Multimodal Exercises Adjunct to Virtual Reality in Acromioclavicular Joint Sprain Rehabilitation: A Case Report.

Acromioclavicular joint (AC) sprains are common, usually resulting from a fall on the corner of the shoulder or, less often, an outstretched arm. In this report, we discussed the assessment and physiotherapy protocol along with virtual reality (VR) training of a 21-year-old male state-level kabaddi player who complained of pain in his left shoulder following a history of fall on his left shoulder while playing. This study highlights clinical assessment, diagnostic assessment, therapeutic intervention, and outcomes for patients with a grade II AC sprain. Pain, range of motion (ROM), and muscle strength were clinically assessed. The patient was managed with cryotherapy, movement with mobilization (MWM), rigid taping, ROM exercises, VR training, and muscle strengthening. The results of the study concluded that our conventional physical therapy along with MWM adjunct to VR facilitates the patient's functional recovery.

Crushing Consequences: A Case Report on the Rehabilitation of a Middle Phalangeal Fracture in an Industrial Incident.

Hand injuries, particularly fractures involving the phalanges and metacarpals, are common occurrences in various settings, including industrial environments. Prompt and effective management of these injuries is crucial to minimize long-term disability and facilitate return to work. This case report focuses on the rehabilitation of a middle phalangeal fracture in an industrial worker following Kirschner wire (K-wire) fixation. The patient, a 24-year-old male, sustained the injury while operating an electric stamping machine. Emergency surgery was performed to stabilize the fracture, and subsequent physiotherapy was initiated due to persistent difficulties in hand function. The rehabilitation protocol aimed to address pain, improve range of motion, and enhance grip strength through passive range of motion exercises, movement with mobilization techniques, blocking exercises, and grip strengthening exercises. Mulligan's mobilization with movement (MWM) concept was incorporated to facilitate rapid pain relief and movement restoration. Follow-up assessments after four weeks of rehabilitation revealed significant improvements in pain levels, range of motion, strength, and overall quality of life. The case underscores the importance of timely intervention and comprehensive rehabilitation strategies in managing traumatic hand injuries in industrial settings, aiming to optimize treatment outcomes and promote successful return to work.

Rehabilitation With Eccentric Training Using Kettlebell and Kinesio Taping in a Young Volleyball Player With Proximal Biceps Tendinopathy: A Case Report.

A prevalent overuse injury among athletes, especially to those participating in sports like volleyball that demand repeated overhead motions, is biceps tendinopathy. The painful condition known as biceps brachii tendinopathy is characterized by changes in the structure of the tendon together with chronic degeneration. Furthermore, the biceps aid in the acceleration and deceleration of the arm in numerous overhead sports. The biceps may experience excessive strain as a result of poor training or exhaustion. It is commonly known that the long head of the biceps tendon plays a significant role in producing pain, particularly when it comes to anterior shoulder discomfort and dysfunction in athletes and working people. Athletes' biceps tendon conditions fall into three broad categories: degeneration, instability, and abnormalities that are of source. This case details the use of kettlebell eccentric exercise and kinesio taping in the rehabilitation of a young volleyball player with biceps tendinopathy. The four primary aspects of the rehabilitation regimen were kinesio taping, pain management and rest, eccentric training with kettlebells, and initial assessment and patient education. Kettlebell eccentric training was used to enhance eccentric strength and encourage tendon remodeling, and kinesio taping was used to give pain relief and structural stability. This case study emphasizes the value of an all-encompassing rehabilitation strategy catered to the unique requirements of every athlete by demonstrating the effectiveness of kinesio taping and eccentric exercise with kettlebells in the treatment of biceps tendinopathy.

Nonsurgical Rehabilitation Perspectives for a Type I Salter-Harris Fracture With Lipohemarthrosis and Concomitant Grade II Anterior Cruciate Ligament (ACL) Tear in a Volleyball Athlete: A Case Report.

Anterior cruciate ligament (ACL) tears represent common occurrences in sports, particularly posing significant risks to young athletes. The diagnostic methods for ACL injury include magnetic resonance imaging (MRI), arthroscopy, and physical examination. Management of this injury can be done both operative and nonoperatively. Pediatric growth plate fractures are classified under the Salter-Harris classification. A 13-year-old male athlete sustained a knee injury during a volleyball match. While landing from a jump after a smash, the athlete directly landed on the ground on his right knee. After this, he reported discomfort and severe anterior knee pain. Due to immobility and pain, he was taken to the emergency unit. Upon radiographic examination, a Salter-Harris Classification Type I fracture was found, indicating epiphyseal slip and separation through the physis of the right proximal tibia medially. An MRI imaging was done to check the integrity of the ACL after the swelling had subsided post-15 days of injury. An MRI identified a bony contusion on the medial tibial plateau, extending to the physeal plate with a Grade II ACL tear. The concurrent occurrence of ACL injury and growth plate injury presents a significant concern. Hence, a referral for physical therapy rehabilitation was given. Our findings highlight the importance of prompt initiation of physical rehabilitation following such injuries. Where non-surgical rehabilitation strategies play a crucial role in managing these cases while focusing on restoring knee stability, promoting healing of the growth plate, and facilitating a safe return to sport. Tailored rehabilitation, including therapeutic exercises, neuromuscular training, and proprioceptive training, is essential for optimizing outcomes and preventing long-term complications. The case underscores the importance of a multidisciplinary approach in managing the complex knee injury of this young athlete.

Effectiveness of Physiotherapy Interventions in Pleural Effusion Patients: A Comprehensive Review.

Pleural effusion, characterized by the accumulation of fluid between the parietal and visceral pleura, presents significant challenges in patient management, particularly in cases of malignant pleural effusion. Despite various therapeutic options, there is a need to evaluate the effectiveness of physiotherapy interventions specifically for pleural effusion patients, as current literature predominantly focuses on medical and surgical treatments. This comprehensive review aims to address this research gap by systematically analyzing the impact of physiotherapy on pleural effusion management, with a focus on symptom relief and improvement in quality of life. The objective is to determine the role of physiotherapy in reducing hospital stay and enhancing patient outcomes. Methodologically, this review synthesizes data from clinical studies and case reports that document physiotherapy interventions, such as breathing exercises, postural drainage, and mobilization techniques, in the treatment of pleural effusion. Our findings suggest that physiotherapy interventions can significantly alleviate dyspnoea and improve respiratory function, contributing to better overall patient outcomes. These results underscore the importance of incorporating physiotherapy into the standard care protocol for patients presenting with pleural effusion to optimize recovery and quality of life.

An Integrated Approach to Chronic Low Back Pain: Evaluating the Impact of Consecutive Loop TheraBand Training Combined With Proprioceptive Neuromuscular Facilitation and Conventional Physiotherapy.

Chronic low back pain (CLBP) is a prevalent musculoskeletal condition characterized by persistent discomfort in the lumbosacral region lasting beyond 12 weeks. Individuals with CLBP often experience limitations in range of motion and compromised performance of affected body parts. Core muscle weakness/delayed activation and impaired lumbar proprioception are established contributors to CLBP. And influence balance dysfunction in CLBP patients. Exercise therapy is a cornerstone in the management of CLBP, aimed at enhancing muscular endurance, strength, and flexibility of the back muscles and soft tissues. However, the efficacy of exercise interventions depends on various factors including the type, intensity, frequency, and duration of exercises. This case report presents the rehabilitation of a corporate employee with a non-specific CLBP. The rehabilitation goals focused on improving balance, reducing disability, and alleviating pain. An integrated approach combining proprioceptive neuromuscular facilitation (PNF) with Consecutive Loop TheraBand (CLX) (The Hygenic Corporation, Akron, USA) along with traditional physical therapy techniques was implemented. PNF, a well-established technique, was chosen for its effectiveness in reducing disability and LBP while enhancing balance. The integration of PNF alongside conventional physiotherapy resulted in notable improvements, including increased lumbar flexion range following the rehabilitation period. This case underscores the importance of early initiation of comprehensive rehabilitation in CLBP patients to preserve strength, alleviate pain, reduce functional disability, and enhance balance. By addressing both the muscular and proprioceptive aspects of CLBP, this integrated approach aims to optimize outcomes in CLBP management.

Management of Low Back Pain With Concurrent Hamstring Tightness: A Case Report Highlighting the Efficacy of Proprioceptive Neuromuscular Facilitation, Mulligan's Two-Leg Rotation Technique, and Exercise Regimen.

Low back pain (LBP) is a prevalent musculoskeletal issue characterized by discomfort in the lumbosacral region. LBP localized between the 12th thoracic vertebra and inferior gluteal folds is common and often lacks a clear etiology. Various factors contribute to LBP, including increased lumbar lordosis, diminished abdominal muscle strength, reduced back extensor muscle endurance, and flexibility limitations in the back extensors, iliopsoas, and hamstrings. Treatment modalities for LBP encompass surgical intervention, pharmacotherapy, lumbar injections, psychotherapy, chiropractic care, and physiotherapy, with manual therapy being a prominent approach. Physiotherapists employ a spectrum of manual techniques, including mobilization, manipulation, and massage, to address LBP. Hamstring flexibility plays a pivotal role in spinal mechanics, and tight or shortened hamstrings can exacerbate LBP. Mulligan's techniques, notably the two-leg rotation (TLR) technique, are valuable interventions for addressing hamstring tightness in cases of LBP. Proprioceptive neuromuscular facilitation (PNF) was also used to manage pain and improve strength. This case report outlines the management of a 32-year-old male presenting with LBP and hamstring tightness coupled with core muscle weakness. Through comprehensive assessment and physiotherapeutic interventions, significant improvements were observed in pain intensity, lumbar range of motion, disability, straight leg raise (SLR), and core muscle strength following a three-week physiotherapy intervention.

Physiotherapeutic Management for Acromioclavicular Joint Sprain With Volar Intercalated Segment Instability at the Wrist: A Case Report.

Among sports enthusiasts and young individuals, acromioclavicular (AC) joint injuries are highly prevalent. In this, we discussed the comprehensive assessment and management of a 22-year-old male patient who is a student by occupation and a recreational badminton player who presented with left shoulder and wrist pain following a road traffic accident. The study highlights the clinical findings, diagnostic assessment, and therapeutic interventions for the patient with volar intercalated segment instability and a grade 1 AC joint sprain. The methodology involves a case report of the patient's clinical evaluation, including range of motion, manual muscle testing, and diagnostic imaging. The patient was managed conservatively with physiotherapy interventions, including Mulligan's movement with mobilization, cryotherapy, light amplification by stimulated emission of radiation, and progressive exercises. The results of the study demonstrate the successful implementation of a multidisciplinary conservative management approach for alleviating pain, restoring function, and promoting optimal recovery for the patient. The implications of the study underscore the significance of tailored physical therapy rehabilitation in the management of AC joint sprains and wrist instabilities.

Integrative Approach of Conventional Physiotherapy, Mulligan's Mobilisation With Movement, and Plyometric Training in a Young Volleyball Athlete After Anterior Cruciate Ligament (ACL) Reconstruction: A Case Report.

The requirements of volleyball include specialized, strategic, and acrobatic skills. In volleyball, it is thus essential to build maximal power and strength properly. Strengthening has been recommended as an effective means to avoid injuries and build muscle strength. It also enhances one's health in relation to performance in the game. Anterior cruciate ligament (ACL) tears are a common knee injury affecting athletes of all levels. A big problem with injury healing and getting back to sports is that there isn't a tried-and-true protocol or set of steps an athlete should follow following an ACL injury. Plyometric training focuses on the core, hip, and thigh muscles to help with appropriate lower limb alignment and recruiting of muscle. We present a 25-year-old male volleyball athlete who suffered from an ACL tear. This case report emphasises how important sports physiotherapy rehabilitation is for athletes. The case report advances the treatment of ACL injury by a multifaceted approach of Mulligan's mobilisation with movement and plyometric-based interventions.

Enhancing Athletic Performance: A Comprehensive Review on Kettlebell Training.

A kettlebell is a weight made of cast iron shaped like a ball with a handle. Commercial kettlebells are offered in capacities that vary from 3 pounds to 100 pounds (or more). The kettlebell has a variety of possible clinical applications, including dynamic flexibility exercises and power training. Players' efficacy during the game can be improved by developing their strongest potential prior to exercising and efficiently converting that strength to power as the event draws near. Strengthening has been recommended as an effective means to avoid injuries, build muscle strength, and enhance one's health in relation to performance in the game. This type of training focuses on the hip, thigh, core, and abdominal muscles to help with appropriate lower-limb alignment and the recruitment of muscle patterns. Kettlebell training is a flexible and useful strategy for improving players' performance in a variety of sports. It adds value to athlete training programs by enhancing strength, power, endurance, explosive power, and postural coordination.

Optimizing Agility and Athletic Proficiency in Badminton Athletes Through Plyometric Training: A Review.

This review study investigates the advantages of plyometric training in badminton, concentrating on the effects on agility, power, speed, and overall athletic performance. It looks at the research on plyometric training in badminton, including training methods, performance effects, and potential injury prevention. The study underlines the value of plyometric training in enhancing agility, letting athletes move swiftly around the court, and producing the explosive force needed for quick and accurate strokes. It also looks at how plyometric training affects jumping ability and explosiveness, with a concentration on vertical jumps and hard smashes. In addition, the research explores the function of plyometrics in injury prevention in the physically demanding sport of badminton. Plyometric training has emerged as a key component in lowering injury risk and extending player life by strengthening muscles and connective tissues and boosting stability. The review study objectively reviews the existing corpus of research to provide a full picture, considering prior studies' strengths and limitations. It gives coaches, athletes, and trainers concrete ideas for incorporating plyometric activity into their badminton training routines. The study gives readers actionable recommendations for improving agility and athletic performance in badminton athletes by tailoring plyometric exercises to the unique demands of the sport and addressing safety concerns. In a sport where margins of victory are frequently razor-thin, embracing the possibilities of plyometric training can provide a competitive edge, ultimately improving the performance and success of badminton competitors.

Effect of Neuromuscular Training and Neurodynamic Solutions for Asymptomatic Prolapsed Intervertebral Disc and Coexisting Piriformis Syndrome in a 19-Year-Old: A Comprehensive Case Report.

This case study examines the treatment journey of a 19-year-old male who presented with bilateral buttock pain, lower limb weakness, and instability caused by piriformis syndrome and asymptomatic Prolapsed intervertebral disc (PIVD) herniation. The intervention strategy was guided by clinical assessments, including neurological and musculoskeletal evaluations, as well as confirmatory magnetic resonance imaging (MRI) findings. The patient's treatment plan adopted a comprehensive approach that incorporated neuromuscular training and neurodynamic solutions. The former focused on strengthening the core and lower limb muscles to correct biomechanical imbalances associated with piriformis syndrome. Concurrently, neurodynamic solutions, such as targeted stretching and mobilization exercises, were employed to alleviate sciatic nerve compression related to asymptomatic PIVD. The results demonstrated significant improvement in symptoms, highlighting the effectiveness of the individualized rehabilitation program. This case report underscores the success of a multifaceted approach in addressing the intricate interaction between muscular and neural components in piriformis syndrome and asymptomatic PIVD. However, further research is necessary to validate the broader applicability of this combined therapeutic strategy.

Medial Patellofemoral Ligament Reconstruction: A Case Report for an Integrated Rehabilitation Approach.

Medial patellofemoral ligament (MPFL) reconstruction is a surgical treatment, primarily indicated for patients grappling with recurrent patellar instability stemming from traumatic injury or underlying anatomical anomalies. This abstract aims to elucidate the indispensable role of physiotherapy in the post-operative rehabilitation trajectory for individuals subjected to MPFL reconstruction. Physiotherapy emerges as a linchpin in securing a triumphant outcome, fostering the healing of patellar stability, augmentation of range of motion (ROM), and bolstering muscular strength while concurrently mitigating potential complications. The abstract accentuates salient facets of a physiotherapeutic regimen, encompassing prompt post-operative mobilization, meticulously tailored exercise paradigms, adept utilization of manual therapy modalities, and comprehensive patient education. Notably, this collaborative endeavor between orthopedic surgeons and physiotherapists is pivotal in optimizing patient convalescence, restoring them to their pre-injury functional acumen. A paramount emphasis is placed on individualized rehabilitation strategies, gradual and systematic exercise protocols, and patient adherence, thereby underscoring how the harmonious synergy between surgical and physiotherapeutic interventions augments the prospects of achieving a successful MPFL reconstruction outcome.

Taping Adjunct to Strengthening and Proprioception in a Hill-Sachs Lesion Patient: A Case Report.

A Hill-Sachs lesion is a bony defect in the head of the humerus due to recurrent dislocation, which results in friction between the humeral head and the glenoid fossa. This recurrent incident of dislocation that occurs in the anterior direction eventually leads to a Bankart lesion (a defect in the glenoid rim). A 21-year-old male, a recreational football player, reported recurrent shoulder dislocation, complaining of pain and difficulty doing certain activities. He had hypermobility of the shoulder joint during joint play assessment. Proprioception is the sense of the position and movement of one's own body. Exercises that improve proprioception can help improve shoulder stability and reduce the risk of shoulder injuries. Proprioception has shown significant positive results in shoulder dislocations. A physiotherapy protocol was designed that included strengthening of shoulder and scapular musculatures, proprioceptive exercises, and plyometric exercises for developing agility. All these exercises were given with taping for the shoulder joint. Taping helps stabilize the shoulder and normalizes muscle function. With the help of physiotherapy, patients can avoid invasive procedures for restoring stability in non-traumatic recurrent shoulder dislocations.

Emphasizing Pulmonary Function With Respiratory Therapy in an Infant With Congenital Adrenal Hyperplasia, Bronchopneumonia and Leptomeningitis.

A set of hereditary diseases affecting the adrenal glands, a couple of walnut-sized structures above the kidneys, is known as congenital adrenal hyperplasia (CAH). The adrenal glands generate essential hormones like cortisol, mineralocorticoids, and androgens. It is usually diagnosed in the early neonatal period. The documentation of this case study is aimed to provide a case of an infant with CAH associated with bronchopneumonia and leptomeningitis. Brought with complaints of poor feeding, moderate fever associated with chills, and loose stools, was an 11-months-old patient with a known diagnosis of CAH. Symptoms have shown that the baby was in a possible adrenal crisis. He was intubated with an endotracheal tube after repeated episodes of seizures. Investigations revealed signs of bronchopneumonia and leptomeningitis. A thorough assessment, once completed, helped in analyzing relevant problems to be treated with respiratory therapy. Respiratory therapy, in this case, was aimed at improving the blood oxygen levels and assisting breathing by clearing out secretions and opening up the airways. Parent education was the foremost part of the treatment regime, followed by bronchodilator administration, conventional chest physiotherapy, postural drainage positions in the mother's lap, lung squeezing technique, and perioral pressure. A holistic and multidisciplinary approach is beneficial in patients with CAH undergoing an adrenal crisis. It needs to be offered to the patients who would be benefited, considering the effect, which needs to be reassessed on specific outcomes with changes in the management with the improving condition.

Effectiveness of Mulligan's Two-Leg Rotation Versus Muscle Energy Technique in Subjects With Hamstring Tightness.

Background Hamstring stiffness has been growing more common, but is often neglected. The hamstring muscle complex is the key and most commonly involved muscle group for stiffness, and the younger generation is particularly susceptible. The tightness causes a limited range of motion and associated consequences. The purpose of this study is to look for the efficacy of Mulligan's two-leg rotation (TLR) and muscle energy technique (MET). Methods To evaluate TLR against MET, an intervention with a duration of six days per week was planned. Modified Oswestry disability questionnaire (MODQ), active knee extension (AKE), lumbar range of motion (LROM), and numerical pain rating scale (NPRS) were used as outcome measures. The duration of the study was six months. It is a pre and post-interventional type of study. Result Statistical analysis was done by using descriptive and inferential statistics using Student's paired and unpaired t-tests. The Statistical Package for Social Sciences (SPSS) version 27 (IBM Corp., Armonk, NY, USA) was used. A p-value <0.05 was considered significant. Both the treatment protocol were beneficial for the patients but TLR yields a more significant reduction in tightness and pain than MET. Conclusion The results after the data analysis show that TLR should be utilized for individuals with hamstring tightness because it exhibited a significant reduction in tightness and pain when compared to MET.

Physiotherapeutic Rehabilitation of a Patient With a Comminuted Displaced Iliac Fracture and Superior and Inferior Pubic Rami Fractures: A Case Report.

Ilium fractures, which commonly advance from the iliac crest to the greater sciatic notch, are high-energy pelvic fractures that are frequently unstable. The general course of management for this injury is conservative, although cases of substantially displaced have been described that warranted surgical intervention. Many conditions, including decreased mobility, structural alterations in the joints, and discomfort, might make people more vulnerable to falls while waiting for hip or knee surgery. This can have an effect on both preoperative and postoperative functioning. The goal of surgical treatment for these individuals is to return them back to their prefracture state. This article presents the case of a 30-year-old male who was obtained a dash injury while riding a motorbike. He was diagnosed by an orthopedic surgeon with right-sided iliac blade fracture extending towards sacroiliac joint with right-sided sacral ala fracture and superior pubic rami fracture extending toward iliopectineal line and right-sided inferior pubic rami fracture (Tile Classification Type B3). He was operated via open reduction and internal fixation (ORIF) with osteosynthesis plating was done. Following surgery, the patient was dependent and his daily living was hampered. However, physiotherapy intervention improved the patient's pain and physical functioning and he gained independence in carrying out daily activities.

Extreme Lengthening of Tibia Using Bone Transport Technique: A Rare Case Report.

This is a case describing a 13-year-old female student having a history of a fall-developed wound over the anterior aspect of the right leg with discharging sinus treated as chronic osteomyelitis and operated and distal tibia corticotomy and Ilizarov fixation was done. The patient was full of complications, but full limb lengthening was restored with follow-up. The Ilizarov frame's proper installation and the middle segment's efficient transportation are essential variables in reducing the likelihood of the transported segment deviating.