Treatment of patella alta with taping, exercise, mobilization, and functional activity modification: a case report

Clinical reasoning of ultrasound imaging-guided manual passive manipulation for adhesion prevention in a patient with total knee arthroplasty: a case report

INTRODUCTION

Patients with total knee arthroplasty occasionally develop postoperative abnormalities such as posttraumatic knee stiffness and arthrofibrosis, which may affect activities of daily living. However, there are no clear assessment methods or interventions for knee stiffness. Musculoskeletal ultrasound imaging enables real-time evaluation of mobility and flexibility of tissues. The purpose of this case report was to describe the use of musculoskeletal ultrasound imaging for evaluating the optimal location and methods of passive manipulation.

CASE DESCRIPTION

The patient was an 82-year-old woman who had undergone total knee arthroplasty. She was unable to climb stairs due to limited knee flexion. Based on the results of musculoskeletal ultrasound imaging assessment, we hypothesized that the knee flexion limitation was caused by decreased sliding movement of the suprapatellar pouch. Hence, we performed passive manipulation on the tissue with decreased sliding under musculoskeletal ultrasound guidance.

OUTCOMES

The patient's knee flexion angle increased from 90° to 110° within 1 week of intervention, and her gait speed improved from 16.48 to 13.2 s per 10 m. Furthermore, after the intervention, she was able to climb 10 steps using a handrail.

DISCUSSION

Ultrasound imaging is important because it allows the examination of tissues with mobility changes such as in arthrofibrosis. Our work highlights the use of musculoskeletal ultrasound imaging for identifying the target region for therapy and for providing guidance during passive manipulation.

The effects of a posterior superior iliac spine support device on upper trunk acceleration during gait in individuals with flat lumbar back posture

BACKGROUND

The orientation of the pelvis is of particular importance to the sagittal curve of the spine and has geometric relationships with the top of the spine and lumbar lordosis. Changes in spinal shape or disruptions of sagittal balance in the spine, such as a flattened lumbar spine, have significant negative effects.

OBJECTIVE

The aim of this study was to investigate the effects of the posterior superior iliac spine support device (PSD) on upper trunk acceleration during gait in individuals with flat lumbar back posture.

METHODS

In total, 10 young male subjects with reduced lumbar lordosis (global lumbar lordosis angle (T10-S2): <-20∘) were recruited for this study. Participants walked 7 m with and without wearing a PSD at a self-selected speed while fitted with an accelerometer attached over the T7 spinous process.

RESULTS

The normalized AP acceleration of T7 with PSD (40.57 ± 11.22%) was significantly higher than those without PSD (37.10 ± 10.46%, p= 0.035).

CONCLUSIONS

We found that wearing the PSD immediately improved pelvic physiological movement during walking in individuals with lumbar flat back posture. Our findings may help healthcare professionals manage flat back posture in asymptomatic younger individuals.

The effects of lumbo-pelvic postural taping on gait parameters in patients with lumbar spinal stenosis

BACKGROUND

Altered gait patterns with lumbar-flexed posture threaten the quality of life in patients with lumbar spinal stenosis; however, few studies have developed management strategies to improve gait patterns and lumbo-pelvic posture. The present study investigated the effects of lumbo-pelvic postural taping on pelvic tilt, spatiotemporal gait parameters, and pain during walking in patients with lumbar spinal stenosis.

METHODS

The pelvic tilt and gait parameters were assessed in 20 patients with lumbar spinal stenosis before sustained walking using a palpation meter and GAITRite system, respectively. Next, the participants were asked to walk on the ground for 20 min or until they complained of symptoms of neurogenic claudication. Pelvic tilt and gait parameters were measured immediately after the manifestation of neurogenic claudication followed by the application of lumbo-pelvic postural taping. The participants rated the pain intensity using a visual analog scale. Changes in dependent variables among the conditions were analyzed using a one-way repeated-measures analysis of variance.

FINDINGS

The results show a decreased pelvic anterior tilt, walking velocity, and step and stride lengths, as well as an increased base of support and pain after severe symptoms of neurogenic claudication (P<0.05). However, a greater pelvic anterior tilt, faster walking velocity with a longer step and stride length, and decreased base of support and pain were found after the application of postural taping (P≤0.001).

INTERPRETATION

These findings suggest that lumbo-pelvic postural taping can provide beneficial management for improving gait patterns and lumbo-pelvic posture in patients with lumbar spinal stenosis.

A novel taping therapy for chronic insomnia: a report on two cases

OBJECTIVES

Here, we report two cases of chronic insomnia treated satisfactorily by re-using of patients' bioelectricity.

PATIENTS

First was a 46 years old male who had taken drugs for several years and depression drug for one year. He had heart beat and felt pressure pain on almost of chest. Second was a 64 years old male who had taken drugs for one year. In spite of the medication, he could not sleep at all and had glint eyes.

INTERVENTIONS

Method of treatment is to put the medical tape (Chimsband) on acupoints and pressure pain points in the chest, which can be traced down by finger pressing examination.

RESULTS

In the first case, the patient escaped from the medications after three weeks. Following seven weeks, depression was reduced remarkably. In the second case, the glint of eyes returned to normal after two treatments. After three treatments, the sleeping time was lengthened to 4h.

CONCLUSIONS

First, pressing chest can be used for tracing neurological symptoms; second, when the bioelectricity of the patient reacts to Chimsband, the symptoms could be ameliorated; third, there is a relationship between treating the neurological symptoms such as insomnia and attenuating pressure pain.