A Case Report of Silent Cervical Spondylosis with Neck Pain

Background: Cervical Spondylosis, commonly known as Cervical Osteoarthritis, is a kind of degenerative osteoarthritis of the joints between the spinal vertebrae's and the neural foramina. It's a condition characterized by changes in the cervical bones, discs, and joints as a result of regular aging wear and tear. Spondylosis of the cervical spine is most common in 40s and 50s. Case Presentation: A 65 years old male came to physiotherapy department with complaints of pain in left upper limb and neck and weakness in his left upper back muscles and unilateral since 2 months. Clinical impression showed cervical non radiculopathy. X-ray of cervical spine revealed osteophytosis and narrowed inter- vertebral space, seen in C6 and C7 cervical vertebral bodies with straightening of cervical spine. Cervical Distraction and compression test was positive. Conclusion: A well planned physical therapy intervention has shown significant improvement in cases with cervical spondylosis in relieving the symptoms and improving quality of life.

Effectiveness and Safety of Physical Therapy Intervention in Adult Dermatomyositis: A Case Report and Review

BACKGROUND The evidence for positive effects of exercise is insufficient in dermatomyositis. This article aims to outline the effects of physical exercise with regard to structure (Disease activity, inflammation, metabolic milieu and muscle structure) as well as clinical outcome in terms of impairment, activity limitation, participation restriction according to the ICF; and QOL in an adult patient with dermatomyositis. CASE DESCRIPTION A 47-years old female diagnosed with definite DM since last 10 months was referred by a Rheumatologist for physical therapy intervention. INTERVENTION 12 weeks (Three days a week) of Physiotherapy (Moderate intensity, individualized, closely monitored) along with a structured home exercise program (Low intensity, 5 days - 6 days a week). OUTCOME MEASURES Assessment of muscular pain, muscle strength, endurance, balance, functional evaluation, and QOL along with serological investigations. RESULTS Effectiveness Patient continued to show meaningful and clinically significant improvement on standardized outcome measures: 1. A major clinical response (total improvement score of 77) on IMAC S core set measures. 2. Improvement across all domains of ICF viz. muscle strength; endurance; movement coordination; balance; aerobic endurance; confidence and performance in activities of daily living; participation in social activities. 3. Probable disease-modifying effect: Progressively tapering dose of prescribed corticosteroids medication and improvement in disease-specific biochemical markers. 4. Patient reported measures: Reduction in muscular pain, shortness of breath & fatigue; and improvement in Healthrelated QOL. SAFETY (As evident clinically and from the investigations): 1. No adverse reaction to exercises or physical activity. 2. Remained in remission - stable disease activity. CONCLUSION Moderate intensity of physiotherapy intervention along with home exercise program is effective and safe in improving functional outcomes for dermatomyositis in a stable disease activity state. This case report enhances our understanding of the effects of physical exercise and may improve treatment and outcome in patients with dermatomyositis.

PHYSICAL THERAPY INTERVENTION FOR PATIENT WITH EAST SYNDROME- A CASE STUDY.

EAST syndrome is autosomal recessive disorder due to mutations in gene KCNJ10, a gene encoding a potassium channel expressed in the brain, eye, ear and kidney. It is characterized by four cardinal features; Epilepsy, Ataxia, Sensorineural deafness, and renal salt-wasting Tubulopathy, thus the acronym EAST syndrome. It was rst described as a distinct clinical entity in 2009 by Bockenhauer and scholl, who named this condition EAST syndrome and SeSAME syndrome for Seizures, Sensorineural deafness, Ataxia, Mental retardation and Electrolyte imbalance respectively. Neurodevelopmental delay is evident in most patients with EAST syndrome that were old enough to be assessed; Thus, physiotherapy intervention also plays a vital role in EAST syndrome along with medical management. From physiotherapy perspective; symptomatic management to Improve overall health, wellbeing and motor control becomes ultimate goal in the patient with EAST syndrome. As there is no specic physical therapy treatment approach and no specic tool to evaluate function for children with EAST syndrome; for clinically presented delay development and ataxia, Neurodevelopment therapy (NDT) was utilized as treatment approach and Gross motor function measure (GMFM) & Gross motor performance measure (GMPM) were utilized for assessment in this case study to track progress on follow ups. Result showed marked improvement in GMFM and GMPM scores at follow ups and concluded that Physical therapy intervention improves the gross motor function as well as gross motor performance in patient with EAST syndrome.