Perks of a Structured Rehabilitation in Suprascapular Neuropathy Injury Post Proximal Humerus Fracture: A Case Report.

Road traffic accidents lead to extensive damage to superficial as well as deep components in the body. Neurological structures that are affected due to open injuries have major impairments in the day-to-day life of an individual. High trauma incidents lead to nerve injuries, which are a common occurrence secondary to fractures after such falls. Nerve entrapment, nerve compression, nerve denervation, or demyelination usually result in the wasting of muscles supplied by it, which eventually causes muscle atrophy. Muscle atrophy limits the ability of an individual to move the extremities to achieve functional activities. Sensory neuropathy, in addition to motor neuropathy, is an associated complication. Physical therapy interventions are observed to play a significant role in nerve and muscle injury rehabilitation courses, thus improving quality of life. This report presents a case of a 43-year-old male who came to the hospital with complaints of pain and inability to move the shoulder after his bike was hit by a truck from behind and he experienced a fall. The patient presented to an orthopedic surgeon who took X-ray, electromyography (EMG), and nerve conduction velocity (NCV) investigations and confirmed fracture of greater tuberosity of the humerus and motor neuropathy of the suprascapular nerve. He was surgically treated and was referred to the physiotherapy outpatient department for postoperative management. A well-planned physical therapy program aimed to improve the range of motion and strength of the affected shoulder joint while preventing atrophy, thus improving quality of life.

Osmotic Demyelination Syndrome: A Rare Clinical Image.

The term "Osmotic Demyelination Syndrome" (ODS) is synonymous with central pontine myelinolysis (CPM), denoting a condition characterised by brain damage, particularly affecting the white matter tracts of the pontine region. This damage arises due to the rapid correction of metabolic imbalances, primarily cases of hyponatremia. Noteworthy triggers encompass severe burns, liver transplantations, anorexia nervosa, hyperemesis gravidarum, and hyperglycaemia, all linked to the development of CPM. Clinical manifestations encompass a spectrum of signs and symptoms, including dysphagia, dysarthria, spastic quadriparesis, pseudobulbar paralysis, ataxia, lethargy, tremors, disorientation, catatonia, and, in severe instances, locked-in syndrome and coma. A recent case involving a 45-year-old woman illustrates these complexities. Upon admission to the Medicine Intensive Care Unit, she presented with symptoms indicative of diminished responsiveness and bilateral weakness in the upper and lower limbs. Of significance, the patient had a pre-existing medical history of hyperthyroidism. Extensive diagnostic investigations were undertaken, revealing compelling evidence of profound hyponatremia through blood analyses. Furthermore, magnetic resonance imaging (MRI) was performed, unveiling conspicuous areas of abnormal hyperintensity located in the central pons, intriguingly accompanied by spared peripheral regions. These radiological findings align with the characteristic pattern associated with osmotic demyelination syndrome, illuminating the underlying pathology.

Impact of Vestibular and Balance Rehabilitation Therapy Along With Conventional Physiotherapy in a Case of Vestibular Schwannoma With CP Angle Tumor: A Case Report.

Vestibular Schwannoma forms in Schwann cells which cover the vestibular nerve, often in the internal auditory canal. Symptoms were likely present before the excision of the tumor. After the excision of the tumor, symptoms may include, hearing defects, tinnitus, facial muscle abnormalities, headache, and balance impairments. This case report is of a female patient with vestibular schwannoma, who had a few above-mentioned symptoms after the surgery. Her physiotherapy protocol included Vestibular and Balance Rehabilitation Therapy along with Conventional Physiotherapy. Also, facial proprioceptive neuromuscular facilitation (PNF) was a part of her treatment. The outcome measures used to rule out the results were the motion sensitivity quotient (MSQ) and the Berg balance scale (BBS). Improvement of symptoms is likely related to the excision of the tumor and the therapy program. The person's balance and coordination improved as a result of the rehabilitation protocol, and she was able to do her regular tasks with minimal assistance. Her standard of living was also enhanced.

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.

Multiple Approaches of Neuro-Physiotherapy Used for Improving Balance, Normalizing Tone, and Gait Training in a Child With Ataxic Cerebral Palsy: A Case Report.

Cerebral palsy (CP) is a non-progressive developmental delay disorder that mainly affects children. A strategy for enhancing organizational abilities, including practices based on evidence, and improving outcomes is the base of clinical management in physiotherapy. A seven-year-old girl presented with a history of difficulty walking, standing for extended periods, and performing gross and fine motor movements. MRI revealed generalized atrophy of the cerebellum. The child was managed by medications and physiotherapy. Physiotherapy intervention was based on goal-oriented strategies, which include Rood's approach, constraint-induced movement therapy (CIMT), proprioceptive neuromuscular facilitation (PNF), passive stretching, etc. This goal-oriented program showed an improvement in the treatment outcomes of the child. The child was walking independently with a proper gait pattern and was able to maintain both static and dynamic balance. Initial physical therapy management using integrated methods promotes the achievement of developmental milestones like gross motor skills in ataxic cerebral palsy children.