Serial Casting of the Ankle and Knee in a Child With Vascular Anomaly of the Calf Musculature: A Case Report

2019 ◽  
Author(s):  
Colleen Peyton
Keyword(s):  
Lower Extremity ◽  
Range Of Motion ◽  
Vascular Anomaly ◽  
The Novel ◽  
Case Description ◽  
Limited Evidence ◽  
Posterior Compartment ◽  
Serial Casting ◽  
Toe Walking ◽  
Gait Impairments

Abstract Background and Purpose Contracture and toe-walking in children due to vascular anomaly of the calf musculature is rarely described and there is limited evidence regarding treatment. The purpose of this case is to describe the novel use of serial casting, combining the knee and ankle, to reduce contracture in a child with hemangioma of the calf. Case Description An 11-year-old girl received 12 casts of the ankle and knee, followed by custom orthotics, to address chronic contracture and gait impairments caused by a vascular anomaly in the posterior compartment of the lower extremity. Outcomes After casting, the patient had fully restored knee range of motion and improved ankle range of motion by 45 degrees. She received custom orthotics and maintained her range of motion four months after casting. Discussion Serial casting of the knee and ankle may be a useful alternative to surgical lengthenings in patients with chronic contractures caused by vascular anomalies of the lower extremity.

Spinal Impairment Evaluation: Fifth Edition Changes

2001 ◽  
Vol 6 (1) ◽  
pp. 1-3
Author(s):  
Robert H. Haralson
Keyword(s):  
Spinal Cord ◽  
Lower Extremity ◽  
Range Of Motion ◽  
Upper Extremity ◽  
Spinal Cord Injuries ◽  
Clinical Findings ◽  
Fourth Edition ◽  
Treatment Results ◽  
Standard Terminology ◽  
Made In

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, was published in November 2000 and contains major changes from its predecessor. In the Fourth Edition, all musculoskeletal evaluation and rating was described in a single chapter. In the Fifth Edition, this information has been divided into three separate chapters: Upper Extremity (13), Lower Extremity (14), and Spine (15). This article discusses changes in the spine chapter. The Models for rating spinal impairment now are called Methods. The AMA Guides, Fifth Edition, has reverted to standard terminology for spinal regions in the Diagnosis-related estimates (DRE) Method, and both it and the Range of Motion (ROM) Method now reference cervical, thoracic, and lumbar. Also, the language requiring the use of the DRE, rather than the ROM Method has been strengthened. The biggest change in the DRE Method is that evaluation should include the treatment results. Unfortunately, the Fourth Edition's philosophy regarding when and how to rate impairment using the DRE Model led to a number of problems, including the same rating of all patients with radiculopathy despite some true differences in outcomes. The term differentiator was abandoned and replaced with clinical findings. Significant changes were made in evaluation of patients with spinal cord injuries, and evaluators should become familiar with these and other changes in the Fifth Edition.

scholarly journals Lower Extremity Rehabilitation in Patients with Post-Stroke Sequelae through Virtual Reality Associated with Mirror Therapy

2021 ◽  
Vol 18 (5) ◽  
pp. 2654
Author(s):  
Roxana Steliana Miclaus ◽  
Nadinne Roman ◽  
Ramona Henter ◽  
Silviu Caloian
Keyword(s):  
Virtual Reality ◽  
Muscle Strength ◽  
Lower Extremity ◽  
Range Of Motion ◽  
Control Group ◽  
Mirror Therapy ◽  
Cohen’S D ◽  
Cohen's D ◽  
Experimental Group ◽  
Post Therapy

More innovative technologies are used worldwide in patient’s rehabilitation after stroke, as it represents a significant cause of disability. The majority of the studies use a single type of therapy in therapeutic protocols. We aimed to identify if the association of virtual reality (VR) therapy and mirror therapy (MT) exercises have better outcomes in lower extremity rehabilitation in post-stroke patients compared to standard physiotherapy. Fifty-nine inpatients from 76 initially identified were included in the research. One experimental group (n = 31) received VR therapy and MT, while the control group (n = 28) received standard physiotherapy. Each group performed seventy minutes of therapy per day for ten days. Statistical analysis was performed with nonparametric tests. Wilcoxon Signed-Rank test showed that both groups registered significant differences between pre-and post-therapy clinical status for the range of motion and muscle strength (p < 0.001 and Cohen’s d between 0.324 and 0.645). Motor Fugl Meyer Lower Extremity Assessment also suggested significant differences pre-and post-therapy for both groups (p < 0.05 and Cohen’s d 0.254 for the control group and 0.685 for the experimental group). Mann-Whitney results suggested that VR and MT as a therapeutic intervention have better outcomes than standard physiotherapy in range of motion (p < 0.05, Cohen’s d 0.693), muscle strength (p < 0.05, Cohen’s d 0.924), lower extremity functionality (p < 0.05, Cohen’s d 0.984) and postural balance (p < 0.05, Cohen’s d 0.936). Our research suggests that VR therapy associated with MT may successfully substitute classic physiotherapy in lower extremity rehabilitation after stroke.

scholarly journals T11/T12 ossification of the yellow ligament contributing to thoracic myelopathy in patient with posterior fossa arachnoid cyst and acquired incidental Chiari I malformation/syrinx

2021 ◽  
Vol 12 ◽  
pp. 246
Author(s):  
Toshiya Aono ◽  
Hideaki Ono ◽  
Takeo Tanishima ◽  
Akira Tamura ◽  
Isamu Saito
Keyword(s):  
Lower Extremity ◽  
Posterior Fossa ◽  
Arachnoid Cyst ◽  
Cord Compression ◽  
Chiari I Malformation ◽  
Case Description ◽  
Thoracic Myelopathy ◽  
Chiari I ◽  
New Onset

Background: Thoracic ossification of the yellow ligament (OYL) may contribute to myelopathy. In the case presented, the patient additionally had a chronic posterior fossa arachnoid cyst with an acquired Chiari I malformation and cervicothoracic syrinx. Case Description: A 40-year-old female with a posterior fossa arachnoid cyst found 17 years ago, and newly acquired Chiari I malformation (tonsils down 5 mm) with a C7-T5 syrnix, presented with the new onset of lower extremity myelopathy. The MR documented marked dorsolateral cord compression due to T11/T12 OYL. Six months following a laminectomy for resection of OYL, the patient was asymptomatic. Conclusion: In patients presenting with the new onset of lower extremity myelopathy, evaluation of the complete neuraxis may be warranted. Here, the patient has an unchanged posterior fossa arachnoid cyst with an acquired Chiari I malformation/C7-T5 syrinx. However, the patient’s symptoms were fully attributed to the MR-documented T11/T12 OYL that was successfully resected.

scholarly journals Physiotherapy Rehabilitation in Post Operative Tibia- Fibula Fracture with External Fixators

2021 ◽  
pp. 283-288
Author(s):  
Gunjan Ambalkar ◽  
Deepak Jain ◽  
Pratik Phansopkar
Keyword(s):  
Lower Extremity ◽  
Range Of Motion ◽  
Road Traffic ◽  
Severe Trauma ◽  
Long Bone ◽  
External Fixators ◽  
Tibial Shaft ◽  
Fibula Fracture ◽  
Shaft Fractures ◽  
Tibial Shaft Fractures

Introduction: A tibia - fibula fracture occurs when a fall or trauma to the lower extremities puts more tension on the bones than they can tolerate. Diaphyseal tibial fractures are the most common long bone fracture. Lower extremity Tibia and fibula fractures are examples of fractures. Tibial shaft fractures are most typically associated with a history of severe trauma. The tibia is the most commonly fractured bone in the lower extremity. The bone's shaft is in the middle Fibula fractures are usually, but not always, accompanied by tibial shaft fractures. Case Presentation: At the previous 15 days, a 49-year-old male patient accounted in a hospital with a road traffic accident. Discussion: The physiotherapy was given to this patient for muscle energy technique resulting in a high degree of range of motion in the lower extremity, reduce pain, and improves flexibility and strength. Conclusion: Physiotherapy has a significant effect on pain, strength, and range of motion. The result of this case report specifies that it may be effective for pain relief, improvement in strength, and functional ability.

Upper Extremity and Hip Range of Motion Changes Throughout a Season in Professional Baseball Players

2019 ◽  
Vol 48 (2) ◽  
pp. 481-487
Author(s):  
Justin M. Chan ◽  
John Zajac ◽  
Brandon J. Erickson ◽  
David W. Altchek ◽  
Christopher Camp ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Range Of Motion ◽  
External Rotation ◽  
Significant Risk ◽  
Case Series ◽  
Significant Risk Factor ◽  
Professional Baseball ◽  
Level Of Evidence ◽  
Baseball Players ◽  
Shoulder Flexion

Background: Loss of upper and lower extremity range of motion (ROM) is a significant risk factor for injuries in professional baseball players. Purpose/Hypothesis: The purpose was to determine changes in ROM in professional baseball players over the course of a single season and their careers. We hypothesized that pitchers and position players would lose ROM, specifically total shoulder motion (total ROM [TROM]) and hip internal rotation (IR), over the course of a season and their careers. Study Design: Case series; Level of evidence, 4. Methods: Upper and lower extremity ROM measurements were recorded during pre-, mid-, and postseason on all professional baseball players for a single organization between 2011 and 2018. ROM measurements were compared for pitchers and position players over the course of the season and their careers. Also, ROM measurements over the pre-, mid-, and postseason were compared between pitchers and position players. Results: A total of 166 professional baseball players (98 pitchers, 68 position players) were included. Pitcher hip external rotation (ER; P < .001), IR ( P = .010), and TROM ( P < .001) for lead and trail legs decreased over the course of the season. Pitcher shoulder ER ( P = .005), TROM ( P = .042), and horizontal adduction ( P < .001) significantly increased over the course of the season. Position player shoulder flexion ( P = .046), hip ER ( P < .001, lead leg; P < .001, trail leg), and hip TROM ( P = .001; P = .002) decreased over the course of the season. Position player shoulder ER ( P = .031) and humeral adduction ( P < .001) significantly increased over the course of the season. Over the course of pitchers’ careers, there was decreased shoulder IR ( P = .014), increased shoulder horizontal adduction ( P < .001), and hip IR ( P = .042) and hip TROM ( P = .027) for the lead leg. Position players experienced loss of hip TROM ( P = .010, lead leg; P = .018, trail leg) over the course of their careers. Pitchers started with and maintained more shoulder ER and gained more shoulder TROM over a season as compared with position players. Conclusion: Pitchers and position players saw overall decreases in hip ROM but increases in shoulder ROM over the course of the season and career.

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