Novelty of Physiotherapy Protocols in a Classic Case of Extrapulmonary Tuberculosis in a 35-Year-Old Male Patient: A Case Report.

Tuberculosis is the most frequent cause of death, specifically caused by a single infectious agent, Mycobacterium tuberculosis. There are two types of tuberculosis: pulmonary tuberculosis and extrapulmonary tuberculosis. Patients with extrapulmonary tuberculosis often have reduced lung function due to the disease's structural abnormalities, which also significantly impair their quality of life. The suggested standard of care for the treatment of extrapulmonary tuberculosis patients is pulmonary rehabilitation. A 35-year-old male patient who complained of shortness of breath, dry cough, and on-and-off fever diagnose with extrapulmonary tuberculosis was the subject of the case study. The patient had extrapulmonary tuberculosis with a history of pleural effusion, which was managed with proper medications. After increasing symptoms of the disease, the patient was referred for pulmonary rehabilitation. Physiotherapy protocol includes breathing exercises, relaxation techniques, and mobility exercises for the upper limb and lower limb. Effective physical rehabilitation was necessary to minimize complications and allow him to resume daily activities. Several outcome measures, like the dyspnea scale, visual analog scale, six-minute walk test, and World Health Organization-Quality of Life (WHO-QOL) questionnaire, were used to monitor the patient's progress during rehabilitation. The benefits of physiotherapy protocols emphasize the need for tailored approaches to addressing individual patient needs for comprehensive recovery as it significantly enhances clinical, physical, psychosocial, and overall quality of life, making it crucial for patients with extrapulmonary tuberculosis. The protocols are beneficial to improve exercise capacity, muscle force, symptoms such as dyspnea, cough, and health-related quality of life in these patients. In this study, the focus was more on breathing exercises such as segmental breathing exercises for lung expansion and increasing air entry in the lungs followed by improving functional capacity and strength.

The Novelty of Orthopedic Rehabilitation After Conservative Management for Patellar Dislocation With Partial Tear of Medial Meniscus and Early Osteoarthritis in a 31-Year-Old Female.

Primary patellar dislocation or first-time patellar dislocation is the second most frequent cause of knee injuries which overall accounts for about 3% of other knee injuries. The patellofemoral joint is formed by the patella connecting to the femoral trochlea and creates both static and dynamic structures of the knee. There are basically three types of patellar dislocation: superior, lateral, and medial. The lateral dislocation is the most frequent one. Females are more vulnerable and are at higher risk than males. Muscular weakness or muscular imbalance leads to patellar instability, and ultimately to dislocation. The recurrence rate after primary patellar dislocation is 15-60%. This case report is of a 31-year-old female with patella dislocation with a medial meniscal tear and a case of early osteoarthritis for whom we planned goal-oriented physiotherapy rehabilitation week-wise and progressed every week. The assessment was taken before and after physiotherapy rehabilitation. The patient was managed conservatively with a long knee brace, and physiotherapy started after one month. Due to prolonged immobilization, the patient suffered from quadriceps muscle atrophy. The physiotherapist focused on biomechanism and got the expected results in pain reduction, regaining strength, and improving range of motion, and the patient was able to walk properly without taking any support after rehabilitation.

Efficacy of Preoperative Physiotherapy Protocols in a 30-Year-Old Patient With Bilateral Osteoarthritis of Hip Secondary to Avascular Necrosis.

Osteoarthritis (OA) of the hip is a rare condition that occurs in adults can be a result of avascular necrosis or a history of steroids that can wear away the articulating cartilage of the hip joint causing friction, pain in the groin region, stiffness, and decreased functional mobility. We present a 30-year-old adult who came with chief complaints of pain in the groin region, stiffness, difficulty in walking, and experiencing pain while walking, which had reduced his activity of daily living. The investigation was done, and the patient was diagnosed with bilateral hip OA secondary to avascular necrosis. To reduce morbidity, preoperative physiotherapy management for eight weeks was planned and started before the operation. The purpose was to educate the patient about the condition, reduce pain, increase the ranges of the hip, improve strength, and provide gait re-education. We added basic proprioception training and plyometric exercises for the hip to improve strength and balance. At the end of the session patient, positive results were achieved. The progress of proprioception or balance training can be improved by using single-leg balance as an outcome measure. Hence, our study aims to use exercise therapy to reduce or postpone the need for hip arthroscopy. However, future research should focus on plyometric exercises for the lower limbs or any abnormalities associated with the lower limbs. However, they should be carried out when some recovery is observed in patients.

The Originality of Neuro Rehabilitation Protocols in a Definitive Case of Syringomyelia Related to Chiari I Malformation.

Syringomyelia is a center-medullary syndrome characterized by the presence of fluid-filled spaces known as syrinx within the spinal canal. Arnold Chiari Malformation (CM-I), a rhombencephalon anomaly formerly identified as hindbrain hernia, is usually associated with it. This disorder causes the brain (cerebellum) to bulge through the opening in the skull known as the foramen magnum. Some asymptomatic patients may develop symptoms quickly if they jolt their heads and cough for a lengthy period of time. Syringomyelia can be caused by trauma, illness, inflammation, or previous surgery that affects the circulation of cerebral spinal fluid resulting in CSF flow obstruction. The discomfort is acute and progressive, radiating to the neck and shoulder, and is accompanied by sensory loss, motor atrophy, decreased hearing, oscillopsia, and cerebellar abnormalities. This case report is of a 39-year-old woman diagnosed with syringomyelia associated with Arnold Chiari malformation and showed similar symptoms managed by foramen decompression and tonsillar elevation surgery. It involves removing a small piece of bone from the skull and a small section of the 1st vertebra from the back of the neck and head. In this way, there is an increase in skull space. Decompression of the spinal canal increases the size of the subarachnoid cisterns and constricts the syrinx cavity. After surgery, physiotherapy was advised because all superficial sensations over C8 and T1 were diminished, the range of motion along with strength was reduced, doing daily activities was difficult, and quality of life was affected. So, by decreasing symptoms and improving the patient's quality of life, physiotherapy improved the patient's condition significantly in this case report. The rationale of this study is to show the importance of physiotherapy in recovering after a neurological condition followed by corrective neurosurgery.