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contractures AND physical therapy

Lirios Dueñas, Mercè Balasch-Bernat, Marta Aguilar-Rodríguez, Filip Struyf, Mira Meeus, Enrique Lluch
STUDY DESIGN: Case series. BACKGROUND: Manual therapy has been demonstrated to reduce pain and improve function in patients with frozen shoulder contracture syndrome (FSCS), but no evidence exists to support one form of manual therapy over another. The purpose of this case series was to describe both short and long-term outcomes after a manual therapy program and home stretching exercises based on specific impairments in shoulder mobility and level of tissue irritability in patients with FSCS...
January 18, 2019: Journal of Orthopaedic and Sports Physical Therapy
Laura E Case, Julie Coats
No abstract text is available yet for this article.
January 2019: Pediatric Physical Therapy
Michael Kiefer, Kelly Bonarrigo, Catherine Quatman-Yates, Amanda Fowler, Paul S Horn, Brenda L Wong
PURPOSE: This study characterizes the progressive loss of ankle dorsiflexion range of motion in boys with Duchenne muscular dystrophy (DMD), the relationship to functional decline, and the implications for physical therapy management. METHODS: Longitudinal data for 332 boys with DMD were extracted from medical records and analyzed. Summary statistics for age, number of visits, ankle dorsiflexion measures, and North Star Ambulatory Assessment (NSAA) scores were computed...
January 2019: Pediatric Physical Therapy
Louis W Catalano, O Alton Barron, Steven Z Glickel, Shobhit V Minhas
The stiff digit may be a consequence of trauma or surgery to the hand and fingers and can markedly affect a patient's level of function and quality of life. Stiffness and contractures may be caused by one or a combination of factors including joint, intrinsic, extensor, and flexor tendon pathology, and the patient's individual biology. A thorough understanding of the anatomy, function, and relationship of these structures on finger joint range of motion is crucial for interpreting physical examination findings and preoperative planning...
November 20, 2018: Journal of the American Academy of Orthopaedic Surgeons
Gunfrid V Størvold, Reidun B Jahnsen, Kari Anne I Evensen, Grete H Bratberg
PURPOSE: To investigate the association between physical therapy frequency and gross motor improvement in children with cerebral palsy (CP). MATERIALS AND METHODS: This is a prospective cohort study of 442 children aged 2-12 years, Gross Motor Function Classification System levels I-V, from the Cerebral Palsy Follow-up Program and the Cerebral Palsy Register of Norway. Outcome was change in reference percentiles for the Gross Motor Function Measure (GMFM-66) between two subsequent assessments (N = 1056) analyzed in a linear mixed model...
November 16, 2018: Disability and Rehabilitation
Astrid Brull, Blanca Morales Rodriguez, Gisèle Bonne, Antoine Muchir, Anne T Bertrand
Emery-Dreifuss muscular dystrophy (EDMD) is a genetic condition characterized by early contractures, skeletal muscle weakness, and cardiomyopathy. During the last 20 years, various genetic approaches led to the identification of causal genes of EDMD and related disorders, all encoding nuclear envelope proteins. By their respective localization either at the inner nuclear membrane or the outer nuclear membrane, these proteins interact with each other and establish a connection between the nucleus and the cytoskeleton...
2018: Frontiers in Physiology
Christina Kapsalis, Jared Davis, Bradon J Wilhelmi
Objective: Immediate flap reconstruction following mastectomy in patients who may require adjuvant radiation therapy can be controversial. However, exposure of vital structure or defects too large for primary closure may necessitate immediate utilization of flaps. In this setting, both functional and cosmetic outcomes must be considered. Methods: We describe a case in which the patient required a wide excision of the axillary skin and a partial mastectomy, with a resulting large axillary and lateral breast skin defect...
2018: Eplasty
Erich M Gauger, Peter C Rhee
Posttraumatic elbow stiffness is common with the primary indication for contracture release being limited motion that affects functional activities which has not adequately improved after intensive therapy and rehabilitation. Preoperative evaluation focuses on the history of previous nonoperative and/or operative treatment, physical exam with particular attention paid to the status of the ulnar nerve, and imaging consisting of radiographs and computed tomography. There are multiple intrinsic and extrinsic causes of posttraumatic contracture...
December 2018: Techniques in Hand & Upper Extremity Surgery
Kristi S Wood, Aaron Daluiski
Upper extremity contractures in the spastic patient may result from muscle spasticity, secondary muscle contracture, or joint contracture. Knowledge of the underlying cause is critical in planning successful treatment. Initial management consists of physical therapy and splinting. Botulinum toxin can be helpful, as a therapeutic treatment in relieving spasticity and as a diagnostic tool in determining the underlying cause of the contracture. Surgical management options include release or lengthening of the causative muscle/tendon unit and joint capsular release, as required...
November 2018: Hand Clinics
Scott G Edwards, Farhad Darbandi
Background: The olecranon osteotomy-facilitated elbow release (OFER) is a safe and effective method for releasing severe posttraumatic elbow contractures. The OFER procedure is easier, faster, and relatively less invasive, and appears to offer superior outcomes, compared with more traditional techniques. Description: An olecranon osteotomy provides a trapdoor through which the surgeon will have circumferential access to the joint and will be able to address all intrinsic and extrinsic causes of contracture...
June 27, 2018: JBJS Essential Surgical Techniques
Daniel J Gittings, Jonathan R Dattilo, George Fryhofer, Derek J Donegan, Keith Baldwin
Introduction: The ilioinguinal approach for psoas recession over the pelvic brim allows for direct visualization and protection of the femoral nerve while preserving hip flexion strength. Indications & Contraindications: <AbstractText Label="Step 1 Patient Positioning Preoperative Assessment and Draping" NlmCategory="UNASSIGNED">With the patient supine and anesthetized, perform the Thomas test, administer antibiotics, and drape to provide access to the inferior aspect of the abdomen, ilioinguinal region, and lower limb...
September 28, 2017: JBJS Essential Surgical Techniques
David Hazlewood, Yi Feng, Qinghua Lu, Jinxi Wang, Xinmai Yang
Post-traumatic joint contracture induced by scar tissues following a surgery or injury can leave patients in a permanent state of pain and disability, which is difficult to resolve by current treatments. This randomized controlled trial examines the therapeutic effect of pulsed high-intensity laser (PHIL) and pulsed high-intensity focused ultrasound (PHIFU) for post-traumatic joint contracture due to arthrofibrosis. The peak power levels of both PHIL and PHIFU are much higher than that of laser or ultrasound currently used in physical therapy, while short pulses are utilized to prevent damage...
October 16, 2018: Physics in Medicine and Biology
Meng Zhou, Shuai An, Mingli Feng, Zheng Li, Huiliang Shen, Kuan Zhang, Jun Sun, Guanglei Cao
BACKGROUND: The main objective of total knee arthroplasty is to relieve pain, restore normal knee function, and improve gait stability. Significant flexion contractures can severely impair function after surgery. The purpose of this study is to evaluate the efficacy of implementing a continuous proximal sciatic nerve block in conjunction with aggressive physical therapy to treat patients with persistent flexion contractures that were recalcitrant to rehabilitation efforts following primary total knee arthroplasty (TKA)...
October 2018: Gait & Posture
A Thibaut, S Wannez, T Deltombe, G Martens, S Laureys, C Chatelle
BACKGROUND: Spasticity is a frequent complication after severe brain injury, which may prevent the rehabilitation process and worsen the patients' quality of life. OBJECTIVES: In this study, we investigated the correlation between spasticity, muscle contracture, and the frequency of physical therapy (PT) in subacute and chronic patients with disorders of consciousness (DOC). METHODS: 109 patients with subacute and chronic disorders of consciousness (Vegetative state/Unresponsive wakefulness syndrome - VS/UWS; minimally conscious state - MCS and patients who emerged from MCS - EMCS) were included in the study (39 female; mean age: 40±13...
2018: NeuroRehabilitation
Patrick J Buchanan, John A I Grossman, Andrew E Price, Chandan Reddy, Mustafa Chopan, Harvey Chim
BACKGROUND: Most brachial plexus birth injuries (BPBI) are caused by traction on the brachial plexus during a difficult delivery. Fortunately, the possibility of complete recovery from such an incident is relatively high, with only 10% to 30% of patients having prolonged and persistent disability. These patients have muscle imbalances and co-contractions typically localized around the shoulder and elbow. These imbalances and co-contractures cause abnormal motor performances and bone/joint deformities...
March 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
Susan L Murphy, Mary Whitehouse Barber, Kate Homer, Carole Dodge, Gary R Cutter, Dinesh Khanna
OBJECTIVE: To determine the feasibility and preliminary effects of occupational therapy to improve upper extremity function in patients with early systemic sclerosis (SSc; scleroderma) who have upper extremity contractures. METHODS: A single-group pilot clinical rehabilitation trial was conducted at the University of Michigan Scleroderma Center. Patients with SSc and ≥1 upper extremity contracture (n = 21) participated in a total of 8 weekly in-person occupational therapy sessions...
November 2018: Arthritis Care & Research
Jetske Viveen, Job N Doornberg, Izaak F Kodde, Pjotr Goossens, Koen L M Koenraadt, Bertram The, Denise Eygendaal
BACKGROUND: The elbow is prone to stiffness after trauma. To regain functional elbow motion several conservative- and surgical treatment options are available. Conservative treatment includes physical therapy, intra-articular injections with corticosteroids and a static progressive or dynamic splinting program. If conservative treatment fails, an operative release of the posttraumatic stiff elbow is often performed. The best Evidence-Based rehabilitation protocol for patients after an operative release is unknown to date and differs per surgeon, hospital and country...
November 22, 2017: BMC Musculoskeletal Disorders
Blake M Bodendorfer, Joshua A Kotler, William D Zelenty, Kareem Termanini, Rafael Sanchez, Evan H Argintar
A stiff total knee arthroplasty (TKA) can manifest as pain and decreased range of motion (ROM). When conservative management including physical therapy and manipulation under anesthesia fails, arthroscopic lysis of adhesions (LOA) is frequently pursued. The authors examined the efficacy of LOA for the stiff TKA. They retrospectively reviewed the records of 18 patients who underwent LOA for stiff TKA between April 2013 and June 2016 and who failed to meet 90° ROM at 6 weeks postoperatively. They recorded patient demographics, ROM prior to TKA, and incidence of manipulation under anesthesia between initial TKA and LOA as well as pre- and postoperative outcomes of ROM, pain, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores...
November 1, 2017: Orthopedics
Emre Ünal
Soft tissue injury due to orthopedic hardware migration is an uncommon complication. However particularly patients who have routine physical therapy sessions for extremity contractures are at risk for vascular injury in the setting of migrated screws. Ultrasound is an efficient modality to evaluate migrated screws and adjacent soft tissue structures. As a consequence of repetitive trauma a migrated screw would eventually result in injury. Herein a case of upper thigh hematoma due to screw migration in a patient with hip osteotomy is reported...
December 29, 2016: Medical Ultrasonography
Joachim Gülke, Martin Mentzel, Gert Krischak, David Gulkin, Daniel Dornacher, Nikolaus Wachter
BACKGROUND: These days there are different types of aftercare following flexor tendon injury. Patients in this study received a dynamic Kleinert protocol and additionally two different postoperative treatments. Both treatment groups were compared to each other and results were put into perspective when compared to other treatment options. METHODS: Sixty-two patients presenting with clean lesions of the two flexor tendons in zone 2 received postoperative treatment with a dynamic Kleinert protocol...
July 2018: Der Unfallchirurg
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