The Effect of Manual Therapy on Lower Extremity Joint Kinematics during Running: A single-subject case study.

BACKGROUND: While there is scarcity of current literature to support the effectiveness of muscle energy techniques (MET) with musculoskeletal injuries, the overall impact on gait kinematics necessitates investigation. This case study involved a 48-year-old male runner and aimed to determine the effect of manual therapy, including joint mobilization and MET, on lower extremity (LE) kinematics. The subject had a medical history that included: Achilles tendonitis, low back pain, and iliotibial band syndrome. METHODS: A clinical exam and Xsens motion capture were performed on the subject prior to treatment and at the conclusion of the 6 weeks of treatment. Motion capture was used to examine bilateral foot contact time, hip transverse plane motion and ankle sagittal plane motion. Pre-treatment and post-treatment ipsilateral and bilateral differences between groups were analyzed. RESULTS: Changes were noted between ipsilateral and bilateral pre- and post-treatment contact times; right foot sagittal plane joint angle at foot off; left hip transverse plane joint angle at foot contact and foot off, all bilateral pre- and post-treatment hip angles at foot contact and foot off, all bilateral pre- and post-treatment ankle angles at foot contact and foot off. CONCLUSIONS: Clinical exams paralleled the change in hip external rotation bringing the hips to a more neutral position. In addition, the final clinical exam noted a decrease in subtalar eversion bilaterally, which may relate to the improved pelvic symmetry and biomechanical compensation pattern. Clinically, these findings may coincide with improving proximal lumbopelvic symmetry assisting with normalizing distal mobility by using manual therapy.

The Impact of COVID-19 on Patient Experience Within a Midwest Hospital System: A Case Study.

Patient-centered communication and patient-provider relationships directly affect patient outcomes. The purpose of this study was to compare inpatient perception of provider/nurse communication in both COVID versus non-COVID diagnoses groups. A qualitative retrospective study was conducted by performing a priori coding analysis on Hospital Consumer Assessment of Healthcare Providers and Systems surveys from 4 different hospitals for both COVID and non-COVID diagnoses. Five themes emerged from non-COVID patient data: inconsistent health care provider communication, variable patient-provider education, pandemic influenced patient satisfaction and mental health stress, inconsistent hospital services, and stable provider professionalism. Five themes arose from the COVID patient data: provider gratitude, controversial communication methods, consistent patient education, lack of quality patient care, and poor timeliness. There is evidence of shared patient perceptions between both COVID and non-COVID patients, but also differences including timeliness and quality of care. The pandemic influenced all patients by creating non-mutually exclusive themes including overall gratitude and patient satisfaction. Future research should focus on a quantitative analysis of pandemic-related patient-provider communication effects on patient outcomes.