Efficacy of immediate physiotherapy after surgical release of zygomatico-coronoid ankylosis in a young child: A case report.

BACKGROUND: Temporomandibular joint ankylosis (TMJ ankylosis) manifests itself as a locked jaw and reduced mouth opening. We hypothesized that the efficacy of TMJ ankylosis surgery in a child may largely depend on physiotherapeutic management. CASE DESCRIPTION: In this case report, we present the treatment of a girl between 1 and 4 years of age, who was unable to open her jaws immediately after birth. Congenital ankylosis was diagnosed. INTERVENTION: Two models of therapeutic management were presented, with a surgical procedure to release bone fusion adopted as a starting point. In the first model, the rehabilitation procedure started 21 days after surgery. OUTCOMES: Despite rehabilitation, no clinical improvement was achieved (i.e. the child was still unable to open her jaws). In the second model, rehabilitation started from the day after surgery and management according to the second model allowed for obtaining therapeutic benefits. After therapy, the girl was able to abduct the mandible to a degree allowing for improved speech and the ability to crush food. CONCLUSIONS: This clinical case shows that the efficacy of surgical procedures may depend on the type of postoperative management. It was demonstrated that physiotherapy started immediately after the procedure to release the ankylosis improved the mandible mobility outcomes for this child.

Ultrasound Assessment of the Abdominal Muscles at Rest and During the ASLR Test Among Adolescents With Scoliosis.

STUDY DESIGN: Observational study. OBJECTIVE: Are there deviations in the thickness of abdominal muscles at rest in individuals with adolescent idiopathic scoliosis (AIS)? Are there deviations in abdominal muscular activity in people with AIS during the active straight leg raise (ASLR) test? SUMMARY OF BACKGROUND DATA: Ultrasound imaging can be used to assess the lateral abdominal muscle. Some authors suggest that scoliosis develops through a weakness or improper functioning of the abdominal muscles that cannot provide adequate support to the spinal segments. However, the literature lacks studies on the functioning of the abdominal muscles in individuals with spinal deviations. This study focuses on the evaluation of the thickness of the external oblique (EO), internal oblique (IO), and transversus abdominalis (TrA) muscles of individuals with AIS. MATERIALS AND METHODS: Seventy-one healthy adolescents and 71 patients with AIS, all aged 10-16 years, were studied. The thickness of the muscles at rest was measured at the end of normal exhalation in millimeters. Muscular activity during the ASLR test was measured in the final position, and the standards were normalized with the thickness produced at rest. Muscular activity during the ASLR test was represented as a percentage change in the muscle thickness. RESULTS: The AIS group demonstrated a smaller resting thickness of all tested muscles of both sides (P<0.01). All the muscles on the right side of the body showed higher activity in the AIS group during the ASLR test (P<0.01). CONCLUSIONS: Patients with AIS had thinner EO, IO, and TrA at rest in the supine position. During the ASLR test, the AIS patients displayed higher activity of the EO, IO, and TrA muscles on the right side.

Effect of manual therapy and neurodynamic techniques vs ultrasound and laser on 2PD in patients with CTS: A randomized controlled trial.

STUDY DESIGN: Randomized controlled trial. INTRODUCTION: Two-point discrimination (2PD) test can be used to assess both clinical condition and the effects of therapy in carpal tunnel syndrome (CTS) patients. PURPOSE OF THE STUDY: To determine whether there are specific differences in 2PD between symptomatic and asymptomatic hands in CTS patients and to evaluate the impact of 2 therapy regimes on 2PD in patients with CTS. METHODS: Therapy for the neurodynamic mobilization group was based on manual therapy and neurodynamic techniques. Therapy for the electrophysical modalities group was based on red and infrared laser and ultrasound therapy using a contact method applied in the transverse ligament area. Therapeutic cycle consisted of 20 therapy sessions delivered at twice-weekly intervals. RESULTS: After therapy, 2PD in the symptomatic limbs in the neurodynamic mobilization and electrophysical modalities groups significantly improved (p < .001). However, there was no statistically significant difference between the treatment groups. CONCLUSIONS: Both therapy programs used in this study were beneficial for improving 2PD. LEVEL OF EVIDENCE: 2.

Effectiveness of physiotherapy in the treatment of excessive lateral pressure syndrome after anterior cruciate ligament reconstruction - preliminary report.

BACKGROUND: The excessive lateral pressure syndrome is a common complication following anterior cruciate ligament (ACL) reconstruction is. It may lead to premature wear of the articular surfaces of the femur and patella. The aim of the study was to assess the effectiveness of physiotherapy in the treatment of excessive lateral pressure syndrome after ACL reconstruction. MATERIAL AND METHODS: A total of 18 patients (4 women, 14 men) after arthroscopic ACL reconstruction were enrolled (age: 16 -54 years). The patients were randomly divided into two groups: experimental (Group E, 9 people), who attended therapy, and control (group C, 9 people). The distance between the lateral edge of the patella and the lateral condyle of femur was measured with an ultrasound scanner in both extremities. The experimental group patients attended 12 treatment sessions of the.Neurac method. A single session lasted 45 minutes. RESULTS: The baseline examination of both groups showed statistically significant excessive lateral pressure in the operated extremity in relation to the non-operated one in every angular position. At the same time, the quadriceps femoris of the operated extremity was found to be significantly weaker than its counterpart. On completion of the rehabilitation, statistically significant differences in quadriceps strength were recorded in the experimental group compared to the baseline examination while there were no significant differences in the control group. An intergroup comparison did not reveal any significant differences in quadriceps strength. There were also no significant differences in the severity of lateral pressure syndrome before and after the therapy in either group. CONCLUSIONS: 1. Rehabilitation improved quadriceps femoris, strength; it did not, however, decrease excessive lateral pressure syndrome. 2. The rehabilitation programme is not sufficient in conservative treatment of excessive lateral pressure syndrome.