exercises with medical staff on weekends. Patient case data (age, sex, study protocols and operations) were studied. Results and discussion. Among GM1 patients, the part of men was 69.39%, and in the GM2 group – 78.05% (χ² = 0.856; p = 0.355). Groups of patients did not have significant differences in age, anatropometric parameters, key results of preoperative studies, characteristics of surgical interventions. The study did not establish the effect of more progressive early mobilization performed in GM1 on the length of stay in the postoperative ward (7 (6; 8) nights versus 7 (5; 8) nights; p=0.428) and the total duration of postoperative hospitalization (9 (8; 10) nights against 10 (7; 11) nights; p=0.733). Statistically better indicators of the GM1 group were obtained in the number of nights spent in intensive care (all patients – two nights, except 3 patients in GM1 and 11 in GM2 – three nights; p=0.007), but this advantage should be considered taking into account the impact of patient logistics, namely longer stay in intensive care on weekends. Conclusion. The data confirmed the same effectiveness of approaches to early mobilization of cardiac surgery patients in terms of duration of postoperative hospitalization

The application of therapeutic exercises on fitballs for postural disorders in students

Poor posture is a fairly common pathology that often occurs among students of higher educational institutions and negatively affects their physical and functional fitness. Upon entering a higher educational institution the physical activity of students decreases significantly, and it causes deterioration in health, reduces the level of physical and mental performance.

Therapeutic Exercise to Improve Motor Function Among Children with Down Syndrome Aged 0 to 3 Years: A Systematic Literature Review

Objective: To determine the effect of therapeutic exercises on the motor function of children with Down syndrome (DS) aged 0 to 3 years.Data Sources: A search was carried out on PubMed, PEDro, EMBASE, SCIELO, Lilacs, Cochrane library without publication date restrictions for the terms.Study Selection: The search yielded 1384 eligible articles, which were screened by 2 reviewers. RCTs that would have evaluated the effectiveness of therapeutic exercise were selected, and that would have reported the effectiveness in the outcomes.Data Extraction: The methodology and results of the studies were critically appraised in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes guidelines. Data Synthesis: Six studies were included. Two types of therapeutic exercises, aerobic and neuromuscular, were identified. A therapeutic aerobic exercise was performed using the treadmill, while a neuromuscular exercise was done using unstable surfaces. The exercise frequency ranged from three days to five days a week, and the duration of each session was between six and 15 minutes. Conclusion: There is moderate to high evidence to support that therapeutic exercise promotes the occurrence of motor patterns such as gait patterns and enhances the motor skills of children with DS aged 0 to 3 years.

New method of performing erector spine plane block for treatment of pain syndrome

Background. Osteochondrosis is one of the most common causes of pain in back and extremities. Treatment methods range from therapeutic exercises and massage to complex transpedicular spine fixations with decompression of the spinal cord and its roots. In the most difficult cases, despite adequate surgery, pain might return with no less intensity. The purpose was to describe a clinical case of pain treatment in a patient with generalized osteochondrosis accompanied by a postoperative surgery muscular-tonic syndrome. Results. Chronic pain could not be controlled with nonsteroidal anti-inflammatory drugs and pregabalin, however, it was effectively relieved using the technique of regional anesthesia, erector spinae plane block. The main difficulty and danger of the blockade was that if the patient already had metal structure in the body this might have changed anatomical landmarks, and metal itself scattered ultrasound rays in such way that the picture on ultrasound monitor was not good enough to safely and effectively perform regional anesthesia. Therefore, erector spinae plane block was performed under the control of digital radiography. Conclusions. Erector spine plane block can be used to treat severe pain regardless of its etiology. The use of digital radiography to perform blockade can be an alternative technique if ultrasound imaging is technically difficult or impossible due to different reasons.