Proprioceptive Neuromuscular Facilitation (PNF) and Modified Procedures for Anterior Cruciate Ligament (ACL) Instability.

Techniques and procedures of proprioceptive neuromuscular facilitation (PNF) are well accepted for therapeutic exercise in rehabilitation of orthopaedic problems. Specific application for the treatment of knee ligament instabilities has not been documented in the literature. Spiral and diagonal PNF patterns emphasize rotatory components of joint function and can provide emphasis in selected musculotendinous structures of the knee. This article describes the application of therapeutic exercise techniques and procedures for anterior cruciate ligament (ACL) and resultant instabilities. J Orthop Sports Phys Ther 1989;11(6):230-236.

Rehabilitation of symptomatic anterolateral knee instability.

Anterolateral instability is a common lesion of the knee which can result in significant disability. Without treatment, this problem can typically cause recurrent meniscal tearing, increased joint laxity, progressive giving way, joint surface deterioration and restrictions of functional activities. Although surgery can be performed to improve static stability, many patients elect a nonoperative approach based on a knee rehabilitation program. The purpose of this paper is to discuss anterolateral knee instability and the authors' conservative management program. Two collegiate athletes are presented as case studies. Both had positive signs of anterolateral instability, but following arthroscopic surgery and rehabilitation, they were asymptomatic with no limitations in functional activity. One of the subjects discontinued rehabilitation prematurely and resumed sports with no recurrence of functional instability or synovitis, but continued with patellofemoral dysfunction. Nonoperative treatment can be effective in providing functional stability to the ACL-deficient knee with signs of anterolateral instability (i.e., positive pivot shift). More reports of similar cases and rehabilitation studies with long-term follow-up are necessary for comparison with surgical results, which are currently controversial and often disappointing. J Orthop Sports Phys Ther 1989;11(6):237-244.

Posterior shoulder instability: approach to rehabilitation.

The treatment of posterior shoulder instability can be a frustrating experience for both the patient and the clinician. Although operative versus nonoperative treatment of this problem has been debated in the literature, and various surgical approaches presented, little specific information can be found regarding the components of an effective rehabilitation program. This paper presents an overview of the dynamics of posterior shoulder subluxation and the authors ' approach to conservative management, with particular emphasis on therapeutic exercise techniques and procedures. J Orthop Sports Phys Ther 1989;10(12);488-494.

A case of prolonged, reversible dementia associated with abuse of electroconvulsive therapy.

Standards for the use of electroconvulsive therapy (ECT) are being considered in Massachusetts. While the relative safety of ECT is sometimes used to justify its extensive use, ECT is abused in some cases, causing prolonged deficits in sensorium. A case of an ECT-induced, prolonged, reversible dementia is presented as an example of present abuses and the need for standards.