Integrated Rehabilitation Approach Utilizing Swiss Ball Training, Mulligan Taping, and Mobilization With Movement for Simultaneous Management of Sacroiliac Joint Dysfunction and Lateral Ankle Sprain in a Badminton Athlete: A Case Study

This case report details an integrated rehabilitation plan implemented for a professional badminton player who presented with issues of sacroiliac joint (SIJ) dysfunction and a lateral ankle sprain. The integrated approach aimed to address both musculoskeletal issues, considering their potential reciprocal influences on biomechanics and functional performance. The athlete underwent a thorough initial assessment, including clinical examination, imaging, and biomechanical analysis. Treatment began with targeted interventions for acute ankle sprain management, such as rest, ice, compression, and elevation (RICE) followed by progressive exercises to restore ankle stability and range of motion (ROM). Concurrently, a specialized program was devised to address the underlying sacroiliac joint dysfunction through manual therapy, therapeutic exercises, and core stabilization routines. Throughout the rehabilitation process, the focus remained on integrated exercises that targeted both the ankle and sacroiliac joint, promoting optimal neuromuscular coordination and joint function specific to badminton demands. Regular reassessments guided the progression of interventions, ensuring a personalized and athlete-centric approach. The positive outcome highlights the importance of a holistic rehabilitation strategy in managing complex musculoskeletal conditions in athletes, facilitating efficient recovery, and reducing the risk of recurrence. This case report highlights the effectiveness of an integrated approach in enhancing performance and preventing reinjury in badminton athletes facing multifaceted musculoskeletal challenges.

Physiotherapeutic Intervention Techniques for Knee Osteoarthritis: A Systematic Review

Globally, knee osteoarthritis (KOA) is the leading cause of disability. The most prevalent complaints associated with KOA are knee pain, joint stiffness, and weakness in the muscles of the lower limbs. These symptoms impede movement and result in functional limitations. As a result, people with KOA have a lower quality of life. For all patient groups with knee OA, an effective rehabilitation program focuses on improving knee range of motion, isometric quadriceps strength, and productivity level while reducing discomfort. The American College of Rheumatology (ACR) categorization criteria for KOA, research on KOA physiotherapy, and reviews covering various physical therapy interventions, including exercise, physical modalities, and patient education, were used to narrow down the pool of 180 systematic reviews to 15 articles. Google Scholar, PubMed, the Cochrane Library, and EMBASE were the databases that were used. The following keyword combinations were included in our search: KOA and physiotherapy or interventions or exercises, strengthening and stretching, concentric and eccentric training. Through our analysis, we identified a few methods that, in addition to standard therapy, could be used in clinical settings for people with osteoarthritis in the knee. It has been shown that Mulligan, Pilates, Kinesiotaping, Aquatic Therapy, and other current therapies are effective. The study employed a broad range of results. This review concludes that rather than relying solely on conventional therapy, it is preferable to combine a number of the most current physiotherapy techniques with it.

Physiotherapy Rehabilitation Following Acoustic Neuroma Resection in a Patient With Cerebellopontine Angle Tumour: A Case Report

Acoustic neuroma excision in patients with cerebellopontine angle (CPA) tumours offers particular rehabilitation problems due to the complicated architecture of the cerebellum and brainstem tissues involved. CPA tumours (acoustic neuromas) are slow-growing tumours that arise from the vestibulocochlear nerve. Surgical excision of these tumours can cause neurological abnormalities that compromise motor coordination, balance, and facial nerve function. The case study emphasises the importance of a comprehensive physiotherapeutic approach in rehabilitating a patient following acoustic neuroma excision, with a focus on particular CPA tumour deficits. The rehabilitation programme focuses on improving functional outcomes through balance, proprioception, and vestibular rehabilitation that is customised to the demands and deficiencies of the patient. Our comprehensive approach seeks to improve patients' quality of life, promote neurological healing, and support easy reintegration into normal activities following CPA tumour surgery.

Effectiveness of Recent Physiotherapy Techniques Along With Conventional Physiotherapy Techniques in a Patient With Knee Osteoarthritis: A Case Report

Osteoarthritis (OA), the most common joint disease, lowers quality of life, restricts social activity participation, and results in incapacity. Osteoarthritis is characterised by changes in subchondral bone, meniscus degeneration, cartilage loss, and synovial inflammation. Physiotherapy plays a vital role in maintaining the stability of this disease. Various treatment approaches have been shown in numerous studies to be successful in improving the condition of individuals with osteoarthritis in the knee. We are presenting a case of a 47-year-old woman who had bilateral osteoarthritis in her knees. We created a six-week treatment plan for this patient that incorporates a number of advanced therapy techniques, including Mulligan mobilisation, Kinesio taping, and plyometric exercise sessions. We created a thorough rehabilitation programme for our patient, who had osteoarthritis in her knee, and it worked incredibly well. We assessed the efficacy of our outcome measures using a variety of outcomes, including the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee Injury and Osteoarthritis Outcome Score (KOOS), visual analogue scale (VAS), range of motion (ROM), and manual muscle testing (MMT). It was found to be more beneficial to provide modern physiotherapeutic approaches in addition to a traditional physiotherapy course for improving the overall health and quality of life of the patient.

The Significance of Proprioceptive Training in the Post-Operative Rehabilitation of Patients Undergoing Achilles Tendon Reconstruction

In the human anatomy, the Achilles tendon (AT) is the strongest and largest tendon. Also, it ruptures the most often. Because it impairs the patient's ability to function adequately, a ruptured AT injury is a serious clinical issue. Reconstruction of the tendon through surgical intervention is the preferred approach to treatment in the case of tendon rupture. Establishing an effective post-operative rehabilitation regimen that mostly consists of functional physiotherapy measures is crucial in the management of AT rupture. In this report, we have presented the case of an AT reconstruction patient who complained of pain in the ankle region, reduced strength and range of the ankle joint, and loss of proprioception. The tailor-made physiotherapy protocol was incorporated, which included strengthening exercises, proprioceptive retraining, cryotherapy, and ambulatory training, which were found to be effective in facilitating early functional recovery.

The Rehabilitation Journey of a Cricket Player With Partial Rotator Cuff Tear: A Case Report of Pre and Postoperative Physiotherapy

In adults, partial rotator cuff injuries can frequently be the root cause of pain in the shoulder. One recurrent pathology that may significantly impact a broad spectrum of individuals, including athletes, laborers, and sedentary people, is partial rotator cuff tears (RCTs). Physical therapy, anti-inflammatories, painkillers, rest or activity modifications, and corticosteroid injections are a few nonoperative treatment options for partial RCTs. We report a case of a 27-year-old male who sustained a rotator cuff injury of the right shoulder. The patient presented with pain and restriction of the right shoulder joint following the injury, which had occurred while throwing a ball forcefully with his right hand. The rehabilitation program emphasized pain management, restoring range of motion (ROM), increasing strength of muscles, and functional activities to optimize the patient's recovery. Concurrently, isometrics, ROM, and strengthening exercises were integrated into the rehabilitation program to enhance muscle strength, prevent tightness, and maintain ROM. The patient's progress was monitored by using the Disabilities of Arm, Shoulder, and Hand (DASH) score and the Upper Extremity Functional Scale (UEFS) at specific intervals during rehabilitation. The treatment and healing of a patient with an RCT who underwent both pre and postoperative physiotherapy are explored in this case report.

Effectiveness of Active Release Technique With Conventional Therapy in the Management of Lateral Epicondylitis: A Case Report

The condition known as tendonitis, tennis elbow, lateral epicondylalgia, or lateral epicondylitis affects the radiohumeral joint and causes persistent, severe discomfort in the elbow. It commonly affects those who work in professions that need repetitive forearm motions, like athletes who play on courts, computer operators, and woodworkers. It tends to originate from additional rapid, tiresome, recurring eccentric contractions and activities that grab gliding joints. It commonly affects the dominant hand. This case report describes the author's seven years of experience living with lateral epicondylitis, including functional disability in day-to-day life, and then physiotherapy management was started. Mill's and Cozen's tests were performed, and lateral epicondylitis was confirmed. From 2023, the physiotherapy session, including active release technique and conventional therapy, was taken regularly for four weeks. The outcome measure score of the Visual Analog Scale (VAS) was 7/10 pre-treatment and 2/10 post-treatment, and for the Patient-Rated Tennis Elbow Evaluation (PRTEE) scale, it was 50/100 pre-treatment and 25/100 post-treatment. The results that are reported from this particular case study suggest that physiotherapy has a significant effect in improving muscle strength, increasing range of motion, improving activities of daily living, and enhancing the overall quality of life. The study concludes a physiotherapist is crucial in treating these overuse injuries and returning the patient to their daily activities.

Septic Arthritis Associated With Hip Joint Subluxation and Epiphyseal Plate Deformation as a Sequala of Sickle Cell Anemia

This case report emphasizes the critical nature of septic arthritis in pediatric patients, particularly its predilection for large joints like the hip. It underscores the importance of rapid diagnosis and early intervention to preserve joint function. The case involves a six-year-old patient with sickle cell anemia who presented with persistent hip pain and hip subluxation and underwent hip joint arthrotomy. Clinical findings revealed limited mobility, weakness, and radiographic abnormalities. Comprehensive rehabilitation resulted in significant improvements in pain, mobility, and function. The key takeaway is the pivotal role of early diagnosis and comprehensive rehabilitation in managing septic arthritis in pediatric patients, especially those with underlying conditions like sickle cell anemia.

Matrix Rhythm Therapy (MRT) Along With Conventional Physiotherapy Proves to Be Beneficial in a Patient With Post-Operative Knee Stiffness in Case of Tibia-Fibula Fracture: A Case Report

Open fractures of the lower extremities are much more serious as compared to those of the upper extremities. Open fractures occur when the damaged bone is exposed to the external environment through injured soft tissue, increasing the risk of infection. The distal tibia can be fractured by a low-energy mechanism, such as rotational strain or perhaps a high-energy mechanism, such as motor vehicle accidents or falls from high altitudes. This case report is of a male individual who underwent an accident that led to a midshaft tibia and fibula fracture with lateral malleolus fracture. For that, he was operated on with open reduction and internal fixation (ORIF) with interlock nailing for a fracture of the tibia on the right side. A thorough physiotherapy protocol was set, which included matrix rhythm therapy (MRT), and improvements were seen in the outcome measures taken. The course of therapy improved the patient's state of well-being. Functional re-education increased the strength and endurance of the muscles. The patient also developed lower limb strength.

Physiotherapeutic Approach for Septic Arthritis of Knee Joint

Septic arthritis is an orthopaedic emergency associated with poor prognosis in cases with delayed treatment. The standard routes through which the infection spreads are hematogenous and direct entry. Any delay in medicine could mean the patient facing severe joint destruction, limitation in joint range, and inability to do activities of daily living. Septic arthritis is treated with a multidisciplinary approach in which physiotherapy is essential in making patients functionally independent. This article discusses a 58-year-old male patient with pain and swelling in the right knee joint and difficulty doing activities like walking, squatting and climbing stairs. On further investigations and diagnostic arthroscopy, he was diagnosed with septic/pyogenic arthritis caused by Staphylococcus aureus in the right knee. The patient was being treated with antibiotics. Along with it, patient-tailored physiotherapy rehabilitation, including, but not limited to, strengthening, range of motion (ROM) exercises, endurance training, etc., was also given, which proved highly effective at enhancing the patient's functional independence and quality of life. The outcome measure used in this report is the Knee Injury and Osteoarthritis Outcome Score (KOOS).

Morphometric Analysis of Anatomy of Anterior Cruciate Ligament of Knee and its Attachments - a Cadaveric Study in Indian Population

Introduction:

The Anterior Cruciate Ligament tends to stabilise the knee in various range of extension and flexion. Precise study of anatomy, attachments and position of bundles is important for successful ACL reconstruction. In our study, we attempt to assess general anatomy of ACL, determine and compare its morphometric data pertaining to length and width and its tibio-femoral foot prints in different gender and secondarily determine changes in the same during ACL dynamics witnessed during knee flexion changes.

Materials and methods:

A total of 19 knees from 10 cadavers were used in the research with mean age of 61±7 years. After dissecting the skin, muscles, patellar and articular capsule were removed and bundle attachments were studied. Thereafter the relative length, width and stiffness of ACL bundles at 0, 90, 140 (maximum) angles of knee flexion were measured along with maximum horizontal and vertical bundle footprints at tibio-femoral attachments were recorded.

Results:

Mean length and width of insertion of anteromedial (AM) bundle on the tibial surface was 8.8mm and 9.0mm in males and 8.1mm and 8.8mm in females. Furthermore, that of PL bundle was 9.1mm and 7.8mm in males and 8.9mm and 7.1mm in females.

Conclusion:

The anteromedial (AM) bundle and posterolateral (PL) bundle of ACL were found to be most relaxed at full extension and were most taut at maximum flexion of 140°. AM bundle underwent greater stretching and change of length in comparison to the PL bundle, indicating that it is comparatively a more dominant bundle.

Basal cell carcinoma arising over lesion of discoid lupus erythematosus: a rare occurrence

Although the association of discoid lupus erythematosus (DLE) with squamous cell carcinoma has been described in the literature, coexistence with a basal cell carcinoma is very rare. The indolent and non-pruritic nature of the lesion cause it often to be diagnosed at the late stage of the disease. Long-standing photosensitivity and chronic inflammation later lead to scarring and hypopigmentation, which are considered as the risk factors for the malignant changes over DLE. Incisional biopsy is often performed from the erythematosus lesion which does not respond to medical treatment. Here we have reported a rare case of basal cell carcinoma of the skin developing in the background of long-standing DLE, which was successfully managed with cold knife local excision.

A manifestation of cutaneous aspergillosis in immunocompetent host: A rare presentation as forearm mass lesion

The Aspergillus species is a ubiquitous fungus, which can cause pathogenic and opportunistic fungal infections in the immunocompromised. This is an atypical occurrence in the host with an otherwise normal immune status. We report a case of an immunocompetent 45-year-old patient who developed cutaneous aspergillosis with a very benign course presenting simply with a gradually enlarging mass and none of the classical signs and symptoms. All prior laboratory examinations failed to detect or reproduce the organism or establish a diagnosis. Surgery was both diagnostic and therapeutic, to remove the mass which causes the patient pain and limitation of activity. This was to our advantage because the fungal elements were very well encapsulated and the mass was a well-organized conglomeration of cystic abscesses that even prolonged chemotherapy alone might not succeed in eradicating the infection.

Bladder Rupture Following Surgical Mid-Trimester Abortion

Nepal Journal of Obstetrics and Gynaecology / Vol 7 / No. 1 / Issue 13 / Jan- June, 2012 / 64-65 DOI: http://dx.doi.org/10.3126/njog.v7i1.8841

Extraction of Metal Ions Using Chemically Modified Silica Gel Covalently Bonded with 4,4'-Diaminodiphenylether and 4,4'-Diaminodiphenylsulfone-salicylaldehyde Schiff Bases

Two new chelating materials (Si-DDE-o-HB, and Si-DDS-o-HB) were synthesized by modifying the activated silica gel phase with Schiff bases of 4,4'-diaminodiphenylether (DDE)/4,4'-diaminodiphenylsulfone (DDS) and o-hydroxybenzaldehyde (o-HB). The synthesized materials were characterized by FTIR and BET surface area measurement techniques. The extraction of metal ions such as Zn2+, Mn2+ and Cr3+ by the chelating material Si-DDE-o-HB was found to be higher than that by Si-DDS-o-HB. The order of metal sorption was found to be Zn2+ > Mn2+ > Cr3+. The correlation coefficients for Freundlich and Langmuir adsorption isotherms were compared for the sorption of Zn2+ onto the chelating material. The loading and elution of the metal ion solution was examined at optimum pH 7.5 and 0.5 cm3 min-1 flow rate of the solution using a column technique. The preconcentration factor for the elution of Zn2+ using dilute HNO3 was found to be 66.2 with a breakthrough volume of 15 cm3. The data obtained for the preconcentration of Zn2+ by the column technique suggested that the material Si-DDE-o-HB can find industrial applications.

Complexation of Ferrocene Derivatives by the Cucurbit[7]uril Host: A Comparative Study of the Cucurbituril and Cyclodextrin Host Families

The formation of inclusion complexes between cucurbit[7]uril (CB[7]) and ferrocene and its derivatives has been investigated. The X-ray crystal structure of the 1:1 inclusion complex between ferrocene and CB[7] revealed that the guest molecule resides in the host cavity with two different orientations. Inclusion of a set of five water-soluble ferrocene derivatives in CB[7] was investigated by 1H NMR spectroscopy and calorimetric and voltammetric techniques. Our data indicate that all neutral and cationic guests form highly stable inclusion complexes with CB[7], with binding constants in the 10(9)-10(10) M(-)(1) and 10(12)-10(13) M(-1) ranges, respectively. However, the anionic ferrocenecarboxylate, the only negatively charged guest among those surveyed, was not bound by CB[7] at all. These results are in sharp contrast to the known binding behavior of the same guests to beta-cyclodextrin (beta-CD), since all the guests form stable inclusion complexes with beta-CD, with binding constants in the range 10(3)-10(4) M(-1). The electrostatic surface potentials of CB[6], CB[7], and CB[8] and their size-equivalent CDs were calculated and compared. The CD portals and cavities exhibit low surface potential values, whereas the regions around the carbonyl oxygens in CBs are significantly negative, which explains the strong affinity of CBs for positively charged guests and also provides a rationalization for the rejection of anionic guests. Taken together, our data suggest that cucurbiturils may form very stable complexes. However, the host-guest interactions are very sensitive to some structural features, such as a negatively charged carboxylate group attached to the ferrocene residue, which may completely disrupt the stability of the complexes.

Cucurbituril homologues and derivatives: new opportunities in supramolecular chemistry

The supramolecular chemistry of cucurbituril, a synthetic receptor, is fascinating because of the remarkable guest binding behavior of the host. Studies in the field, however, have met with limitations, since the only species known was the hexameric macrocyclic compound, cucurbit[6]uril. Recently we synthesized its homologues, cucurbit[n]uril (n = 5, 7, 8), and derivatives. These new members of the cucurbituril family have expanded the scope further, and interest in them has grown enormously. This Account is a compilation of recent literature covering the syntheses of the homologues and derivatives, and their supramolecular chemistry.

Unexpected solute aggregation in water on dilution

Studies on cluster-cluster aggregation phenomena in aqueous solutions of fullerene-cyclodextrin conjugates, beta-cyclodextrin, sodium chloride, sodium guanosine monophosphate, and a DNA oligonucleotide revealed that there are larger aggregates existent in dilute aqueous solutions than in more concentrated solutions.

Menstrual disorders in genital tuberculosis

Study included 120 cases of genital tuberculosis proved by histopathology. Analysis of their menstrual history showed that the common menstrual disorder was oligohypomenorrhoea found in 54.0% cases, menorrhagia in 19.0% cases, and postmenopausal bleeding in 1.6% cases. History of amenorrhoea was present in 14.3% cases. There were 8 cases of secondary amenorrhoea and one case was of primary amenorrhoea. The pelvic examination showed cervical involvement in 43.1% of cases. Tubo-ovarian mass was present in 19.8% cases. Genital tract tuberculosis is a disease of varied symptomatology. A high degree of suspicion and efficient investigation are important for diagnosis.

Chronic myeloid leukaemia with massive lymphadenopathy

A 35 year old patient with chronic myeloid leukaemia presented with massive lymphadenopathy and unilateral limb oedema, when still in the chronic phase. Four weeks later, she passed into frank blast crisis, despite treatment with busulphan and palliative radiotherapy to the lymph nodes.

Nucleotide and deduced amino acid sequence of the nonstructural phosphoprotein, NS2, of bluetongue virus serotype 17: comparison to two isolates of serotype 10

The nucleotide sequence of bluetongue virus (BTV) serotype 17 segment 8 from North America (NA) coding for the nonstructural phosphoprotein, NS2, was determined. This segment contains 1125 base pairs and codes for a protein of 40,581 daltons containing 354 amino acids with a net charge of -8.5 at pH 7.0. The carboxyl terminal portion of the protein is very hydrophilic and has a high degree of potential alpha-helix. Serine is the major, if not the exclusive, phosphorylated amino acid residue and ten of the twenty serine residues present in NS2 are found in consensus phosphorylation sites. Comparison of the nucleotide sequence of BTV-17NA segment 8 with the sequence of BTV-10NA and BTV-10 South Africa (SA) revealed a greater degree of homology between different serotypes within the same geographical area, i.e., 17NA and 10NA, than between isolates of the same serotype located in different areas, i.e., 10NA and 10SA. The same homology relationship as above was found at the amino acid level.