Physiotherapy theory and practice
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Physiother Theory Pract · Jan 2016
Case ReportsEffect of sternoclavicular joint mobilization on pain and function in a patient with massive supraspinatus tear.
Massive irreparable rotator cuff tears can be difficult to treat conservatively, especially when the patient has multiple comorbidities. Although there is evidence to support interventions aimed at the spine, there is paucity in the literature describing interventions to the sternoclavicular joint (SCJ) in individuals with rotator cuff pathology. A 57-year-old female with multiple comorbidities and a body mass index of 59 was referred to physical therapy with a 4-month history of right shoulder pain, significant functional limitations, and magnetic resonance imaging (MRI), demonstrating a full-thickness supraspinatus tear. ⋯ SCJ mobilizations at visit 7 immediately improved pain, active ROM, and subjective reports of function. The patient was discharged after 13 visits with increased active shoulder flexion ROM to 0-170°, NPRS 1/10, QuickDASH 31.8%, and Global Rating of Change (GROC) +5. This case highlights the successful conservative treatment of an individual with an irreparable rotator cuff tear and numerous comorbidities by using a multimodal approach including SCJ mobilizations.
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Physiother Theory Pract · Jul 2015
Case ReportsPhysiotherapist-initiated lung ultrasound to improve intensive care management of a deteriorating patient and prevent intubation: a case report.
This case report describes the physiotherapy assessments and interventions provided to a 56-year-old male in an Australian intensive care unit. The non-intubated patient suffered from respiratory deterioration, secretion retention, complete opacification of the left hemithorax on chest X-ray (CXR) and widespread coarse crackles on lung auscultation. The addition of lung ultrasound (LUS) facilitated more accurate diagnosis than what was formed on the basis of CXR and lung auscultation resulting in more effective treatment. ⋯ The addition of LUS to the critical care physiotherapist's assessment skills may provide clinical benefit. The increased diagnostic accuracy of LUS compared with other routine assessments warrants further investigation.
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Physiother Theory Pract · May 2015
Observational StudyPatients' and therapists' perception of change following physiotherapy in an orthopedic hospital's outpatient clinic.
The aims of this observational, prospective cohort study were to: assess the patients' and therapists' perception of change after physiotherapy in an orthopedic hospital's outpatient clinic; relate these retrospective assessments to a serial assessment of pain; and study the influence of patient characteristics on the perceived change. ⋯ The addition of at least one GPC scale might be valuable in evaluating the outcome in physical therapy, which requires little time and thus may be ideal for a clinical setting. Patients' and therapists' perception of change is significantly influenced by the patients' education level and the number of problems, which might be of relevance when choosing adequate treatment strategies.
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Physiother Theory Pract · Feb 2015
Randomized Controlled Trial Comparative StudyEffectiveness of mobilization therapy and exercises in mechanical neck pain.
While studies have looked into the effects of Maitland mobilization on symptom relief, to date, no work has specifically looked at the effects of Mulligan mobilization. The objective of this work was to compare the effectiveness of Maitland and Mulligan's mobilization and exercises on pain response, range of motion (ROM) and functional ability in patients with mechanical neck pain. ⋯ Our results showed that manual therapy interventions were no better than supervised exercises in reducing pain, improving ROM and neck disability.
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Physiother Theory Pract · Feb 2015
Clinical TrialModified Rivermead Mobility Index: a reliable measure in people within 14 days post-stroke.
The reliability of the Modified Rivermead Mobility Index (MRMI) has not previously been investigated in the very early post-stroke phase. The aim of the study was to evaluate inter-rater and intra-rater reliability and internal consistency in patients, 1-14 d post-stroke. ⋯ The MRMI is a reliable measure of physical mobility in the early post-stroke phase.