Gait Training With Motor Relearning Program in Conjunction With Functional Electrical Stimulation in Quadriparesis Secondary to Cervical and Lumbar Myelopathy.

Degenerative cervical myelopathy is a frequently encountered age-related pathology following compression of the spinal cord. This case report delineates the clinical manifestation of cervical and lumbar myelopathy in a 78-year-old male patient, characterised by chief complaints of difficulty in moving bilateral upper and lower extremities and difficulty in bed mobility. Motor impairment can manifest in three different presentations, which are paraparesis, hemiparesis, or quadriparesis. The motor relearning program incorporating functional electrical stimulation constitutes a rehabilitative approach used for the restoration of motor function. This study outlines the protocol for the physiotherapy intervention protocol, mainly focusing on gait training. Along with it, balance training, proprioceptive neuromuscular facilitation, etc., were also included. The goal of physiotherapy rehabilitation was to improve the patient's ability to do tasks related to daily living. The outcome measures used were the dynamic gait index, functional independence measure, and Modified Japanese Orthopaedic Association score. We document significant increases in muscular tone and power, improved active range of motion, enhancements in gait parameters, and notable advancements in the individual's functional independence through the implementation of a physiotherapeutic regimen.

Enhancing Muscle Strength Post Anterior Cruciate Ligament Reconstruction: A Case Report Assessing the Effectiveness of Russian Current.

The effectiveness of Russian electrical stimulation in enhancing muscular strength after anterior cruciate ligament (ACL) restoration is examined in this case study. In addition to traditional physiotherapy, a 29-year-old male athlete having ACL repair took part in a Russian contemporary rehabilitation regimen. Subjective evaluations of pain and functional tests all showed a substantial increase in muscular strength following the intervention. The Russian current's distinct waveform and high-frequency bursts appeared to improve neuromuscular control and quicken the activation of skeletal muscle in the excitation-contraction phase. The evaluation conducted after the intervention revealed notable enhancements in muscular strength and scores on the lower extremity functional scale. The initial score of 32, indicating a moderate functional limitation, improved to 64, indicating a minimal functional limitation. Additionally, the use of Russian electrical stimulation in ACL rehabilitation programs resulted in a reduction in pain levels from 9/10 to 3/10, as measured by the visual analog scale. These findings suggest that the implementation of Russian electrical stimulation shows promise in ACL rehabilitation. However, to validate and further explore these results, it is necessary to conduct larger-scale research studies and randomized controlled trials.

A Tailored Physiotherapy Program in a Rare Case of Bilateral Territorial Cerebral Artery Infarction With Systemic Lupus Nephritis: A Case Report.

A stroke is a medical emergency that requires rapid treatment. Early intervention can help prevent brain damage and other negative consequences. An ischemic stroke occurs when a blood clot blocks or narrows a blood artery leading to the brain. Systemic lupus erythematosus (SLE) is characterized by systemic inflammation, autoantibodies, and a relapsing-remitting illness. Patients with SLE have an increased cumulative risk of cardiovascular events, including stroke, especially in the first five years after diagnosis. This case study presents the comprehensive physical therapy treatment of a 52-year-old woman diagnosed with systemic lupus nephritis and bilateral area infarct, an unusual combination. This condition resulted in issues such as decreased mobility, muscle weakness, and cognitive impairments. The specialized physiotherapy program employed a diverse strategy to address neurological weaknesses with multimodal stimulation, range of motion exercises, strength training, balance training, and more. The approach also includes energy-saving techniques and adaptive ways to manage symptoms associated with lupus nephritis to address fatigue and joint stiffness. The positive outcomes highlight the importance of tailored physical therapy regimens in maximizing functional recovery and improving the quality of life in the challenging context of concurrent bilateral infarct and systemic lupus nephritis. This case study emphasizes the need for individualized rehabilitation strategies in enhancing overall patient outcomes, contributing valuable insights to the sparse literature on managing such complex cases.

The Effect of Perturbation-Based Balance Training vs Step Training on Reaction Time in Older Persons: A Review.

As the global population ages, understanding the impact of aging on cognitive abilities becomes increasingly crucial. One such cognitive function that exhibits significant changes with advancing age is reaction time (RT). This article presents a comprehensive analysis of RT in older adults, examining its underlying mechanisms, age-related changes, and implications for cognitive functioning. Through a review of existing literature, this study explores various factors influencing RT in older individuals, including sensory, motor, and cognitive processes. It highlights how age-related changes in the central nervous system, such as declines in processing speed and neural efficiency, play a significant role in prolonging RTs. Additionally, the role of cumulative life experiences and environmental factors in shaping reaction time in older adults is discussed.

Scope of an Integrative Neurophysiotherapy Approach in Achieving Gross Motor Milestones in a Child with Meningitis: A Case Report.

Meningitis caused by bacteria, which is an inflammation of the meninges affecting the pia, arachnoid, and subarachnoid space, is still one of the leading causes of death and morbidity in infants and young children. Neisseria meningitidis, group B streptococcus (GBS), Haemophilus influenzae type B (Hib), Listeria monocytogenes, and Streptococcus pneumoniae have been found to be the most frequent causative agents. Infants and children can have modest, fluctuating, non-specific, or even absent clinical signs of bacterial meningitis. They may include bulging fontanelles, vomiting, diarrhea, respiratory distress, hypothermia, lethargy, irritability, poor feeding, and fever in babies. In this case report, an 18-month-old child presented to a local hospital with complaints of multiple episodes of high-grade fever. After 10 days, his symptoms worsened and he experienced two episodes of seizures at one-day intervals at night. He was taken to Acharya Vinoba Bhave Rural Hospital for further management. Blood investigations revealed seropositive results for dengue virus infection. On MRI and CT scan, it was diagnosed as an old case of subdural hematoma in the right frontotemporal region of the brain. The patient was on intravenous ceftriaxone and phenytoin. Gross motor developmental milestones in children with meningitis can be improved with early integrative neurophysiotherapy and a goal-oriented therapeutic regimen that includes mobility exercises, proprioceptive neuromuscular facilitation techniques, positioning, oromotor retraining, neurodevelopmental techniques, and balance and coordination retraining. A complex case presents with bacterial meningitis, hydrocephalus, and seizure disorder. The bacterial infection inflames the protective membranes of the brain, causing hydrocephalus. Increased cerebrospinal fluid puts pressure on the brain, leading to seizures. Managing these interconnected conditions requires a multidisciplinary approach making it unique, involving infectious disease, neurology, and neurosurgery expertise.

Functional Electrical Stimulation in Conjunction With Proprioceptive Neuromuscular Facilitation (PNF) Technique to Improve Upper Limb Function in Traumatic Brachial Plexus Injury: A Case Report.

Traumatic brachial plexus injuries (TBPIs) in the adult population are primarily a result of road traffic accidents or falls on a shoulder, which mainly affects the young population. Adult TBPI is a serious incapacitating injury that affects young adults. It decreases the function of upper extremity muscles, which affects social participation and quality of life. Physiotherapy intervention demonstrates its effectiveness in enhancing and maintaining the function of the upper extremity, eventually decreasing the participation restriction and improving quality of life. The proprioceptive neuromuscular facilitation (PNF) technique has been selected as a useful therapeutic option to enhance upper limb function after TBPI. The preceding case report proved the effectiveness of six weeks of functional electrical stimulation in addition to the PNF technique in improving upper limb function after TBPI.

Promoting Flexibility and Functionality in a Surgically Managed Tibial Fracture: A Case Report on Physiotherapeutic Interventions for Postoperative Stiffness.

This case study explains the complete care of a 45-year-old male patient who had a high-impact road injury that resulted in a displaced proximal tibial fracture. Substantial soft tissue damage was discovered during the initial assessment, requiring careful thought before undergoing surgery. A customized physiotherapy program was instituted after an incremental strategy involving open reduction and internal fixation. The patient made a satisfactory functional recovery, regaining nearly normal mobility and going back to daily activities within 12 weeks despite difficulties encountered during the rehabilitation phase, including temporary postoperative complications. The present study underscores the significance of a multidisciplinary approach involving Mulligan mobilization in the effective management of intricate proximal tibial fractures. It also underscores the importance of meticulous surgical intervention and organized rehabilitation protocols in enhancing patient outcomes and regaining functional abilities to improve patients' quality of life.

Implementation of Multimodal Stimulation and Physical Therapy in Improving the Level of Consciousness and Recovery in Acute Disseminated Encephalomyelitis.

This case report aims to explore the use of multimodal sensory stimulation and physical therapy in rehabilitating a 30-year-old female patient with severe acute disseminated encephalomyelitis (ADEM). ADEM, characterized by autoimmune demyelination in the central nervous system, presents challenges in clinical management, particularly in cases with severe motor deficits and coordination issues. The patient's progress was measured using the Glasgow Coma Scale (GCS), Extended Glasgow Outcome Scale (GOS-E), and Coma Recovery Scale-Revised (CRS-R). The patient showed significant improvement in consciousness levels, functional status, and cognitive and neurological function. The study concludes that a collaborative approach involving both therapeutic modalities and active family participation contributed positively to the patient's recovery.

Implementation of the Gamut of Physiotherapy Maneuvers in Restoration and Normalization of Functional Potencies in a Patient With a Hemorrhagic Stroke: A Case Report.

A stroke is a medical emergency characterized by a sudden onset of focal neurological deficits due to an interruption in the blood flow to the brain tissues, with signs and symptoms persisting for more than 24 hours. Motor, sensory, recognition, language, and perceptual deficiencies are typical signs of the disease, depending on the areas affected, the size of the injury, and the origin of the injury. Patients who have had a stroke frequently have problems like weakness, stiffness, and altered movement patterns in addition to poor balance and mobility issues. Numerous physiotherapeutic strategies concentrate on helping stroke victims recover quickly. Stroke-related mortality rates have decreased over the past few decades due to advancements in stroke therapy and rehabilitation. One approach that can be primarily used to normalization of tone is facilitation by Rood's technique. The present case report is of a 45-year-old female with a history of hypertension presented with complaints of weakness on the right side of the body. The patient had right hemiplegia with more involvement of the right upper extremity. The patient underwent a decompressive craniotomy. On investigation, the magnetic resonance imaging (MRI) report revealed an area of blood density attenuation with multiple air foci in the left gangliocapsular region. Treatment was started after the patient was operated on. An approach-oriented rehabilitation program was planned for the patient. Physiotherapy maneuvers such as the proprioceptive neuromuscular facilitation (PNF) approach and Rood's approach were used to restore and normalize functional potencies and recover the patient's condition. Oral facial facilitation was also used for swallowing frequency control, sensory awareness, and motor control. Posttreatment changes such as changes in muscle tone, strength, and mobility, which are essential for patients with the activity of daily living (ADLs), were observed. Outcome measures used in this patient are the Functional Independence of Measures (FIM) scale, Brunnstrom grading, voluntary control grading, and the National Institute of Health Stroke Scale (NIHSS).