The Impact of Physical Therapy in Individuals With Benign Paroxysmal Positional Vertigo: A Case Report.

Benign paroxysmal positional vertigo (BPPV) is a mechanical condition of the peripheral vestibular system. It is characterized by recurrent, short-lived episodes of vertigo caused by calcium carbonate crystals that get dislodged from the utricle and move into the semicircular canals. In this case report, a 33-year-old female presenting with complaints of neck pain and dizziness upon head movement was diagnosed with BPPV following a comprehensive evaluation, which included a thorough history, assessment, and investigations. The Dix-Hallpike maneuver was positive on the right side. The patient was then treated with canalith repositioning manuever (CRM) and conventional physiotherapy. There was a reduction in pain, improvement in range of motion, and reduction in the duration and frequency of vertigo. Therefore, it can be concluded that the application of CRM or Epley's maneuver decreases the duration and frequency of vertigo and improves quality of life.

Determining the Optimal Position of Surface Electrodes for Diaphragm Electromyography: A Cross-Sectional Study.

BACKGROUND: Placing electrodes on different aspects of the chest determines the motor firing from the diaphragm. The electrode placement close to the extent of the muscle gave promising readings as compared to the ones that were placed away. The position with the maximum amplitude and least duration was chosen. Positions of the electrodes were decided as per the extent of the muscle. The aim is to determine the appropriate position of surface electrodes for surface diaphragm electromyography (EMG). MATERIAL AND METHODOLOGY: Thirty healthy individuals of age ranging from 21 to 45 years were included in the study. Participants were made to lie down in a supine position and different positions like G1 (recording electrode) 5 cm superior to the tip of the xiphoid process and G2 (reference) 16 cm along the costal margin from G1, G1 over the xiphoid tip and G2 at the seventh intercostal space at the costochondral junction and G1 over the xiphoid tip and G2 at the eight intercostal space at the costochondral junction were used for assessing maximum amplitudes and durations were observed by using a Octopus New Wave EMG machine (Octopus Medical Technologies, Vadodara, IND). After observing all the positions, an optimum position for maximum amplitude and least duration was analyzed. RESULTS: As per the study, out of the four positions, the electrode placements on the tip of the xiphoid process and 16 cm away diagonally on the sixth intercostal space showed maximum amplitude and the least duration with maximum mean amplitude and less mean duration of 232.35 and 7.316. On the seventh intercostal space it was 199.15 and 7.887 and on the eighth intercostal space was 176.055 and 8.639. The tip of the xiphoid process and 16 cm away diagonally on the sixth intercostal space is chosen as the appropriate position for electrode placement for EMG of the diaphragm. CONCLUSION: We conclude that the best electrode position was when the electrodes were placed 5 cm superior to the xiphoid process, i.e., G1, and 16 cm away from the recording electrode on the costochondral junction, i.e., G2, at the sixth intercostal space. Ground electrode placement is the nearest bony prominence, i.e., xiphisternum.

Matrix Rhythm Therapy as a Novel Clinical Approach in the Rehabilitation of Surgically Treated Distal Radius Fracture: A Single Case Study.

Distal radius fractures (DRFs) are prevalent among all hand injuries, commonly due to a fall on an outstretched hand. Not being treated properly can cause many complications such as malunion, non-union, reduced range of motion, and muscle strength. This case report presents a multidisciplinary approach to the physiotherapeutic management of a DRF treated with closed reduction internal fixation using K-wires. The rehabilitation protocol incorporated matrix rhythm therapy (MRT), a novel therapeutic technique, in combination with targeted therapeutic exercises. The study outlines the patient's journey from injury to recovery, detailing the integration of MRT sessions alongside conventional physiotherapy exercises. The comprehensive rehabilitation aimed to enhance pain relief, restore range of motion, and improve functional outcomes. The case highlights the synergistic benefits of incorporating MRT into traditional rehabilitation strategies through assessment, personalized treatment planning, and regular progress evaluations. The outcomes underscore the potential of this combined approach in optimizing the recovery process.

Revitalizing Recovery: Unveiling the Transformative Impact of Physiotherapy in Rehabilitating a Neglected Case of Shoulder Hemiarthroplasty.

The shoulder joint has a complex anatomy and biomechanics. It is a ball and socket joint made by the articulation surface of the humeral head (ball) and glenoidal fossa (socket) of the scapula. Shoulder arthroplasty is done when parts of the shoulder joint are severely affected and damaged beyond repair. The damaged parts are replaced with artificial parts. Prosthetic implants are typically made of metal or plastic material. Implants come in various sizes and shapes. There are three types of surgical arthroplasty: total shoulder arthroplasty, partial shoulder arthroplasty, and reverse arthroplasty. Indications of shoulder arthroplasty may include osteoarthritis, fractures, rotator cuff injuries, osteonecrosis, and rheumatoid arthritis. This case study aims to provide a case of anteroinferior dislocation of the left shoulder with humeral head comminuted fracture confirmed by an investigation like radiograph and CT scan operatively managed by left shoulder hemiarthroplasty. In this case study, a 58-year-old male cannot lift his arm and perform actions of the shoulder joint independently after the operative procedure, thus reducing the functional status and quality of life. After the left shoulder hemiarthroplasty repair post due to inadequate rehabilitation, there was a failure in achieving the ranges and gaining back the strength of the muscles. The patient has a combined plan of action, which consists of pharmacological interventions along with physiotherapy rehabilitation. The physiotherapy protocol consists of goals like using electrical muscle stimulation, activation exercises of muscles, strengthening protocol, stretches, and counselling. By the end of the physiotherapy treatment, the patient showed significant progress in re-establishing the ranges and enhanced muscle strength, which resulted in a positive self-boost along with improved functional independence quotient, thereby increasing quality of life.

Growing Trends in Scientific Publication in Physiotherapy Treatment of Knee Osteoarthritis: A Bibliometric Literature Analysis.

There has been an increase in the life expectancy of people worldwide, especially in developing countries like India. Osteoarthritis, a condition that usually onsets during later decades of life, has also been on the rise, even with advancing technology. This has led osteoarthritis of the knee to become a global disabling condition of the lower extremity that increases dependency on the affected individual. A bibliometric study has not been conducted on knee osteoarthritis research. Therefore, a bibliometric analysis which includes statistical analysis of recent articles, books, and other forms of publications is done for evaluation of scientific output and to find the importance of scientific studies in terms of quality as well as quantity. The aim of this analysis was to evaluate the productivity of research articles indexed in PubMed related to the condition. The PubMed database was used and articles related to osteoarthritis of the knee, phonophoresis, and start excursion balance test were extracted. In the bib text format, all the files were downloaded and placed together. The R studio software (R Foundation for Statistical Computing, Vienna, Austria) for bibliometric analysis was then used, into which the research data was uploaded and a data framework of bibliometric analysis was made. Analysis of bibliometric publications related to knee osteoarthritis, phonophoresis, Otago exercises, star excursion balance test, ultrasound, and exercise therapy generated between 1989 and 2021 lists a total of 120 relevant documents from 75 sources with an average of 4.53 articles per year of publication. The use of an advanced PubMed database enables the extraction of adequate articles and powerful bibliometric analysis of the studies conducted on osteoarthritis of the knee published from 1989 to 2021. It includes an assessment of the contributions from major countries. This study allowed us to validate our methodology which can be used to evaluate research policies and promote international collaboration.

Changing Trends in Publication Regarding Temporomandibular Joint Dysfunction From 1975 to 2021: A Bibliometric Analysis.

Temporomandibular joint (TMJ) is a bicondylar joint. Various conditions have the same clinical presentation as TMJ dysfunction, which requires a thorough assessment of active and passive movements and palpation of the joints surrounding the joint. Many times, TMJ dysfunction occurs due to an alteration in the cervical spine. The patient complains of clicking or popping sound at the jaw and a reduced maximum mouth opening. The conditions that lead to TMJ dysfunction include bruxism, arthritis, stress, injury to the jaw, and overuse. The trend of the available literature has changed from 1972 to 2021 to assess changing trends in the publication on TMJ about authors, country, collaboration of the institutes, and the journal. We have done this bibliometric assessment. The articles were collected from the PubMed database; the keywords used were temporomandibular dysfunction (TMD), neck pain, physiotherapy, and rehabilitation. A total of 437 articles were found from 1975 to 2021, which were then converted into pictorial forms using the CiteSapce R software, and the data were interpreted. The analysis of the bibliometrics of publications on TMD, neck pain, and functional disability between the years 1975 and 2021 shows a total of 437 articles were published. The articles were from 196 sources; the highest number of publications were seen from 2014 until 2021, with the highest number of published papers by author Yoo WG and the highest number of articles published by the Journal of Physical Therapy Science. This bibliometric analysis depicts that the quantity of literature on TMD and the forward head has increased, as has the effectiveness of physical therapy interventions on the forward head in terms of correcting temporomandibular dysfunction.

Virtual reality a technological miracle transforming physical rehabilitation: A scoping review.

Physical rehabilitation is evolving day by day. In the same way, simulation in rehabilitation is increasing and has now become a cornerstone for rehabilitation programs. Increase in the number of new protocols, clinical methods, and treatment standardization, virtual reality is appearing as a new medium to deliver the simulation. Virtual reality gives the benefits of forming standardized treatment protocols on demand for various conditions repetitively with a cost-effective delivery system. This was an observational retrospective study. The PubMed database was used to obtain the available material related to virtual reality and rehabilitation and was searched using the same keywords. The articles were then sorted as the subject to the recent decade. The basic information was then obtained, which included timespan, sources of the document, average years of publication, document types we collected, and average citation per year per document. Analysis of the literature that was available online related to virtual reality and rehabilitation between 2011 and 2021 generated a list of 813 documents from 275 sources, of which 810 were from journal articles and 3 were book chapters with an average year of publication of 2.16. The highest number of publications was 480 in 2020, followed by 150 in 2019, 95 in 2018, and 28 in 2017. The annual growth rate percentage of scientific publications was 26.1%. Therefore, more studies should be performed on virtual reality.

Early-Stage Physical Therapy for a Patient With Proximal Tibial Fracture With Acute Compartment Syndrome and Neurovascular Deficits Managed With External Fixation Complicated by Chronic Osteomyelitis: A Case Report.

Tibial fractures occur following low-energy and high-energy trauma resulting from indirect and direct impacts, respectively. High-velocity trauma like road traffic accidents usually results in open fractures of the tibia associated with acute compartment syndrome, posing a serious threat. Thus, this injury requires prompt operative management with fasciotomy followed by fixating the fracture with an external fixator to avoid infection. Despite all the efforts, sometimes this condition may lead to osteomyelitis of the tibia requiring further care. Meanwhile, the patient has to be kept immobilized for a longer duration of time, which allows further complications to occur. Therefore, structured physiotherapeutic management of patients postoperatively is of immense necessity to prevent complications associated with prolonged immobility and achieve an optimal level of functional independence, thereby facilitating the patient to come back to near-normal life as soon as possible. Our case report provides a structured early-stage postoperative physical therapy treatment protocol for a patient with a proximal tibial fracture with acute compartment syndrome and neurovascular deficit managed with Ilizarov fixation.

Physical Therapy Management in a Severe Case of Overlapping of Bone Post Crush Injury: A Case Report.

Crush injuries are sustained due to high velocity and usually have a poor outcome. Since the compressive forces are of high energy, such injuries are usually seen in road traffic accidents or in industrial workers. Crush injuries of the hand account for relatively a smaller percentage of the injuries to the hand and include an open wound along with fracture dislocation of the carpometacarpal, interphalangeal, and radiocarpal joints. Since these injuries are uncommon, they are often overlooked in radiological findings or misdiagnosed. Their recognition depends on a careful physical and radiographic examination that may require trispiral computed tomograms. Physical therapy rehabilitation post-surgery becomes a necessity, especially in cases where the dominant hand is affected. Functional rehabilitation to improve the independence and efficiency of activities of daily living is a goal of utmost importance.

Postoperative Physiotherapy Approach for a Rare Case of Adult Ileocecal Intussusception.

We report a rare case of a 32-year-old male diagnosed with a mass of intussusception in the right lumbar region. Adult intussusception has a prevalence of less than 5%. Among all cases of intestinal obstructions, adult intussusception is found to be only 1-3%. Adult intussusception of the bowel is uncommon. In contrast to intussusception in children, the traditional trio of palpable sausage, jelly stools, and discomfort is rarely seen. Adults usually present with nonspecific findings that last for a long time. We share the case of a patient who presented with complaints of pain in the abdomen and loss of appetite for six months. In addition, the patient also complained of constipation. The patient had a history of easy fatigue on moderate-intensity activity. Ultrasonography of the abdomen was suggested which revealed bowel wall thickening in the subhepatic region, with likely intussusception and formation of a lump with few enlarged lymph nodes adjacent to it. A confirmatory diagnosis was made after a computed tomography scan. In all cases, surgical intervention is required, and an organic lesion inside the invaginated section of the colon is discovered to be the lead point in up to 90% of cases. The laparoscopic procedure can be used for both diagnostic and therapeutic purposes. A right hemicolectomy was performed through a vertical midline incision. The patient was referred to the physiotherapy department for further management.

Current Trends in the Management of Temporomandibular Joint Dysfunction: A Review.

The temporomandibular joint (TMJ) is a synovial bi-condylar joint with 3 degrees of freedom. One-third of the adult population reportedly suffers from temporomandibular joint dysfunction (TMD). Females are more commonly affected than males. Almost 50% of TMD patients do not require any intervention, and the symptoms are self-limiting within one year after the onset; however, 75-80% of adults suffering from TMD require medical intervention and it takes up to three years for the complete remission of the symptoms. The clinical features of TMD are clenching, clicking, and locking of the jaw, and occlusion due to faulty posture. Based on the diagnostic criteria for temporomandibular disorder (DC/TMD) criteria proposed in the year 2014, the classification of TMD is done based on axis I and axis II diagnoses. This review aims to provide an overview of TMD and examine available treatment strategies for TMD. Various conservative treatment methods have been proven to be effective, including self-care strategies, dental treatment strategies, pharmacological treatment, physical therapy modalities, manual mobilization, electrotherapy and dry needling, relaxation techniques, intra-articular injections, cognitive behavioral therapy, and surgical corrections.

A Physical Therapy Rehabilitative Approach in Improving Activities of Daily Living in a Patient With Morel-Lavallée Syndrome: A Case Report.

A limited soft tissue injury known as Morel-Lavallée syndrome is brought on by the violent segregation of the dermis and subcutaneous tissue layer. Shear injury causes perforating arteries and lymphatics to burst, potentially releasing serosanguinous fluid, blood, and necrotic fat into the area. Morel-Lavallée lesions (MLL) can be accompanied by pelvic or acetabular fractures or by blunt trauma without a fracture. MLL is distinguished by enlargement, tightness, and tenderness of tissue. The skin around the lesion is frequently associated with diminished sensory perception. Plain radiography, USG, CT scan, and MRI are some of the imaging modalities that can be utilized. MLLs have a distinct location in the US, anterior to the muscle layer and posterior to the hypodermis. Morel-Lavallée lesions are frequently associated with complications as a result of delayed or inappropriate diagnosis. Surgical drainage and debridement are the standard surgical treatments for the lesion. Physiotherapy rehabilitation helps in reducing pain and regaining functional activities after the syndrome. This documentation includes the case of a 55-year-old male patient who had complaints of difficulty in moving their left leg and inability to walk. The patient was diagnosed with Morel-Lavallée syndrome left thigh and was advised physiotherapy. This study found that by employing strengthening exercises and other physical therapy interventions, after four weeks of therapy, joint degree of movement, muscular strength, and daily functioning, as well as cardiovascular and pulmonary capabilities all significantly improved.

An Integrated Physiotherapeutic Approach With Virtual Reality in Schizophrenic Patients With Ipsilateral Femoral Shaft and Intertrochanteric Fractures: A Case report.

Femoral shaft fracture occurs through the diaphyseal region of the femur. The intertrochanteric (IT) fracture is an extracapsular fracture that occurs through the proximal metaphyseal area of the femur. The ipsilateral femoral shaft and IT fractures happen in rare cases following high-energy trauma. These fractures are difficult to manage due to their complexity. They are usually managed surgically and require prompt physiotherapeutic management postoperatively. The postoperative complications involve pain, stiffness, reduced muscle strength, deep vein thrombosis, muscular weakness, and atrophy. These complications occur primarily due to immobilization. In our case, the 30-year-old male patient was a known case of schizophrenia for three years. He met with a road traffic accident (RTA) while driving a car and acquired ipsilateral femoral shaft and IT fractures. He presented with the chief complaints of pain, swelling, deformity over the right thigh, and unable to bear weight over the right lower limb. X-rays revealed a right-side ipsilateral IT fracture and a femoral shaft fracture. The patient underwent an operation that involved open reduction and internal fixation with a proximal femoral nail under spinal epidural anesthesia. We started physical therapy management on postoperative day three. On clinical evaluation, there was a decrease in the range of motion and muscle strength of the right lower limb. This case posed us with a challenge to deliver postoperative physiotherapeutic intervention without elicitation of the symptoms associated with schizophrenia. The physiotherapy protocol involved virtual reality-based (VR-based) interventions in adjunct to conventional therapeutic interventions like strengthening exercises, range of motion exercises, application of electrical modality, balance training, gait training, VR-based relaxation, and aerobic exercises. We used the Lower Extremity Functional Scale, Manual Muscle Testing, Range of Motion, Brief Psychiatric Rating Scale, and the Numerical Pain Rating Scale as outcome measures. The comparison of pre-and post-outcome measure scores demonstrates a significant improvement.