REHABILITATION OF A CONSERVATIVELY MANAGED CLAVICULAR FRACTURE

The collarbone, or wishbone, is a thin, S-shaped bone about 6 inches (15 cm) long and serves as a support between the shoulder blade and the sternum (sternum). Clavicle fracture so occur as a result of injury or trauma. The most common site of fracture is the junction between the two curvatures of the bone, which is the weakest point. The displacement post fracture is most common in clavicular fracture because the attachment of the muscle sternocleidomastoid pulls the Sternal head upwards and the pectoral muscle pulls the distal clavicle downwards. After a distal clavicle fracture, radiographic nonunion has been identified in 10% to 44% of patients. Most of clavicular fractures are managed non-surgically by physical therapy which consists of a rehabilitation program without hampering the fracture healing, the rehabilitation consists of pain reduction, improving strength and range of motion of the shoulder, Scapular and neck muscles and postural correction exercises in addition to a brace to support the upper limb as the clavicle is the bone connecting the Axilla to the shoulder girdle. And the patient is started with medical management which usually consist of analgesics. 62 year old male patient with left clavicle fracture was diagnosed on x-ray after a hit from a bullock cart. Following this incident the patient underwent a prompt series of physical rehabilitation which included strengthening exercises, thoracic expansion exercises, breathing exercises. The case report suggests that a physiotherapy treatment procedure led to the improvement of functional goals progressively and significantly.

Does adding extracorporeal shock wave therapy to postural correction exercises improve pain and functional disability in postpartum sacroiliac joint pain? A randomized controlled trial

El objetivo de este estudio fue examinar el resultado de la terapia de ondas de choque extracorpóreas (TOCH) en mujeres con dolor en la articulación sacroilíaca posparto. Cuarenta mujeres primigrávidas (seis semanas después del parto) con dolor sacroilíaco participaron en este estudio. Fueron asignadas al azar a los grupos A y B. El grupo A fue tratado mediante TOCH, además de ejercicios de corrección postural y ejercicios de inclinación pélvica posterior. El grupo B fue tratado únicamente con el mismo programa de ejercicios. Ambos grupos recibieron dos sesiones por semana durante cuatro semanas. Las variables estudiadas fueron el dolor sacroilíaco y el nivel de función, las cuales se midieron mediante la escala visual analógica (EVA) y la escala funcional de dolor de espalda (EFDE), respectivamente. Todas las mediciones se evaluaron antes y después de las cuatro semanas de intervención. El análisis dentro de los grupos mostró una mejora significativa en la EVA y un aumento significativo en la EFDE en ambos grupos después del tratamiento en comparación con el valor inicial. Con respecto a los análisis entre grupos, hubo una mejora significativa en la EVA y un aumento significativo en la EFDE en el grupo A en comparación al grupo B. En conclusión, tanto la TOCH como el programa de ejercicios son efectivos para disminuir el dolor y mejorar la función en mujeres con dolor sacroilíaco posparto. Sin embargo, al agregar TOCH a los ejercicios en el programa de tratamiento, los resultados son mejores, por lo que esta combinación se recomienda en el tratamiento de mujeres con dolor sacroilíaco posparto. Examining the outcome of the extracorporeal shock wave therapy (ESWT) on females with postpartum sacroiliac joint pain was the aim of this study. Forty primigravida (six weeks postpartum) females with sacroiliac pain was the sample in this study. The subjects equally randomly allocated in group A and B. Group A was treated by ESWT in addition to postural correction and posterior pelvic tilting exercises. Group B was treated by the same exercise program only. Two sessions every week for four weeks were received by both groups. The measurement variables were sacroiliac pain and function level that were measured by visual analogue scale (VAS) and the back pain functional scale (BPFS), respectively. All measurements were evaluated pre and post four weeks of intervention. The within groups analysis showed a significant improvement in VAS and a significant increase in BPFS in both groups after treatment compared with baseline. Regarding between groups analyses there was a significant improvement in VAS and a significant increase in BPFS in group A compared with group B. In conclusion, both ESWT and exercise program are effective in decreasing the pain and improving the function in females with postpartum sacroiliac pain. However, by adding ESWT to exercises in the treatment program the results are better, so this combination is recommended in treatment of females with postpartum sacroiliac pain.

HIGH GRADE DYSPLASTIC SPONDYLOLISTHESIS IN AN 11 YEAR OLD GIRL CHILD - A CASE REPORT

High-Dysplastic Developmental Spondylolisthesis (HDDS) is an extremely rare situation, comprising of around 5% of the total cases of spondylolisthesis. Clinical Description :- A eleven year-old girl with high-grade dysplastic L5-S1 spondylolisthesis with pain in her lower back along with radicular pain to her lower limbs (right > left). Her X-rays depicted a L5 - S1 anterolisthesis leading to an abnormal kyphosis at lumbo-sacral junction, increased lumbar lordosis and reversal of thoracic kyphosis to lordosis. Management:- A was done along with a cage insertion at the L5 - S1 level. L5 - S1 posterior - spinal fixation Outcome:- Postural correction was achieved immediately post-op and the patient also had relief from the radicular symptoms.

PHYSICAL THERAPISTS’ PERCEPTIONS OF ADOLESCENT IDIOPATHIC SCOLIOSIS TREATMENT

Background: Few studies have demonstrated the benefit of physical therapy in the treatment of adolescent idiopathic scoliosis (AIS), alone or in conjunction with bracing or surgery. To our knowledge, there is no consensus in pediatric physical therapists who treat AIS patients. Purpose: To identify the optimal physical therapy practices for AIS including; weekly frequency, session length, treatment duration, clinical interventions, therapeutic goal-setting, and outcome measures from pediatric physical therapists’ perspectives. Methods: A 40-question validated survey, The Analysis of the Schroth Method in Adjunct to Physical Therapy Services for Treatment of AIS, was distributed to pediatric physical therapists across the country via the Academy of Pediatric Physical Therapy electronic newsletter and via dissemination by the Injury Prevention Research Interest Group from Pediatric Research in Sport Medicine. REDCap was used to collect and organize responses. The responses were analyzed by a descriptive statistics using percentages (%). Results: Sixty-five responses were obtained. The majority of physical therapists, 78.5%, were Doctors of Physical Therapy (DPT), treating 1-5 AIS patients a week (69.2%), and 18.8% had Schroth certification. Preferred treatment frequency was twice a week (41.5%) for a duration of 60 minutes (53.8%), over the course of 3-5 months (44.6%). The top three common clinical interventions were; core and trunk stability enhancement (90.8%), abdominal strengthening (83.1%) and postural correction (80.0%). The three most common therapeutic goal-setting parameters were activity based (78.5%), quality of life measure based (56.9%), and therapy participation based (50.8%). Additionally, for outcome measures, patient reported outcome was the most common objective measurement (78.5%), followed by pain (63.1%), manual muscle testing (46.2%), range of motion (44.6%), cobb angle (27.7%), scoliometer readings (26.2%) and Adam’s forward bend test (10.8%). Therapists often monitored progress with completed surveys by patients. However, patients’ ability to return to activity was the most common marker of improvement (72.3%). Patient’s scoliosis was often being treated in another manner aside from PT (46.2%), and many patients had medical conditions in addition to scoliosis (52.3%). Conclusion: According to our data, pediatric physical therapists believe that patients with AIS can benefit from physical therapy treatments addressing core and trunk stability, abdominal strengthening, and postural correction. Ideal treatment sessions would occur twice a week for 60 minutes over a period of 3-5 months. Objective measurements can be monitored to ensure improvements in quality of life, pain, strength, range of motion and curvature of the patient’s spine. Acknowledgements The Injury Prevention Research Interest Group from Pediatric Research in Sports Medicine and Suzanne M. McCahan, PhD

Assessment of Posture Related Musculoskeletal Risk Levels in Restaurant Chefs using Rapid Entire Body Assessment (REBA)

Background: Objective To assess the level of risk in posture associated work related musculoskeletal disorders in restaurant chefs using Rapid Entire Body Assessment [REBA]. Method: 30 subjects were included. Out of 30 subjects, all of them were males. The Mean Age, Weight, Height and working hours were 19.57 years, 52.06 kg, 185.28 cms and 8.63 hours respectively. Postures using REBA score sheet were evaluated based on the most difficult work tasks (based on observation and interview), the posture that was sustained for a longer period of time. Result: Body posture was evaluated using REBA sheet and it can be concluded that the major areas susceptible to painful working postures were of the neck and the wrist positions having the most frequent risk reported. Followed by the upper arm and trunk position having moderate risk and the least frequent area involved were legs and lower arm position. Conclusion: The study concludes that most of the restaurant chef’s fall under moderate risk of musculoskeletal disorders and require intervention and awareness about postural correction exercises to prevent further musculoskeletal injuries. Key words: Restaurant chefs, Posture, Rapid Entire Body Assessment, Ergonomics, Musculoskeletal risk.

POS1471-HPR EVALUATION OF THE EFFECTIVENESS OF MOBILE APP-BASED EXERCISES PROGRAMME IN PATIENTS WITH NECK PAIN: THE RANDOMIZED CONTROLLED TRIAL

Background:Mobile health applications are frequently used to increase exercise adherence in patients with musculoskeletal problems. However, the usability of these health mobile applications mostly has not been proven. In our previous study, the usability of the mobile app, which includes postural correction and neck spinal stabilization exercises, has been proven. (M.U-NeckExercise application)Objectives:The aim of this study is to evaluate the effectiveness of the mobile application-based home exercise program for patients with chronic neck pain.Methods:60 people with chronic neck pain were participated in the our study. They were randomized into two groups. The first group (n:30) received home exercises via the novel mobile app, and the second group (n:30) received the same home exercises via the brochure. The exercise program consisted of neck and thoracic postural correction and neck spinal stabilization exercises. Participants has been requested to do the exercises 3 days in a week for 6 weeks. Participants’ pain levels were assessed by using the Visual Analogue Scale (VAS), their neck-related functional limitations were evaluated by Neck Pain and Disability Index (BADI). Exercise adherence was meausered with a ratio of total participated sessions compared with the target defined by patient activation monitor and exercise adherance questionnaire. Targeted participation were %60 of total sessions.Results:In both groups, the improvement in VAS and BADI scores was statistically significant (p<0.05). It was found that the pain parameters of VAS score decreased statistically more in the mobile application-based exercise group (p<0.05). While there was no statistically significant difference between the groups in the BADI score, the effect size results was higher in the mobile app group (effect size= 0.411). Our exercise commitment target in the mobile app group was an average of 10.5 sessions. The target session number has been reached 11.25 sessions.Conclusion:It has been observed that the mobile application-based exercise program is effective in reducing pain and increasing exercise adherence in people with chronic neck pain. The findings support M.U-NeckExercise-App could be recommended to health professionals for exercise prescription in patients with cronic neck pain.References:[1]Tonga E, Can M, Polat MG (2019). ”SAT0730-HPR development and design of smartphone application for postural alignment of cervical and thoracic spine for young adults.” Annals of the Rheumatic Diseases, 78,2.[2]Voth, E. C., Oelke, N. D., & Jung, M. E. (2016). A theory-based exercise app to enhance exercise adherence: a pilot study. JMIR mHealth and uHealth, 4(2), e62.VariableGroupX±SSzpPost-Exercise VAS Value (0-10 cm)Mobile app2,90±2,04-3,272**0,001Brochure4,63±1,69Post-Exercise BADI ValueMobile app38,86±12,380,0310,861Brochure32,23±12,35Disclosure of Interests:None declared

Topspin’s Influence on the Spine in Female Juniors III in Table Tennis

The consolidation of topsin, the most prolific technical & tactical element in the attack’s area, requires, besides the daily training and efficient biomechanics, an optimal health of the osteo-articular and muscular system, due to the fact that the performance of this element requires forceful speed developed throughout the muscle chain. The purpose of the present scientific research is to identify the problems occurred at spine level resulted following to topspin attack and the importance of this technical element in the female junior’s performance. The social enquiry-based survey was conducted on a number of 27 coaches and athletes, using a number of 15 questions. Objectives: optimization of topspin attack in 11-12 years old female juniors. Premises: the knowledge on statistics of spine specific areas generating pain at the time of the attack will allow us to create a postural correction program meant to optimize performance. Research methods: The registration method was based on an opinion poll, on a statistical and mathematical method, on computer graphics method. Conclusion: around 78% of the interviewed specialists consider that the lumbar area is the most affected and predisposed to pain in case of topspin, existing a strong correlation between it and the technical element considered to be the most important in the attack phase (topspin – 66.67%) in female juniors, p = 0.003 < α = 0.05, V = 0.620 and C = 0.659.

Effects of a Personalized Exercise Rehabilitation Device on Dynamic Postural Balance for Scoliotic Patients: A Feasibility Study

Scoliosis, which is defined as a 3-dimensional spine deformity, may be caused by new-onset degenerative changes that occur well after skeletal maturity and exhibit an asymmetrical postural balance pattern more common to adult deformity than adolescent scoliosis. The aim of this study was to verify whether an exercise program using a personalized exercise rehabilitation device can influence the dynamic postural balance of scoliotic patients. The personalized exercise rehabilitation device was designed to increase the efficacy of 3D postural correction for different curve patterns. 20 subjects were instructed to perform the personalized exercise program that consists of axial elongation, derotation, deflexion, facilitation and stabilization. The results of this study showed that the differences in clinical variables associated with imbalanced posture between the convex and concave side decreased after performing the personalized exercise. Consequentially, a well-designed and manufactured exercise rehabilitation device could be helpful for improving postural balance. Furthermore, the paper suggests that specific exercises using a personalized exercise rehabilitation device can provide the most appropriate exercise therapy and positively correct the asymmetrical postural balance patterns for scoliotic patients.