Prehabilitation in a Periprosthetic Fracture of the Femur: A Case Report.

Periprosthetic fractures (PPF) are related to orthopaedic implants like internal fixators, replacement devices, etc. In this case report, we discussed a 55-year-old male patient who came to our tertiary care hospital with complaints of pain and swelling over the left hip for six months. After radiological investigations, he was diagnosed with a left PPF of the femur with posterior dislocation. He was referred to the musculoskeletal physiotherapy department for in-patient rehabilitation before surgery. He received strengthening exercises for lower limb, back, and abdominal muscles, pain management, gait training, etc. for two weeks before his decided surgery date. The patient showed improved strength and maintained his range. There were an improved Visual Analogue Scale (VAS) score and a Lower Extremity Functional Scale (LEFS) score, which signified a reduction in pain and improved functional independence due to enhanced lower limb function, respectively.

Rehabilitation of a Patient With D12 Wedge Compression Fracture and Bilateral Foot Drop With Spinal Fusion and Posterior Decompression: A Case Report.

Vertebral fracture (VF) is one of the most common injuries seen in individuals with osteoporosis, especially in post-menopausal females. There is an increase in bone resorption rate, leading to the destruction of the microarchitecture of bone. A 67-year-old female patient diagnosed with wedge compression fracture of the D12 vertebra, mild compression of the spinal cord, and bilateral foot drop came to a tertiary care hospital, where she underwent spinal fusion at the D11-L1 level and posterior decompression, after which she was referred to physiotherapy, where a patient-tailored treatment protocol was made and implemented over three weeks. Outcome measures like the visual analog scale (VAS), functional independence measure (FIM), and Oswestry's low back disability questionnaire were recorded before and after rehabilitation, and improvement in pain and activities of daily living (ADL) was found. The patient needed mild assistance. There was also improvement in the range and strength of the lower limb muscles. This case report aims to provide a comprehensive treatment protocol for a post-operative spinal fusion and bilateral foot drop patient.

Positive Outcomes of Physiotherapy Intervention in a Wedge Compression Fracture of the L1 Vertebra: A Case Report.

The thoracolumbar spine is prone to vertebral compression fractures (VCFs). An injury mechanism known as flexion compression is responsible for thoracolumbar spine compression fractures. Usually, this mechanism affects the longitudinal ligament at the front and the front part of the vertebral body as the first components. Pain is the first and foremost symptom; here we present a case report of a 34-year-old male, who came to the hospital with complaints of back pain, and difficulty in breathing followed by a road traffic accident (RTA). MRI and X-ray investigations were done. The patient was diagnosed with a fracture of the anterolateral aspect of the right fourth and fifth ribs and posterolateral aspect of the sixth rib, acute anterior wedge compression fracture of the L1 vertebra, and bilateral minimal pneumothorax and haemothorax. The patient was managed surgically with post-decompression and spinal fusion at the D12-L2 level. The outcomes used were the Oswestry Low-Back Disability Questionnaire, the numerical pain rating scale, and Manual Muscle Testing (MMT). This case report specifies the physiotherapeutic rehabilitation protocol, mainly focusing on techniques like breathing exercises, and upper limb and lower limb strengthening along with trunk and pelvic floor muscles strengthening.

Physiotherapy Approach to a Stage V Parkinson's Disease Patient: A Case Report.

Parkinson's disease (PD) is a neurodegenerative disorder caused due to decreased dopamine, a neurotransmitter, advancing to a range of motor and non-motor attributes. There is a death of dopamine-producing neurons (dopaminergic neurons) in the Substantia Nigra. Bradykinesia, postural instability, resting tremor, and rigidity are four main symptoms in this patient. A variety of other symptoms, like hypomimia, micrographia, freezing gait, decreased movement amplitude, constipation, cognitive impairments, etc., can be seen in this patient. In this paper, we report a 62-year-old female with stage 5 PD with chief complaints of uncoordinated movements, weakness, and difficulty in daily activities. She was treated with strengthening, stretching, Lee Silverman Voice Treatment (LSVT) BIG, bed mobility, gait training with auditory cueing, balance training, etc. LSVT-BIG enhances motor function by incorporating high amplitude motions of high intensity, consisting of numerous repetitions and progressive complexity. At the end of three weeks, the patient had improved strength, static and dynamic balance, gait, and quality of life.

Physiotherapeutic Approach for Septic Arthritis of Knee Joint.

Septic arthritis is an orthopaedic emergency associated with poor prognosis in cases with delayed treatment. The standard routes through which the infection spreads are hematogenous and direct entry. Any delay in medicine could mean the patient facing severe joint destruction, limitation in joint range, and inability to do activities of daily living. Septic arthritis is treated with a multidisciplinary approach in which physiotherapy is essential in making patients functionally independent. This article discusses a 58-year-old male patient with pain and swelling in the right knee joint and difficulty doing activities like walking, squatting and climbing stairs. On further investigations and diagnostic arthroscopy, he was diagnosed with septic/pyogenic arthritis caused by Staphylococcus aureus in the right knee. The patient was being treated with antibiotics. Along with it, patient-tailored physiotherapy rehabilitation, including, but not limited to, strengthening, range of motion (ROM) exercises, endurance training, etc., was also given, which proved highly effective at enhancing the patient's functional independence and quality of life. The outcome measure used in this report is the Knee Injury and Osteoarthritis Outcome Score (KOOS).

A Comprehensive Physiotherapeutic Rehabilitation Protocol for Malunited Post-operative Patellar Fractures: A Case Report.

A patellar fracture is a fracture of the kneecap. The patella is a shield that plays a vital function in the biomechanics of the knee joint. Traumatic knee injuries produced by direct trauma or quick quadriceps contraction with the knee bent can result in the loss of the extensor mechanism. A 69-year-old female patient presented with pain in her right knee following a slip at her home, which resulted in an injury to her knee. Subsequently, a radiological investigation suggests a patellar fracture. The purpose of this case report is to investigate the rehabilitation techniques and concrete the result. This report emphasizes the value of a comprehensive rehabilitation program designed to assist people with this type of fracture pattern in reaching their peak operational capacity. The patient underwent a comprehensive rehabilitation regimen that included cryotherapy, range of motion exercises, strengthening exercises, gait training, balance and proprioception training. The functional outcomes were assessed using a visual analogue scale, goniometry, manual muscle testing, Berg balance scale and lower extremity functional scale. The patient exhibited significant improvement and a positive response to the therapeutic techniques and outcome assessments. This underscores the necessity for a well-rounded treatment approach to manage patellar fractures and optimize patient outcomes effectively.

Rehabilitation of Traumatic Acute Subdural Hematoma and Subarachnoid Hemorrhage: A Case Report.

A head injury or cerebrovascular illness may be the cause of acute intracranial hemorrhage. Making a precise diagnosis is challenging since diagnostic imaging might be challenging in both situations. In this case report, an aneurysmal rupture related head injury resulted in an acute subdural hematoma (SHD) after the patient lost consciousness. A 54-year-old male was found in a state of unconsciousness on the ground and was brought to the nearest hospital. Computed tomography (CT) scan showed an oblique fracture involving the bilateral frontal and right parietal bones along with underlying SDH, subarachnoid hemorrhage (SAH), and hemorrhagic contusion along with midline shift. The case report highlights the rehabilitation journey of a patient with acute SDH and SAH. The patient can now sit independently and stand with minimal assistance. Vasospasm detection, prevention, and treatment need to be the norm at that time. This case demonstrates the effectiveness of a comprehensive rehabilitation approach in promoting mobility and independence for patients with traumatic brain injuries.