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Wierciak-Rokowska A, Sliwka A, Maga M, Gajda M, Bogucka K, Kaczmarczyk P, Maga P. Upper Vascular Thoracic Outlet Syndrome: A Case Study. Biomedicines 2024; 12:1829. [PMID: 39200294 PMCID: PMC11352045 DOI: 10.3390/biomedicines12081829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2024] [Revised: 07/29/2024] [Accepted: 07/31/2024] [Indexed: 09/02/2024] Open
Abstract
Thoracic outlet syndrome (TOS) is recognised in approximately 8% of the population. Vascular presentation is rare and diagnosis is often elusive due to its rarity. As episodes of TOS in the upper extremities are rare, proven protocols for rehabilitation management are lacking. The purpose of our article is to present a clinical examination protocol and a treatment protocol for patients after an episode of venous thrombosis in the upper limb (VTOS). We report the case of a middle-aged woman with right venous TOS with pain in the right upper extremity, accompanied by oedema and mild violet discolouration. The results after 10 sessions of physiotherapy were as follows: a reduction in symptoms of approximately 40%, an improvement of approximately 15% in sports performance, and an improvement of approximately 25% in work. There was also an improvement in the results of TOS provocation tests, i.e., a 50-100% improvement in pulse rate and about 30% less discolouration in the extremity. Additionally, there was a significant improvement in posture between the two sides of the upper quadrant. The results after 10 physiotherapy sessions are surprising due to chronic disease after the thrombosis episode. It appears that even after a long period of time since diagnosis, improvement is possible.
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Affiliation(s)
- Agnieszka Wierciak-Rokowska
- Independent Researcher, Reha Centrum, Physiotherapy Practice, Orthopaedic Field, Zakopianska Street 166, 30-435 Krakow, Poland;
| | - Agnieszka Sliwka
- Institute of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, 31-126 Krakow, Poland
| | - Mikolaj Maga
- Department of Angiology, II Chair of Internal Medicine, Jagiellonian University Medical College, 30-688 Krakow, Poland; (M.M.); (M.G.); (K.B.); (P.K.); (P.M.)
| | - Mateusz Gajda
- Department of Angiology, II Chair of Internal Medicine, Jagiellonian University Medical College, 30-688 Krakow, Poland; (M.M.); (M.G.); (K.B.); (P.K.); (P.M.)
| | - Katarzyna Bogucka
- Department of Angiology, II Chair of Internal Medicine, Jagiellonian University Medical College, 30-688 Krakow, Poland; (M.M.); (M.G.); (K.B.); (P.K.); (P.M.)
| | - Pawel Kaczmarczyk
- Department of Angiology, II Chair of Internal Medicine, Jagiellonian University Medical College, 30-688 Krakow, Poland; (M.M.); (M.G.); (K.B.); (P.K.); (P.M.)
| | - Pawel Maga
- Department of Angiology, II Chair of Internal Medicine, Jagiellonian University Medical College, 30-688 Krakow, Poland; (M.M.); (M.G.); (K.B.); (P.K.); (P.M.)
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Jonely H, Jayaseelan D, Costello E, Signorino J, Wooten L, Murray D, Woolstenhulme J. Changes in pulmonary function following thoracic spine manipulation in a healthy inactive older adult population-a pilot study. J Phys Ther Sci 2023; 35:492-496. [PMID: 37405180 PMCID: PMC10315198 DOI: 10.1589/jpts.35.492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 04/03/2023] [Indexed: 07/06/2023] Open
Abstract
[Purpose] Pulmonary function pathology is primarily treated pharmacologically, with a range of medication side effects. Few studies have systematically examined non-pharmacologic approaches such as joint manipulation effects on pulmonary function. This study examined the immediate and short-term effects of thoracic manipulation on pulmonary function. [Participants and Methods] Twenty-one physically inactive otherwise healthy participants aged 50 years or older were randomly assigned to either receive three sessions of thoracic manipulation (n=10) or three sessions of "sham intercostal training" (n=11). Outcome measures included forced vital capacity, maximal voluntary ventilation and thoracic excursion during maximal inhalation and exhalation. [Results] There was a statistically significant difference in maximal voluntary ventilation in the manipulation group, when measured within a week of the third intervention session and immediate effects in thoracic excursion during exhalation in the sham group following a single intervention session. There were no significant changes in other measures. [Conclusion] Spinal manipulation had no immediate effect on pulmonary function, however, affected an improvement in maximal voluntary ventilation within 7 days following a third session. The sham intervention showed a change in thoracic excursion during exhalation after the first session. Future research is necessary to further explore the relationship between thoracic manipulation and pulmonary function.
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Affiliation(s)
- Holly Jonely
- The School of Medicine & Health Sciences, Physical
Therapy & Health Care Sciences, The George Washington University: 2000 Pennsylvania
Ave, NW, Suite 2000, Washington, DC 20006, USA
| | - Dhinu Jayaseelan
- The School of Medicine & Health Sciences, Physical
Therapy & Health Care Sciences, The George Washington University: 2000 Pennsylvania
Ave, NW, Suite 2000, Washington, DC 20006, USA
| | - Ellen Costello
- The School of Medicine & Health Sciences, Physical
Therapy & Health Care Sciences, The George Washington University: 2000 Pennsylvania
Ave, NW, Suite 2000, Washington, DC 20006, USA
| | - Joseph Signorino
- The School of Medicine & Health Sciences, Physical
Therapy & Health Care Sciences, The George Washington University: 2000 Pennsylvania
Ave, NW, Suite 2000, Washington, DC 20006, USA
- Division of Physical Therapy, Shenandoah University,
USA
| | - Liana Wooten
- Department of Public Health and Community Medicine, School
of Medicine, Doctor of Physical Therapy Program, Tufts University, USA
| | - Donal Murray
- The School of Medicine & Health Sciences, Physical
Therapy & Health Care Sciences, The George Washington University: 2000 Pennsylvania
Ave, NW, Suite 2000, Washington, DC 20006, USA
| | - Josh Woolstenhulme
- The School of Medicine & Health Sciences, Physical
Therapy & Health Care Sciences, The George Washington University: 2000 Pennsylvania
Ave, NW, Suite 2000, Washington, DC 20006, USA
- Department of Physical Therapy and Athletic Training,
Meridian Health Sciences Center, Idaho State University, USA
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Bordoni B, Escher AR. Palpation of the Respiratory System in Osteopathic Manual Medicine: From the Trachea to the Lungs. Cureus 2021; 13:e18059. [PMID: 34552839 PMCID: PMC8448380 DOI: 10.7759/cureus.18059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2021] [Indexed: 02/07/2023] Open
Abstract
There is a lack of published literature in osteopathic manual medicine on how to perform palpation of the lower respiratory tree such as the trachea, main bronchi, and lungs. Several authors have studied the osteopathic effect and respiratory response of palpation but have failed to demonstrate how to perform palpation of the visceral areas involved in breathing, either in the context of a clinical trial or as a case report. This paper reviews the innervation of these anatomical areas, the mechano-metabolic weight of the passage of fluids and air in the respiratory tract, the anatomical topography, and the movements involved in respiration. Drawing from current knowledge, this article illustrates, for the first time, how to place the hands for an effective osteopathic assessment of the tracheal, bronchial, and pulmonary structures. Understanding how to perform palpation of the lower areas is a fundamental tool in the clinic and potential therapy in osteopathic manual medicine.
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Affiliation(s)
- Bruno Bordoni
- Physical Medicine and Rehabilitation, Foundation Don Carlo Gnocchi, Milan, ITA
| | - Allan R Escher
- Anesthesiology/Pain Medicine, H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA
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