From Trauma to Recovery: A Comprehensive Management of Achilles Tendon Injury in a Young Female.

The incidence of the Achilles tendon getting injured has recently increased by 18 in 100,000. Compared to non-surgical treatment, surgical results are superior. The Achilles tendon repaired with surgery has a re-rupture rate of only 5%, while if treated non-operatively, it has a rupture rate of 40%. This case report analyses the traumatic Achilles tendon rupture and subsequent surgical repair in a young woman. In this case study, a 19-year-old female patient's severe Achilles tendon injury was successfully managed by integrating prompt surgical intervention and structure. After rehabilitation, the patient's range of motion (ROM), muscle strength, and gait patterns all significantly improved. Scores on the Lower Extremity Functional Scale (LEFS) and the Dynamic Gait Index (DGI) both significantly improved. This case study reiterates the significance of an integrated healthcare strategy for Achilles tendon injuries. An immediate surgical procedure followed by a specific rehabilitation programme accelerates healing and the return to optimal function. The results emphasize the critical role of physical therapy in assisting surgical interventions and underline the necessity of comprehensive patient care in the treatment of complex orthopaedic problems.

Effectiveness of Sensory Integration Therapy on Functional Mobility in Children With Spastic Diplegic Cerebral Palsy.

Background  A set of non-progressive brain abnormalities and nervous system dysfunctions are referred to as cerebral palsy (CP). Due to this, the child's mobility, eyesight, learning, and thought processes are affected. It can evolve before, through birth, or the first year of a child's life. The activity through which the brain organizes and analyses external sensations like touch, motion, body awareness, vision, hearing, and gravity is indicated as sensory integration. The use of sensory integration therapy (SIT) necessitates that the sensorimotor exercises target the specific parts of difficulties that the child experiences daily. This study aims to study the effectiveness of SIT on functional mobility in children with spastic diplegic CP. Methods In this study, 40 children of CP with spastic diplegic who met the inclusion and exclusion criterion were enlisted and were separated into two groups, with Group A (n=20) receiving SIT for 25 minutes along with conventional physiotherapy for 20 minutes, and Group B (n=20) were given conventional physiotherapy for 45 minutes. A four-week therapy plan was followed. Short sensory profile (SSP) and Gross Motor Function Classification System (GMFCS), Pediatric mini-mental state examination (MMSE), and Modified Ashworth Scale were taken as outcome measures. Results SIT along with traditional treatment is described in the study protocol which aids CP children to improve themselves. Following a four-week protocol, combined therapy of SIT and conventional physiotherapy show an effect on the motor function of the children. After therapy, scores in GMFCS and SSP improved. By using Student's paired t-test, a statistically significant difference was found in GMFCS score at pre and post-test treatment in group A (7.28, p=0.0001) and group B (4.48, p=0.0001), in SSP score at pre and post-test treatment in group A (27.91, p=0.0001) and group B (11.31, p=0.0001), in MMSE score at pre- and post-test treatment in group A (6.89, p=0.0001) and group B (6.32, p=0.0001). The significance threshold was p<0.0001. Conclusion Under the study's experimental conditions, both groups showed substantial improvements in the functional mobility of children. When the efficacy of SIT along with conventional physiotherapy was examined, the impact resulted in a significantly greater improvement in the functional mobility of spastic diplegic CP children.

Promoting Survival and Primitive Reflexes to Prevent Brain Imbalance in Premature Infants: A Scoping Review of New Insights by Physiotherapists on Developmental Disorders.

Survival reflexes, originating from the brainstem, are involuntary motor responses that are present at birth and facilitate the survival of the neonate. The age of the baby is critical enough to give information about the maturation of these reflexes. In the case of preterm babies, the delayed maturity of these reflexes may pose a threat to the life of the newborn. One can perceive what the baby can feel, taste, smell, see, and hear through reflex maturation. The objective was to identify and understand the role of survival reflexes and primitive reflexes and their importance in premature children. PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), ProQuest, The Cochrane Library, Scopus, and Web of Science were the electronic databases used from January 2017 until November 2022. We included the original articles, reviews, and randomized clinical trials that focused on the importance of survival reflexes. Later on, all the articles were systematically arranged as per the information they provided, and 101 titles were selected, of which 32 met the inclusion criteria. Various articles were written regarding the present literature about primitive reflexes, but none promoted them in the neonatal intensive care unit (NICU). This review is regarding the use of survival reflexes to improve the outcomes of neonates, specifically in the NICU. Simple interactions with the environment are made possible by primitive reflexes, which also serve as the foundation for early movement. This review presents a better understanding of the maturation of survival reflexes and primitive reflexes and provides further insight into how a physiotherapist can concentrate on the early identification and development of these reflexes to prevent further complications. Assessing the primitive reflex in the NICU will help in the early identification of developmental delay and further help us predict reflex maturation. Promoting them will provide positive outcomes in terms of neonatal development. A physiotherapist can play a vital role starting from the NICU to get the baby into an environment similar to the mother's womb and therapy to get the early maturation of the reflex.

Effect of the Dynamic Neuromuscular Stabilization Technique on Functional Capacity in Overweight and Obese Individuals: A Randomized Controlled Trial.

Background Individuals with overweight and obesity (OW/OB) have poor performance in weight-bearing exercises, resulting in low functional capacity. The dynamic neuromuscular stabilization (DNS) technique was created to engage the core-postural chain in conjunction with the core muscles, generating enough intra-abdominal pressure to dynamically support the spine through muscular activity. DNS is a strategy that emphasizes the activation of the spine's intrinsic stabilizers, as well as proper breathing patterns, before any intended functional movement. The aim and objective of this study was to determine the effectiveness of the DNS technique on functional capacity in OW/OB individuals and to compare the effectiveness of the DNS and conventional approach. Methods The study recruited 100 individuals, who were separated into an experimental group (DNS technique) and a control group (conventional exercises), each with 50 participants. Outcome measures, including a six-minute walk test (SMW test) and body mass index (BMI), were taken pre-treatment and post-treatment. Results and discussion Based on the inclusion criteria of this study, the age group included was 20 to 25 years old. Pre- and post-treatment statistically significant changes were observed in the experimental and control groups in the BMI and SMW test. However, the BMI (kg/m2) was not statistically significant in the experimental group (t-value=-0.15, p=0.87) and control group (t-value=-0.22, p=0.82). Moreover, in the SMW test (meter), no statistical significance was found in the experimental group (t-value=-0.15, p=0.87) and control group (t-value=- 0.22, p=0.82). Conclusions Both groups are effective in increasing the functional capacity of obese and overweight individuals. The study indicates a strong need for further research into its long-term effectiveness in the OW/OB population.

Handwriting Evaluation in School-Aged Children With Developmental Coordination Disorder: A Literature Review.

Despite widespread computer use, legible handwriting remains an important common life skill that requires more attention from schools and health professionals. Importantly, instructors and parents typically attribute the difficulties to laziness or a lack of effort, causing the youngster anger and disappointment. Handwriting issues are a public health concern in terms of both prevalence and consequences. Writing is a tough and diverse activity that requires cognitive, perceptual-motor, mental, and emotional talents. It is largely a motor process involving an effective level of motor organization that results in exact movement synchronization. Handwriting problems have been connected to developmental disorders such as developmental coordination disorder. For the affected youngsters, forming letters takes more work, and the kid may forget what he or she planned to write. School children's primary handwriting issues include illegible writing, slow handwriting, and strained writing. Handwriting problems may lead to scholastic underachievement and low self-esteem. Because of this complication, some school-aged children develop handwriting difficulties, which cause psychological distress and learning impairments. In the treatment of children with bad handwriting, the therapeutic intervention has been demonstrated to be successful. We aimed to determine how efficient tools and scales are which assess handwriting in school-aged children having developmental coordination disorder. Keyword searches were conducted on Google Scholar and PubMed, yielding 45 results, eight of which met the inclusion requirements. We concluded that there are a lot of scales and tools to date but no scale focuses on the temporal and spatial parameters for handwriting evaluation.

Advantages of a Structured Conditioning Program to Optimize the Aerobic Capacity and Functional Independence of a Patient With Acute Inflammatory Demyelinating Polyneuropathy.

Acute demyelinating inflammatory polyneuropathy is a variant of Guillain-Barre syndrome (GBS) - an asymmetrical condition that primarily affects the segment of the peripheral nervous system. Weakness or tingling sensations that be commenced in the inferior limbs and progress to the brachium and face are early signs of this condition. Physiotherapy plays a very crucial role in acute demyelinating inflammatory polyneuropathy in combination with medical management. Criteria through which the clinicians conclude the same are marked affection in the proximal musculature, lower motor neuron type of manifestation, and commencement of symptoms in an ascending sequence. In this study, we presented a case of a 62-year-old male who manifested with the complaint of bilateral superior and inferior limb weakness and was admitted to our hospital. He was diagnosed with acute demyelinating inflammatory polyneuropathy after investigations, such as a lumbar puncture, which revealed a raised level of proteins in cerebrospinal fluid (CSF). With these complaints, he was referred to the physiotherapy wing, and physiotherapy rehabilitation was commenced. Thus, we concluded from this study that in the case of acute demyelinating inflammatory polyneuropathy, physiotherapy rehabilitation was proven to be fruitful in the speedy recovery of the patient and preventing secondary complications along with improving strength and activities of daily living (ADLs) and enhancing the overall quality of life.

Positive Outcomes of Early Task-Specific Training and Action Observation Mirror Therapy Following Infarction of Hand Knob Area: A Case Report.

Traumatic nerve damage or compression neuropathy is the most common cause of unilateral weakness in an upper extremity. Rarely, a central nervous system lesion may cause syndromes that initially appear to indicate peripheral nerve injury. The most well known of these is pseudoperipheral hand palsy, which is typically brought on by a minor brain lesion in the contralateral motor cortex. The term "hand knob" refers to a restricted area in the posterior frontal lobe's precentral gyrus, a lesion that causes isolated weakness in the upper extremity that mimics injury to peripheral nerves. The majority of the time, an embolic infarction is the cause of this uncommon condition. We present a case of a 52-year-old female who presented to the medicine outpatient department with sudden onset of acute pure motor paresis of the right hand. She also complained of clumsiness in her hand and several episodes of generalized headache in the parieto-occipital region in the past two weeks. Following an initial evaluation by a physician, she was advised for MRI of the head and neck, which reported occlusion in the petrous part of the left internal carotid artery, and referred to physiotherapy for further management. She was assessed and a task-specific training protocol was made for the patient, which also included physiotherapy techniques like grip exercises, mirror therapy, and strengthening. There was an improvement in the patient within a few weeks that was evident with the outcome measures post-rehabilitation. This case study is really a good case not only in regards to peculiarities and clinical presentation but also in promoting rarely implementation of rehabilitation to get patients back to their previous functional status.

Appraisal of the Effectiveness of Pelvic Proprioceptive Neuromuscular Facilitation Methods to Optimize Balance and Gait in an Eight-Year-Old Child.

Among the different variants of cerebral palsy (CP), spastic diplegia has a greater frequency than the other variants, with each subtype having a diverse clinical presentation. Pelvic asymmetry is observed frequently in children with spastic diplegia which influences the functional abilities of the child such as balancing abilities and independent walking. Currently, physical therapists tackle this condition through numerous strategies of treatment, with each treatment strategy having its own significance. This case report emphasizes the effectiveness of pelvic proprioceptive neuromuscular facilitation (PNF) techniques in optimizing the balance and gait parameters in an eight-year-old female child who presented with spastic diplegia. The child came into the outpatient Department of Neuro Physiotherapy with complaints of delay in attaining milestones according to her age as well as her inability to balance and walk on her toes. History revealed that there was a delayed cry pointing toward birth asphyxia and the linkage of birth asphyxia in the emergence of CP. Pelvic PNF has a beneficial impact on optimizing trunk control and stability. This research presents evidence that pelvic PNF optimizes the balancing capacities and gait parameters and rectifies the malalignment of the pelvis in children with spastic diplegia. The findings of this case report prove that pelvic malalignment which influences the balance and walking abilities of the child can be rectified and tackled with pelvic PNF techniques.

Bilateral Lower Limb Training for Post-stroke Survivors: A Bibliometric Analysis.

Stroke is one of the most disabling conditions affecting the middle-aged population all around the world. This study aims to explore the rehabilitation of stroke patients using bibliometric analysis, which includes statistical analysis of recent articles, books, and other kinds of publications, to assess scientific output and determine the significance of scientific investigations in terms of both quality and quantity. In this study, an analysis of global trends in research in bilateral lower limb training for training balance and walking for patients in the subacute stage post-stroke between 1988 and 2021 was done. All the articles were obtained from PubMed databases. CiteSpace software was used to analyze the relationship between publications and country, journals, institutions, authors, references, and the keywords used. A total of 160 publications were included in the analysis. There was a tremendous increase in the research of physiotherapy intervention in patients who had residual disability post-stroke with a publication rate of 7.1 articles per year of publications. The use of the sophisticated PubMed database to extract articles allowed for a thorough and powerful bibliometric analysis of stroke rehabilitation research published between 1988 and 2020. In general, the number of studies on bilateral training has increased in recent decades. This historical overview of rehabilitation for post-stroke survivors will serve as a valuable starting point for future study into possible collaborators, focus issues, and trends. This bibliometric analysis highlights the potential value of exercise therapy for stroke survivors in creating more effective hemiplegia rehabilitation programs. This research may encourage the use of strengthening in the therapeutic therapy of hemiplegia balance. The groundwork will be laid for future research on strengthening stroke to be organized and given top priority.

Novelty in the Impact of Physical Therapy in a Known Case of Right-Sided Grade V Facial Nerve Palsy: A Case Report.

Here we present a case study of a 75-year-old hypertensive elderly male suffering from right-sided malignant otitis externa with right-sided grade V facial nerve palsy. Malignant otitis externa is an uncommon but critically and extremely challenging kind of disease, along with the involvement of cranial nerves. The main aim of our case study is to highlight and explain the novelty impacts, efficacy, and role of physical therapy interventions and rehabilitation strategies in this case. The assessment consists of observations and structural impairments assessed through proper assessment strategies. The outcome measures used here are the House-Brackmann Facial Nerve Scale and the Sunnybrook Facial Grading Scale.

Effectiveness of Pelvic Proprioceptive Neuromuscular Facilitation on Balance and Gait Parameters in Children With Spastic Diplegia.

Background  Among several variants of Cerebral Palsy, Spastic Diplegic is encountered most commonly in clinical setups. A majority of children with Spastic Diplegia manifest themselves with a disturbance in the geometrical orientation of their pelvis, which imposes an effect on their functional capabilities like walking with independence. This research had an emphasis on the extraction of the efficacy of Pelvic Proprioceptive Neuromuscular Facilitation (PNF) Techniques on Balance and Gait Parameters in children suffering from Spastic Diplegia. Method Participants included in the study were between the age groups of 8 to 12 years who were diagnosed with Spastic Diplegia with an independent sitting and walking ability and who are coming in stages I to III according to Gross Motor Function Classification System. Subjects in group A were given Pelvic PNF techniques for 15 minutes on both sides along with Task-Oriented training for 30 minutes, six days a week and continuously for four weeks, while the subjects in group B were given only Task-Oriented activity for the same duration. The pre- and post-treatment assessments of all 40 subjects were gathered using the Paediatric Balance Scale, Palpation Meter device, and Gait Parameters. Results The study included 40 participants, which were segregated into two groups of 20 subjects in each group. Group A received Pelvic Proprioceptive Neuromuscular Facilitation with Task-Oriented Training, and group B received only Task-Oriented training activities. The contrast of pre- and post-treatment findings of both the groups revealed that group A reported a significant improvement in their outcomes (P>0.0001). Conclusion  The present study, which included 40 subjects, has generated evidence regarding the efficacy of Pelvic PNF on Balance and Gait Parameters in children with Spastic Diplegia.

Vestibular Rehabilitation Thinking Beyond Benign Paroxysmal Positional Vertigo: Inference in a Rare Case of Oculocutaneous Albinism.

Albinism is a group of heritable illnesses defined by a lack or loss of melanin in tissues originating from the ectoderm (most notably the skin, hair, and eyes). The most common kind of albinism is oculocutaneous albinism (OCA). Clinical evidence of less pigmentation of the hair and skin, as well as the characteristic ocular symptoms, are used to diagnose OCA. Nystagmus is one of the impacts of albinism on the eyes. Nystagmus is a term for involuntary ocular movements that are usually conjugate and rhythmic. Almost always, vertigo, dizziness, and loss of balance occur when nystagmus is accompanied by a condition of the inner ear's vestibular system or the brain. Nystagmus, which is induced by the rotation of an optokinetic drum or the rotation of the body in space, aids in visual maintenance. This case report describes the case of a 10-year-old male child with nystagmus associated with albinism, with typical complaints of dizziness that are scored on a Vanderbilt Pediatric Dizziness Handicap Inventory for Patient Caregivers (DHI-PC). Vestibular rehabilitation for nystagmus aids gaze stabilization, ocular muscle strength improvement, and vestibular function maintenance. The patient recovered with well-planned vestibular rehabilitation, which included gaze stability exercises, Cawthorne-Cooksey exercises, habituation exercises, eyeball resistance exercises, eye-hand coordination exercises, and parent education and home exercise programs.

Effectiveness of Pelvic Proprioceptive Neuromuscular Facilitation Techniques on Balance and Gait Parameters in Chronic Stroke Patients: A Randomized Clinical Trial.

Background Stroke is the second leading reason for death and the third most common reason for disability. Stroke is a source of possible substantial harm and is often more disabling than lethal. Common stroke defects include stiffness, tiredness, loss of balance on the afflicted side, as well as gait impairment, resulting in an inability to sustain postural alignment. Pelvic proprioceptive neuromuscular facilitation (PNF) is a physical rehabilitation that combines functionally dependent diagonal activity patterns with neuromuscular facilitator strategies to improve motor behaviour, endurance, and muscle activity and control. This protocol was created to describe the experimental study design for evaluating the combined impact of pelvic PNF and task-oriented exercises in chronic stroke patients to improve balance and gait parameters. Aim and objective The purpose of our study is to investigate the effectiveness of pelvic PNF as well as task-oriented exercises on balance, gait parameters, and in pelvic asymmetry. Methods The participants (n=30) were stroke survivors who fulfilled the inclusion criteria for research and were divided into two groups. The regimen lasted four weeks and took 30 minutes each day. Patients were evaluated at the beginning and end of their treatment. In both groups, pre- and post-intervention outcome measures were recorded and the data was analyzed. Result Following four weeks of rehabilitation, subjects showed remarkable improvement in balance, gait parameters, and pelvic inclination in both groups, i.e., pelvic PNF and task-oriented exercises in group A and task-oriented exercises in group B, but Group A showed a major improvement in outcome measures. A p-value of less than 0.05 was considered significant. Despite the fact that both treatment regimens were successful for the patient, pelvic PNF combined with task-oriented exercises exhibits a statistically significant difference from task-oriented exercises. Conclusion Pelvic PNF along with task-oriented exercises proved to be beneficial and can help in the restoration of balance and gait parameters as a result of normalisation in the geometry and symmetry of the pelvis in stroke patients. The pelvis, which is a connecting link between the trunk and lower limbs, plays a crucial role in balance and also in lower limb performance exclusively in gait.

Efficacy of Bilateral Lower-Limb Training Over Unilateral Lower-Limb Training To Reeducate Balance and Walking in Post-Stroke Survivors: A Randomized Clinical Trial.

Background and objective While designing the rehabilitation regime of a hemiplegic patient, most physiotherapists focus on the affected/hemiparetic side. The less affected/unaffected side remains unused and loses its properties, i.e., muscle strength, girth, balance, and gait, thus causing deconditioning effects in patients' overall rehabilitation. To enhance the recovery process, the focus should be drawn to training both sides equally to fasten the recovery process. The rationale behind designing this study was to maintain the integrity of the unaffected side along with rehabilitation of the affected side in hemiplegic patients. Many proven studies focus on bimanual upper-limb training in post-stroke survivors, but there is a lack of literature regarding the same in the lower limbs. This clinical trial was designed to study the effect of bilateral lower-limb training over unilateral lower-limb training on balance and walking in post-stroke survivors. Methods 40 hemiplegic patients were selected and randomly divided into two groups: Group A (unilateral training group (UTG)) and Group B (bilateral training group (BTG)). Patients in Group A underwent approach-oriented training using the motor relearning program (MRP) and proprioceptive neuromuscular facilitation (PNF) for the affected side, while those in Group B underwent strength training for the lower-limb muscles using DeLorme's principle for the unaffected side and approach-oriented training using the MRP and PNF for the affected side for a period of six weeks, five days per week. A strengthening regimen was designed for the unaffected side, considering the frequency, intensity, time, and type (FITTs) principle provided by the American College of Sports Medicine (ACSM). The static and dynamic balance along with gait parameters were measured using the functional reach test (FRT), one-leg stance test (OLST), Berg balance scale (BBS), Dynamic Gait Index (DGI), gait parameters (stride length, gait velocity, and cadence), and Brunnstrom recovery stages (BRS) at the baseline and post rehabilitation. Results Both groups significantly improved following therapy (p<0.05). Group B showed more significant results both statistically and clinically. The enhancement in the FRT (2.25, p<0.03), OLST (5.12. p<0.0001), BBS (0.68, p<0.020), and DGI (1.70, p<0.030) scores indicated improvement in static and dynamic balance in the two groups. Patients showed improvement in the stereotyped sequence of movements indicating recovery on the BRS (4.62, p<0.0001). The overall gait parameters in patients, i.e., gait velocity (6.78, p<0.0001), stride length (3.59, p<0.001) and cadence (6.15, p<0.0001), improved post rehabilitation. Conclusion The results of this study showed that the BTG had positive impacts on the postural balance and walking capacities of subacute hemiparetic stroke patients, promoting early recovery in comparison to the UTG. This study also helped to design a strengthening protocol for the unaffected side according to DeLorme's principle in line with the FITTs principle.

Early Rehabilitation for Cerebellar Complications Following Left Atrial Myxoma Excision: A Stitch in Time Saves Nine.

The most known of all primary cardiac tumors is myxoma, which is most usually detected in the left atrium. As there are no physical signs or symptoms, a diagnosis is rarely made purely based on clinical evidence. Our study aims to investigate the case of post-operative left atrial myxoma with cerebellar signs. A 50-year-old woman complained of dizziness and syncope, which caused her to collapse on the floor early in the morning. Myxoma in the left atrium and mitral valve regurgitation was discovered after prompt medical assistance. She was recommended for surgery to excise the left atrial myxoma and mitral valve repair. Post the surgery, she developed breathing difficulties and cerebellar signs for which she was referred for physiotherapy. She underwent two weeks of tailor-made inpatient rehabilitation. This case study intends to emphasize the importance of early diagnosis, treatment, and, most importantly, rehabilitation to return the patient to her functional state. A structured exercise regimen assists the patient while also reducing post-surgery problems. Timely monitoring and treatment are projected to improve outcomes in patients treated with a multidisciplinary approach.

The Effect of Neuro-Physiotherapy on Gross Motor Function in a Male Child With Spastic Diplegic Cerebral Palsy: A Case Report.

Cerebral palsy (CP) is a condition caused by a non-progressive lesion in the developing brain. CP has a wide range of prevalence, ranging from 1.5 to three cases per 1,000 persons. Newborns weighing less than 2,500 grams now account for half of all incidences of CP. Clinical management in physical therapy is a paradigm for enhancing organizational capacity, integrating evidence-based best practices, and enhancing outcomes. This is a case report of a 21-month-old male child with a history of sudden onset of seizure, fever, drowsiness, frothing from the mouth, and up rolling of eyes. He had a global developmental delay with microcephaly and breakthrough seizures with anemia under evaluation. Magnetic resonance imaging (MRI) brain revealed the possibility of hypoxic-ischemic insult. The child was managed conservatively using medications i.e., ibuprofen (7.5mL/6hrly), cephalosporin (450mg/day in divided doses), and phenytoin. Physiotherapy management was provided with integrative approaches including Neurodevelopmental treatment principles, passive stretching, static weight-bearing exercises, and task-oriented approaches. The evaluation was done using the Modified Ashworth Scale and Gross Motor Function Measure-88 (GMFM-88). Early physiotherapy with integrative approaches helps in the improvement of gross motor developmental milestones in children with Spastic diplegic CP.

Impact of Neuro Physiotherapeutic Reformation in a Teenager Agonizing With Guillain-Barre Syndrome Linked With COVID-19 Infection.

Coronavirus disease 2019 (COVID-19) has spread around the globe. The most common symptoms associated with this are usually respiratory, but different central nervous system manifestations have been reported. There are many cases of Guillain-Barre syndrome (GBS) post-COVID-19. However, only a few simultaneous afflictions of COVID-19 with GBS have been reported. Therefore, our study aims to investigate a case of GBS along with COVID-19 infection in India. A 22-year-old male with no medical history presented with fever along with global weakness and breathing difficulty. There was no history of travel. At the time of admission, he had developed quadriparesis and had muscular strength of 2/5 in bilateral lower limbs and 3/5 in bilateral upper limbs. When the patient developed breathing difficulty, he was transferred to the intensive care unit. The cerebrospinal fluid evaluation showed albumin-cytological dissociation, and a nerve conduction study was done. The patient was managed by neuro physiotherapy 34 days after COVID-19 exposure. After proper physiotherapy and rehabilitation, the patient was able to return to his college life.

Novelty in Impact of Neurorehabilitation in a Classic Case of Syringomyelia.

A fluid-filled hole inside the parenchyma or central canal of the spinal cord causes syringomyelia, a neurological condition. It is most frequently linked to type 1 Chiari malformations. Syringomyelia can be caused by tumors in the spinal cord, trauma, and post-traumatic or infectious adhesive arachnoiditis. Syringomyelia is shown to have a prevalence of 8.4/100,000 to 0.9/10,000 in certain studies, making it one of the few unusual cases. A large proportion of patients are between 20 and 50 years of age. In our case, the patient is a 17-year-old boy who complained of tingling and weakness in both lower extremities, as well as loss of sensation in both hands. MRI of his spine revealed a Chiari I malformation involving evidence of medulla, fourth ventricle, and cerebellar vermis displacement into the foramen magnum. Arnold Chiari's malformation with cord syringomyelia and tonsillar herniation was diagnosed based on the symptoms and investigation findings. The goal of this case is to highlight the benefits of exercise treatment in improving the patient's quality of life, as physiotherapy protocol instillation is not practiced on a daily basis for such conditions.

The Refinement of Home Exercise Program for Children and Adolescents With Muscular Dystrophy in the Present COVID-19 Pandemic Scenario: A Scoping Review.

Muscular dystrophies (MDs) are a category of hereditary illnesses characterized by the gradual malfunction and/or weakening of the skeletal muscles. This disease of the muscles also results in hypotonia and joint contracture, along with raised serum creatine kinase (CK) levels. To prevent complications, continuous physiotherapy is advised for children with muscular dystrophy, which is even asked to perform at home as a home exercise program (HEP). As a result, the home exercise program (HEP) is critical in maintaining the optimal health of children with Duchenne muscular dystrophy (DMD). The present coronavirus (COVID-19) pandemic has adversely affected these children as there was very little scope to get direct help from a physiotherapist. Meanwhile, the home program was continued by many to compensate for the direct benefit. However, because of the lack of specific guidelines and structured methodology to follow for a home program, there was a deterioration in the health status of many children. There is a need to understand how the children are getting affected and the way the home program can be refined to help needy children with muscular dystrophy. Our scoping review aims to identify the present home program patterns being followed for children with DMD and their scope for refinement. The data were collected from electronic databases including PubMed, ProQuest, Cochrane, and Web of Science. We searched four electronic databases until September 2021. We included the published case studies, observational and experimental studies that described the positive impact of home exercise programs, and the methodology they followed as an alternative to institution-based physiotherapy. One hundred thirty-eight titles were screened, and 58 met the inclusion criteria. Along with regular physiotherapy, the incorporation of HEP helped in early complication prevention in patients with muscular dystrophy. The HEP was found to be a successful adjunct in the COVID-19 scenario. This review presents different therapeutic measures that can be taken for the prevention of complications in patients with MD and how the HEP plays an important role in removing the gaps on how HEP is beneficial in the COVID-19 scenario and a scope to refine the present methodologies for more accurate management.

Efficacy of Single Stretching Session of Iliopsoas Using Proprioceptive Neuromuscular Facilitation Versus Muscle Energy Technique on Low Back Pain in Patients With Lumbar Hyper-Lordosis.

Background and objectives One of the most frequent conditions for which people seek physiotherapy treatment is low back pain (LBP). When the aetiology of low back pain is whittled down to mechanical factors, pelvic tilting becomes apparent. The iliopsoas muscle is the key to relieving LBP in such circumstances, and since it is tightened, we concentrated on stretching it adequately in this study. Proprioceptive neuromuscular facilitation (PNF) and muscle energy technique (MET) are two stretching techniques that we have compared for this purpose. There are many other stretching techniques available, but the evidence has proven these two to be the most effective. Methods The participants in the study were those between the ages of 18 and 60 who had exaggerated lumbar lordosis, or LBP, and met the inclusion criteria. There were two groups created: A and B. PNF and traditional physiotherapy was used to manage the participants in group A, and MET and traditional physiotherapy were used to manage the participants in group B. Each group underwent the same pre-and post-tests, which included the Numerical Pain Rating Scale (NPRS) to assess pain intensity; a universal goniometer to measure hip joint extension range of motion (ROM) to assess iliopsoas flexibility; and a side-lying X-ray to measure the lumbosacral angle (LSA) to determine the angle of lumbar lordosis. Result In both the stretching interventions, i.e., PNF and MET, there were statistically significant differences in pain, hip extension range of motion, and lumbar lordosis angle (P > 0.0001). However, for the PNF group, the difference between the pre-and post-test was greater than that for the MET group. Conclusion The current study, which included 100 participants, demonstrated that both PNF and MET are remarkably effective for loosening the tight iliopsoas. A comparison of both techniques showed that the PNF group had benefited significantly more than the MET group.