Exploring the Efficacy of Physiotherapy in Guillain-Barré Syndrome Through Virtual Reality-Based Rehabilitation: A Case Report.

Guillain-Barré syndrome (GBS) refers to a spectrum of acute immune-mediated polyradiculoneuropathies, among which is acute motor axonal neuropathy (AMAN), which is typified by predominant motor involvement and axonal degeneration. This case study describes the presentation, diagnosis, and physiotherapy management using virtual reality-based technology in a 29-year-old male patient with AMAN. Nerve conduction velocity testing was used to diagnose motor axonal neuropathy in the patient, who had weakness subsequent to gastrointestinal symptoms. Intravenous immunoglobulin therapy was started, and a physiotherapy protocol was planned for eight weeks according to the patient's functional status. Physiotherapy plays an important role in the rehabilitation of patients with GBS, addressing the specific motor deficits and promoting recovery. The aim was to improve muscle strength, mobility, and functional independence through progressive exercises targeting specific motor deficits. Virtual reality-based training was also part of this rehabilitation process as an adjunct to conventional rehabilitation to improve dynamic balance and function of the upper and lower limbs, which showed significant improvement in the outcome measures.

A Novel Physiotherapy Approach for Enhancing Mobility in a 53-Year-Old With Down Syndrome: A Case Report.

Down syndrome (DS) is a genetic condition developing from a supplementary chromosome 21, referred to as trisomy 21. It ranks among the most prevalent developmental disabilities. People with DS often live inactive lifestyles, not meeting the weekly physical activity guidelines. With age, they face increased risks of cardiovascular disease and osteoporosis, as well as neurological and orthopedic concerns. Physiotherapy is especially important for improving balance, coordination, strength, and endurance in adults over the age of 50. Our approach consisted of a three-week regimen that included strengthening exercises based on the DeLorme strength training principle, balance exercises with perturbation and treadmill training, and coordination exercises with equilibrium and non-equilibrium movements. We evaluated outcomes using measures such as the Berg Balance Scale, Timed Up and Go test, and Functional Independence Measure, which were performed before and after the physiotherapy intervention. We present a case study of a 53-year-old woman to demonstrate the importance of physiotherapy in making lifestyle changes and improving strength, balance, and endurance, thereby improving overall quality of life through tailored interventions.

The Prevalence of Nomophobia in Medical Undergraduate Students of Central India.

Introduction Nomophobia is an emerging phobia resulting from people's excessive interaction with mobile phones. This phobia is rapidly increasing due to significant technological innovations and widespread acceptance and usage of mobile phones worldwide. Nomophobia is often associated with complications such as panic attacks, irritability, and anxiety. Smartphone usage is particularly high among the younger population, raising concerns as it generates distress and leads to various problems. This study aims to determine the prevalence of nomophobia among undergraduates. Method  The study utilized the Nomophobia Questionnaire (NMP-Q) with a minimum sample size of 136. A total of 300 Google Forms (Google, Mountain View, California) were circulated, out of which 172 responses were received. A Google Form comprising 20 questions related to smartphone use and nomophobia was designed and distributed to all undergraduate students, who were requested to complete the form. The data based on their responses were subsequently analyzed. Results In this study, approximately 31.40% of students disagreed with experiencing panic when running out of credits or hitting monthly data limits. Additionally, 24.42% of students agreed that not having smartphones made them worried, as their family and friends could not contact them. About 16.86% of students strongly disagreed with feeling uneasy because they could not stay updated without their phones. Furthermore, 16.28% strongly agreed that they felt anxious due to the inability to contact their family and friends when not having smartphones. Conclusion It can be concluded from this study that nomophobia is present among undergraduate students. The overall usage of smartphones has increased in this population, highlighting the emergence of a serious disorder that warrants attention. Consequently, the usage of smartphones should be reduced through structured training programs, as this proves to be an effective method for enhancing undergraduates' understanding of the prevention and treatment of nomophobia.

Effects of a Tailored Pediatric Rehabilitation Protocol on Children With Neurometabolic Disorder: A Case Report.

Neurometabolic disorders encompass a diverse group of conditions characterized by inborn errors of metabolism, affecting various aspects of neurological function. This case report focuses on an 11-year-old male child with a neurometabolic disorder who presents with walking difficulties, speech impairment, and neurological symptoms. The background emphasizes the heterogeneity of neurometabolic disorders, their genetic and clinical complexity, and the need for tailored interventions to address specific manifestations. The primary aim of this study is to implement a comprehensive physiotherapy intervention plan for an 11-year-old male child with a neurometabolic disorder, targeting the improvement of gait abnormalities, regaining developmental milestones, and addressing associated challenges such as fatigue. The physiotherapy intervention plan employs a multifaceted approach, incorporating principles of neuroplasticity, motor learning, and adaptive strategies. A comprehensive gait training protocol involves proper orthotic fitting, forearm support walker training, treadmill exercises, and parallel bar training. Developmental milestones are addressed through motor and fine motor skill exercises. Coping strategies and energy conservation techniques are integrated to manage fatigue. The study utilizes outcome measures, including the Gross Motor Function Measure, Manual Ability Classification System, and Functional Independence Measure, to assess the impact of the intervention on the patient's functional abilities. Preliminary findings suggest promising improvements in gait, motor skills, and overall functional independence following the implemented physiotherapy intervention. The study underscores the potential effectiveness of a tailored approach rooted in neuroplasticity and motor learning principles for individuals with neurometabolic disorders. The patient-centered care model, encompassing coping strategies and energy conservation techniques, contributes to holistic well-being. While specific literature on these interventions in neurometabolic disorders is limited, the study provides valuable insights and calls for further research to refine and expand tailored therapeutic approaches in this challenging clinical context.

Exploring the Impact of Neurophysiotherapy in Managing Leukoencephalopathy Challenges: A Case Report.

Leukoencephalopathy (LE), characterized by structural changes affecting cerebral white matter, presents a complex clinical picture with diverse etiologies. This case report details the presentation, clinical findings, and physiotherapy management of a 32-year-old female with colony-stimulating factor 1 receptor (CSF1R)-related leukoencephalopathy and a history of diabetes and hypertension. She suddenly stopped her medications, which led to the worsening of her condition. She presented with symptoms of headache, slurred speech, visual disturbances, cognitive impairment, and impaired balance and coordination, due to which her activities of daily living were affected. The symptoms highlighted the challenges and multidisciplinary approach required for its management. The patient exhibited neurological deficits, cognitive decline, and abnormal reflexes, with magnetic resonance imaging (MRI) revealing white matter abnormalities. Outcome measures demonstrated significant improvements in cognitive and functional abilities, emphasizing the effectiveness of tailored rehabilitation in managing the complexities of colony-stimulating factor 1 receptor-related leukoencephalopathy. A six-week physiotherapy rehabilitation program addressed various domains, including strength training, task-specific exercises, errorless learning, facial muscle retraining, balance exercises, visual restoration therapy, and mobility training. All these interventions effectively improved her functional capacity and made the patient independent in performing activities of daily living.

Physical Rehabilitation Crucial in Motor Axonal Neuropathy Following Organophosphorus Poisoning: A Case Study.

In India, organophosphorus (OP) chemicals known as anticholinesterases cause a considerable amount of disease and mortality. While precise figures are unavailable, data from hospitals indicates that about 50% of acute poisoning episodes are attributed to organophosphates. Anticholinesterases, when accidentally or suicidally exposed, cause three different neurological disorders. The first is an acute cholinergic crisis that can be fatal and necessitates administration in an intensive care unit; the second is an intermediate syndrome that frequently results in cranial nerve palsies, proximal and respiratory muscle weakness, and respiratory support for patients; and the third is a delayed organophosphate-induced polyneuropathy. Together, these neurobehavioral alterations have been identified and are referred to as "chronic organophosphate-induced neuropsychiatric disorders" (COPIND). A 40-year-old male patient tried suicide by swallowing a significant dose of OP pesticide. He was breathing heavily, gasping for air, foaming at the lips, and smelled intensely of pesticide when he was brought to a private hospital. Investigations like nerve conduction velocity (NCV) were done, which revealed motor axonal polyneuropathy.

The Role of Early Rehabilitation in Better Outcomes in a Rare Presentation of Tuberculous Meningitis With Broca's Aphasia.

There is a complex link between tuberculous meningitis (TBM) and aphasia, in which a language impairment is caused by an injury to the cortical language centre. The parts of the brain that function for speech and language production are the Wernicke's, Broca's, and arcuate fasciculus regions. This case report mainly highlights the neurological consequences of TBM, and how it affects language and speech functioning. It outlines a comprehensive physiotherapy rehabilitation program that targets a range of issues for the patient, such as verbal output, weakness, motor deficits, articulation issues in speech, and coordination issues. Various treatment modalities can help correct weakness, improve balance and coordination, increase flexibility and range of motion (ROM), and make speech more fluent. The case report emphasizes the necessity of using an integrated approach that combines speech-language therapy (SLT), melodic intonation therapy (MIT), constraint-induced aphasia therapy (CIAT), medication treatments, and physical therapy to address the multifaceted impacts of TBM-induced aphasia on a patient's quality of life (QOL).

Rehabilitation Strategies for Wernicke-Korsakoff Syndrome: Physiotherapy Interventions and Management Approaches.

Korsakoff syndrome and Wernicke's encephalopathy (WE) show neurological and cognitive deficits. Wernicke-Korsakoff syndrome (WKS) is a compound neurological condition. The cause of this neurological condition could be the consumption of alcohol regularly for a chronic duration. A tailored rehabilitation protocol that focuses on cognitive and physical deficiencies was implemented along with thiamine supplementation for managing a case of a 49-year-old male patient who had a history of high alcohol consumption and was exhibiting typical signs of WKS. After planning a proper physiotherapy plan, it is necessary to look after the patient's progress along with re-evaluation, which reveals notable gains in cognitive function, memory, and functional independence. There is a dearth of research on the impact of physical therapy in managing WKS. The above case report reflects the benefits of combining physiotherapy, cognitive rehabilitation, and balance training to improve patient functionality and independence. Tailored rehabilitation interventions like the Benson relaxation method (BRM), brain gym exercises, Frenkel's exercise, electrical stimulation, sensorimotor training, basic body awareness therapy (BBAT), and gait training can be used to enhance a patient's quality of life. Addressing individual needs is essential in managing WKS, focusing on the importance of comprehensive care beyond cognitive rehabilitation alone.

Persistent Pulmonary Hypertension of Newborns Secondary to Labile Hypoxemia Associated With Cyanosis: A Case Series.

Persistent pulmonary hypertension of the newborn (PPHN) is a condition that can be fatal, marked by increased pulmonary vascular resistance that causes blood to shunt from the right to the left. Six infants that present with PPHN due to labile hypoxemia and related cyanosis are examined in this case series. Clinical manifestations, such as premature deliveries, maternal problems, and different reactions to early therapies, are revealed by perinatal and postnatal histories. The newborns' respiratory distress prompted the use of oxygen supplementation and continuous positive airway pressure (CPAP), but intubation was required due to continued hypoxemia. The series aims to establish a way for further study in this crucial area while offering insightful contributions to the clinical subtleties of PPHN and illustrating the importance of specific therapeutic approaches.

A Rare Case Report on Postoperative Rehabilitation in Hirschsprung Disease.

Hirschsprung disease (HD) is characterized by the absence of ganglion cells in the myenteric and submucosal plexuses of the hindgut. Here, we report a case of an eight-year-old male child who had abdominal distension with a history of repetitive gas passage and a complaint of stool passage. In February 2023, the patient was diagnosed with Hirshsprung disease, for which a left-side colostomy was done. In November 2023, he underwent Hirshsprung stage 2 repair. He was operated on the 17th of December 2023 under general anaesthesia colostomy mobilization. Physiotherapy commencement and evaluation were started on the 18th of December 2023. After the colostomy procedure, the incision weakened the abdominal and lower limb muscles, while bowel obstruction and discomfort further impeded the patient's ability to perform daily activities. Physical examination revealed increased work of breathing, reduced range of motion of the bilateral hip joint, reduced muscle strength of lower limb musculature, reduced abdominal muscle strength, difficulty in walking and waddling type of gait. Physiotherapy goals were set based on the problem list. The patient showed improvement in the two weeks of physiotherapy commencement, followed by improvement in functional ability. The comprehensive care provided during the rehabilitation phase aimed at addressing the specific needs arising from the surgical intervention, promoting optimal bowel function, improving ranges and strength and ensuring overall well-being.

A Tailored Physiotherapy Program in a Rare Case of Bilateral Territorial Cerebral Artery Infarction With Systemic Lupus Nephritis: A Case Report.

A stroke is a medical emergency that requires rapid treatment. Early intervention can help prevent brain damage and other negative consequences. An ischemic stroke occurs when a blood clot blocks or narrows a blood artery leading to the brain. Systemic lupus erythematosus (SLE) is characterized by systemic inflammation, autoantibodies, and a relapsing-remitting illness. Patients with SLE have an increased cumulative risk of cardiovascular events, including stroke, especially in the first five years after diagnosis. This case study presents the comprehensive physical therapy treatment of a 52-year-old woman diagnosed with systemic lupus nephritis and bilateral area infarct, an unusual combination. This condition resulted in issues such as decreased mobility, muscle weakness, and cognitive impairments. The specialized physiotherapy program employed a diverse strategy to address neurological weaknesses with multimodal stimulation, range of motion exercises, strength training, balance training, and more. The approach also includes energy-saving techniques and adaptive ways to manage symptoms associated with lupus nephritis to address fatigue and joint stiffness. The positive outcomes highlight the importance of tailored physical therapy regimens in maximizing functional recovery and improving the quality of life in the challenging context of concurrent bilateral infarct and systemic lupus nephritis. This case study emphasizes the need for individualized rehabilitation strategies in enhancing overall patient outcomes, contributing valuable insights to the sparse literature on managing such complex cases.

Targeted Physiotherapy for an Interesting Case of Spontaneously Resolving Extracapsular Infarct: A Case Report.

Stroke is a prevalent and disabling illness that is becoming more common in developing countries. After a stroke, physical inactivity frequently results in long-term deconditioning and disappointing consequences. This case study focuses on an infrequent 0.3% of ischemic stroke cases that occur in the external capsular (ECC) or extreme capsular (EXC) region. In sub-insular infarcts, ECC-EXC lesions are distinct and frequently linked to the anterior opercular syndrome. We are presenting the case of an 86-year-old female patient who had a fall and loss of consciousness. Diagnostic tests revealed that the patient had an extracapsular ischemic event; due to unstable vital signs and frequent drop in saturation of peripheral oxygen (SpO2) levels, the patient was intubated and admitted to the intensive care unit (ICU). When stable, the patient experienced generalized weakness, for which she was referred for physical therapy. Balance and gait impairments were secondary to weakness. A planned two-week structured physiotherapy intervention was created with an emphasis on gait training, muscle strengthening, and balance. Adaptive gait training, progressive exercises, and balancing activities addressed the patient's limitations. This case study demonstrates how an elderly individual with an external capsule ischemic event can benefit from targeted physical therapy for increasing muscle strength, balance, and gait performance. Positive results emphasize how crucial early and targeted physiotherapy is for supporting stroke survivors' neurological recovery.

Reviving Consciousness: A Neurophysiotherapy Triumph in Decompressive Craniotomy Recovery.

This case report presents a 54-year-old male with a history of type-2 diabetes mellitus who experienced sudden unconsciousness and vomiting, leading to aspiration and subsequent diagnosis of a hemorrhagic stroke. The patient underwent an immediate decompressive craniotomy, revealing a sizable intraparenchymal hematoma in the right basal ganglia and corona radiata. Postoperatively, the patient exhibited left-sided weakness, hyporeflexia, and cognitive impairment. A comprehensive neurophysiotherapy intervention addressed impaired mobility, strength, balance, coordination, respiratory complications, pain management, and other associated challenges. The rehabilitation protocol involved diverse strategies such as passive and active exercises, sensory stimulation, and the application of neurophysiotherapeutic approaches. The patient's progress was assessed using various outcome measures. Neurophysiotherapy plays a crucial role in the recovery of decompressive craniotomy.

Scope of an Integrative Neurophysiotherapy Approach in Achieving Gross Motor Milestones in a Child with Meningitis: A Case Report.

Meningitis caused by bacteria, which is an inflammation of the meninges affecting the pia, arachnoid, and subarachnoid space, is still one of the leading causes of death and morbidity in infants and young children. Neisseria meningitidis, group B streptococcus (GBS), Haemophilus influenzae type B (Hib), Listeria monocytogenes, and Streptococcus pneumoniae have been found to be the most frequent causative agents. Infants and children can have modest, fluctuating, non-specific, or even absent clinical signs of bacterial meningitis. They may include bulging fontanelles, vomiting, diarrhea, respiratory distress, hypothermia, lethargy, irritability, poor feeding, and fever in babies. In this case report, an 18-month-old child presented to a local hospital with complaints of multiple episodes of high-grade fever. After 10 days, his symptoms worsened and he experienced two episodes of seizures at one-day intervals at night. He was taken to Acharya Vinoba Bhave Rural Hospital for further management. Blood investigations revealed seropositive results for dengue virus infection. On MRI and CT scan, it was diagnosed as an old case of subdural hematoma in the right frontotemporal region of the brain. The patient was on intravenous ceftriaxone and phenytoin. Gross motor developmental milestones in children with meningitis can be improved with early integrative neurophysiotherapy and a goal-oriented therapeutic regimen that includes mobility exercises, proprioceptive neuromuscular facilitation techniques, positioning, oromotor retraining, neurodevelopmental techniques, and balance and coordination retraining. A complex case presents with bacterial meningitis, hydrocephalus, and seizure disorder. The bacterial infection inflames the protective membranes of the brain, causing hydrocephalus. Increased cerebrospinal fluid puts pressure on the brain, leading to seizures. Managing these interconnected conditions requires a multidisciplinary approach making it unique, involving infectious disease, neurology, and neurosurgery expertise.

Effectiveness of physiotherapy interventions on improving quality of life, total neuropathy score, strength and reducing pain in cancer survivors suffering from chemotherapy-induced peripheral neuropathy - a systematic review.

BACKGROUND: Cancer treatment frequently results in chemotherapy-induced peripheral neuropathy (CIPN), which is a side effect that is now neither properly preventable nor treatable. Physical therapy has been studied in this patient population and is frequently utilised for neurological rehabilitation after damage. PURPOSE: This study set out to thoroughly review randomised controlled trials (RCTs) examining the efficacy of physical therapy for patients with chemotherapy-induced peripheral neuropathy. DATA SOURCES: From their beginning in January 2017 to January 2023, EMBASE, PubMed, Medline, PEDro, and the Cochrane Library were searched for pertinent RCTs. Additionally, manual search techniques were applied. STUDY SELECTION: On the basis of the inclusion criteria, two reviewers independently determined the study's eligibility. DATA EXTRACTION: Reviewers evaluated the quality of the studies and took note of their methodologies, designs, interventions, outcomes, and conclusions. DATA SYNTHESIS: Ten RCTs met all inclusion criteria. LIMITATIONS: Overall results are constrained by the variety of interventions and the small sample sizes of the included studies, which also indicate the need for more studies. CONCLUSIONS: Physical therapy has additional benefits for enhancing the quality of life of patients with peripheral neuropathy brought on by chemotherapy.

Rehabilitation of Traumatic Acute Subdural Hematoma and Subarachnoid Hemorrhage: A Case Report.

A head injury or cerebrovascular illness may be the cause of acute intracranial hemorrhage. Making a precise diagnosis is challenging since diagnostic imaging might be challenging in both situations. In this case report, an aneurysmal rupture related head injury resulted in an acute subdural hematoma (SHD) after the patient lost consciousness. A 54-year-old male was found in a state of unconsciousness on the ground and was brought to the nearest hospital. Computed tomography (CT) scan showed an oblique fracture involving the bilateral frontal and right parietal bones along with underlying SDH, subarachnoid hemorrhage (SAH), and hemorrhagic contusion along with midline shift. The case report highlights the rehabilitation journey of a patient with acute SDH and SAH. The patient can now sit independently and stand with minimal assistance. Vasospasm detection, prevention, and treatment need to be the norm at that time. This case demonstrates the effectiveness of a comprehensive rehabilitation approach in promoting mobility and independence for patients with traumatic brain injuries.

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.

C5 Nerve Root Palsy: An Uncommon Postoperative Complication and Its Management.

The standard treatment for multiple levels of cervical prolapsed intervertebral disk (PIVD) is anterior cervical decompression and fusion. Although it is associated with positive outcomes, it is also fraught with complications. In this report, we present an unusual postoperative case of a 58-year-old male who underwent anterior decompression and cervical fusion at two levels - C4-C5 and C5-C6 - for traumatic PIVD and developed a postoperative complication of unilateral C5 motor palsy, making it difficult for the patient to elevate the shoulder. This postoperative complication had no known cause, but it could be iatrogenic or due to structural variation. There is sparse research on possible ways to avoid this complication. Physiotherapy management is critical in improving the patient's functional recovery. The neck and upper extremity functional measure scale and Neurogenic Claudication Outcome Score (NCOS) scale were used for measuring outcomes. The patient also had a two-year history of tingling and numbness in both lower extremities, which was treated conservatively. The difficulties that physiotherapists encounter in managing this uncommon postoperative complication in addition to the lumbar PIVD make it unique. The key to a better prognosis is early detection and management.

Influence of Brain Gym Activities on Sleep Quality in Moderate Insomnia.

Mental health has suffered considerably as a result of advancing time and technological developments. Poor quality of sleep affects people of all ages, and non-pharmacological remedies are becoming increasingly important. Nearly 60% of all undergraduate students are reported to have a poor quality of sleep, with 7.7% fitting the criteria for insomnia. Sleep deprivation is found to affect the immune function, brain maturation, development of the body, metabolic process, and cognition, as well as maintaining normal homeostasis of the body. Sleep quality and quantity have a severe influence on learning and memory and thus a major influence on students' quality of life. Brain gym exercises are a formidable contender in this race. Still, further study is required before a solid conclusion can be formed on its value as an intervention, so to evaluate the effect of brain gym exercises as a non-pharmacological measure, this study was conducted with a total of 65 participants based on the inclusion and exclusion criteria with the duration of practice as five days in a week with a session of 25 minutes with adequate intervals. An insomnia rating scale (IRS) is used to get the desired population for giving the intervention, along with the Pittsburgh Sleep Quality Index (PSQI). This study was conducted at the Physiotherapy College of Wardha. The results were given by statistical analysis using descriptive and inferential statistics. The data analysis depicted that after the brain gym activity intervention, there was a marked reduction in the score of PSQI, suggesting significant improvement in their sleep quality, and it can be used as non-pharmacological management for mild to moderate insomnia students.