Trunk and Hip Analysis During Gait in Post-Discectomy, Active Lumbar Stabilization.

This paper presents a post-discectomy rehabilitation program through active lumbar stabilization with focus on trunk and hip movement analysis during gait. Material and methods: Analysis consisted of a kinematic gait study, with kinematic point tracking and software data processing in MATLAB. The analysis was performed on a patient with L5-S1 discectomy. The purpose was to track progress and change in trunk and hip during the rehabilitation program and to establish a relationship between trunk and hip movement during gait, in regards to the patient's rehabilitation program. Results: Trunk and hip analysis during gait showed significant differences in patient hip and trunk rotational movement between the three analyzed readings of the patients. Changes were found in both left and right hip flexion-extension coupling and flexion in terminal swing. The rotational movement of the trunk is reduced in a more physiological margin from -13.4 to -1.0 anterior-posterior movement which correlates with unimproved in transversal rotation. The analysis made for hip and trunk synchronization revealed an increased synchronization after the end of the functional reeducation program. Conclusions: This method allowed to evaluate changes in trunk and hip motion during gait. Tracking and visualizing the motion between trunk and hip during gait gives a better understanding of the importance of each movement and the strong link between gait phase coordination and motion angle amplitude. It gives a new perspective on the rehabilitation process that targets lumbar stabilization.

Neuro-proprioceptive facilitation in the re-education of functional problems in facial paralysis. A practical approach.

UNLABELLED: Facial paralysis, in the form of Bell's syndrome, is an acute paralysis of idiopathic origin. Disability in patients with this medical condition is the result of impairment or loss of complex and multidimensional functions of the face like emotion expression through facial mimics, facial identity and communication. AIM: This study aimed to present new and improved practical manual techniques in the area of facial neuromuscular facilitations and to review the literature for disability indexes and facial nerve grading. MATERIAL AND METHODS: We present the practical modality of using neuro-proprioceptive facilitation techniques, such as rhythmic initiation, repeated stretch (repeated contractions), combination of isotonics and percussion, and also report the effects of these techniques in three Bell's syndrome patients which were previously evaluated. CONCLUSIONS: Recovery from facial paralysis can be a difficult and long lasting process and the utilization of a grading system may help the physical therapist. The effects of this type of therapy may help_benefit the patient if the therapist is well trained and familiar with the neurophysiological background.

[Discarthrosis with hyperalgic lumbar multileveled radicular syndrome]. / Spondilo-discartroza cu sindrom lombar radicular etajat hiperalgic.

UNLABELLED: The problems at the level of intervertebral discs are producing dysfunctions and important functional regression at the level of lumbar column, at a stage at which the patient could remain blocked in an anterior or lateral flexion position or producing an antalgic position of scoliosis that could incapacitate the patient to perform activities of daily living. The medical rehabilitation, in such cases, must seek not only the relief of local pain through different methods of obtaining it, but also the functional reeducation of the intervertebral articulations through specific analytical mobilization in order to achieve the biomechanical harmonization of the rachis. MATERIAL AND METHODS: We report the case study of a 66 year-old patient who presented to our clinic for medical consult and physical therapy when he was diagnosed with discharthrosis, hyperalgic lumbar multileveled radiculopathy at L4-L5 and L5-S1. The lumbar x-ray showed osteophytes, disc narrowing at the level of L5-S1 and inter-apophysis arthrosis. The clinical examination revealed difficulty walking with pain in the right sacroiliac articulations and right sciatic emergence with plantar paraesthesia. The patient developed pain induced scoliosis on the right side that restricted the lumbar range of motion and prevented the right flexion blocking him into an left flexion, any attempt of straightening inducing pain. The condition was treated using specific analytical lumbar mobilization for the realignment of the vertebrae complex. CONCLUSIONS: In this case study, we found that functional reeducation in cases of pain induced deviations of the rachis of the column should be centered on the harmonization of inadequate pressure and position of the complex intervertebral articulations.