Rehabilitation and Therapy Commons^™

Inpatient Rehabilitation For A Cancer Survivor Following A Lumbar Spinal Fusion Secondary To A Pathological Fracture: A Case Report, Nicole Marczak, Amy J. Litterini

Case Report Posters

Pathologic fractures are considered a skeletal-related event of bone metastasis. Bone metastases indicate a shorter prognosis with the survival rate varying from 6-53 months, depending on the primary type of cancer. Indications for surgery include spinal instability, vertebral collapse with or without neurologic deficit and intolerable pain that is not responsive to conservative treatment. Palliative physical therapy (PT) is provided to the patient and their family to offer education, optimize their functional independence and provide comfort and support. The purpose of this case report was to describe the plan of care for a man with advanced cancer to bone status-post …

Home Health Physical Therapy For A 90-Year-Old Patient Following Transient Ischemic Attack: A Case Report, Kendra Stephens

Case Report Posters

Transient ischemic attack (TIA) is an episode of focal brain dysfunction that is temporary (<24 hrs.) and is due to a dysfunction of an arterial territory of the brain. Its most common symptoms include facial droop, arm weakness, and speech difficulty. An estimated 200,000 to 500,000 people per year experience a TIA in the U.S. After having TIA, 1/3 of them will have a stroke within a year. About 25% of people will die within a year after a TIA. While research for secondary prevention of stroke is clear for pharmacological and surgical interventions, there is limited research on non-pharmacological interventions. The purpose of this case report was to describe the immediate home health physical therapy (PT) management of an elderly community-dwelling patient following a TIA.

Restoring Functional Mobility Following A Ruptured Abdominal Aortic Aneurysm: A Case Report, Grace Laughlin

Case Report Posters

An abdominal aortic aneurysm (AAA) is a dilation of the abdominal aortic artery greater than three centimeters involving all layers of the vessel wall. There are two surgical options for treatment of AAA: open repair and endovascular aneurysm repair (EVAR). An endoleak is a complication following EVAR when blood leaks into the aneurysm sac. A type III endoleak occurs when there is a defect between parts of endografts causing an increase in the systemic pressure in the aneurysm sac. The purpose of this case report was to describe the physical therapy (PT) plan of care of an elderly patient following …

Physical Therapy Intervention For An Elderly Patient With Comorbidities Following Surgical Fixation Of A Femoral Neck Fracture: A Case Report, Yu-Min Chou

Case Report Posters

More than 300,000 elderly people over age 65 required hospitalization due to hip fracture in 2016. More than 95% of hip fractures are the result of falls. Strength training programs are suggested for geriatric patients with surgical fixation following hip fracture. Returning to prior level of function and quality of life is the primary goal of rehabilitation for geriatric patients recovering from a hip fracture. Complex comorbidities such as heart failure, diabetes, and extensive medical history will lead to a poor prognosis for recovery. Literature is limited on adverse responses or hardware failure in physical therapy patients following open reduction …

Physical Therapy Interventions To Increase Independence With Functional Mobility For An Older Individual With Spinal Stenosis: A Case Report, Eleni Bautz

Case Report Posters

Spinal stenosis includes narrowing of the spinal canal which can affect nerves and other structures that pass through. Symptoms commonly associated with spinal stenosis are pain and paresthesia into the lower extremities. Spinal stenosis is diagnosed through patient history, clinical findings, and/or physical tests. Literature supports the use of physical therapy (PT) for conservative treatment in decreasing signs and symptoms of spinal stenosis The purpose of this case report was to describe a comprehensive physical therapy program with goals to decrease pain and improve functional mobility for a patient diagnosed with lumbar spinal stenosis living a sedentary lifestyle.

Early Mobilization And Functional Mobility Training For A Patient With Triple Vessel Coronary Artery Bypass Grafting: A Case Report, Cody Hall

Case Report Posters

Coronary artery bypass grafting (CABG) is a widely used procedure (200,000 annual cases in the US)1 in individuals with Coronary artery disease (CAD). CAD is a build-up of plaque in the blood vessels that supply the heart, which can result from diabetes, smoking, and a vast number of other conditions. The procedure involves harvesting blood vessels (usually autografts of the patient’s saphenous vein) and surgically attaching them to the aorta and the poorly perfused area of the heart, bypassing the damaged vessels. Early mobility is now the standard of care in physical therapy (PT) practice following CABG, however some clinicians …

Functional Mobility Interventions For A Bariatric Patient With Necrotizing Fasciitis: A Case Report, Jakub Cwalinski

Case Report Posters

Necrotizing Fasciitis is a life threatening soft tissue infection that is characterized by a rapid spreading infection of the subcutaneous tissue. Symptoms include red or purple skin in the affected area, severe pain, fever, and vomiting. Typically, the infection enters the body through a break in the skin such as a cut or burn. Surgical debridement is the mainstay of treatment for necrotizing fasciitis. Intravenous antibiotics are started immediately upon diagnosis. The purpose of this case report is to describe functional mobility interventions for a bariatric patient with necrotizing fasciitis.

Joint Stability And Proprioception Training To Reduce Chronic Pain For A Female Patient With Hypermobile Ehlers-Danlos Syndrome: A Case Report, Ashley Tullo

Case Report Posters

Ehlers-Danlos Syndrome (EDS) is a heritable connective tissue disorder with many subtypes. Hypermobile EDS (hEDS), the most common subtype, is characterized by generalized joint hypermobility, musculoskeletal impairments, systemic involvement, and a familial history of EDS. Due to the many subtypes of EDS, and general hypermobility, a categorization of all terms was created called the Hypermobility Spectrum Disorder. Patients present with physical, psychological, and central nervous system impairments reducing their quality of life (QoL). The purpose of this case report was to describe the interventions utilized for a 28-year-old female with hEDS and chronic pain with the intention of reducing symptoms …

Physical Therapy Management Of A Patient With Unilateral Headache, Neck, And Shoulder Pain Who Presents With Undiagnosed Mastoiditis: A Case Report, Alexandr Kostenko

Case Report Posters

Mastoiditis is an infection and inflammation of the mastoid cells. If left untreated, mastoiditis can lead to intracranial complications and ultimately death. Diagnosis is confirmed with imaging such as computed tomography or magnetic resonance imaging. Common symptoms include earache, retroauricular pain, headache, mastoid tenderness, hearing loss, and discharge from the ear. Mastoiditis is typically managed with antibiotics, but may require mastoidectomy which is the surgical removal of the mastoid bone. The purpose of this case report is to illuminate the signs/symptoms of Mastoiditis as well as Cervicogenic Headaches and their commonalities which include overlapping site of cervicalgia.

Rehabilitation And Prosthetic Training For An Individual With Bilateral Lower Extremity Amputations Due To Peripheral Vascular Disease: A Case Report, Morgan Bessette

Case Report Posters

Peripheral vascular disease (PVD) is a condition in which there is a disruption of blood flow to the extremities. Common causes of PVD include: hypertension (HTN), smoking, cardiac disease and/or diabetes. 12 to 20% of the population greater than 60 years old are affected by PVD. PVD can cause intermittent claudication or critical limb ischemia (CLI) and is therefore the most common cause of lower extremity amputation (LEA). Individuals with diabetes are at even greater risk of LEA. The purpose of this case report is to describe the physical therapy (PT) interventions and prosthetic training for a patient with bilateral …

Functional Mobility In A Patient With Antiphospholipid Antibody Syndrome Following A Femoral Neck Fracture Surgical Repair: A Case Report, Mckenna Young

Case Report Papers

Background and Purpose: The main focus of chronic disease in healthcare has typically been about treatment of the disease itself, with little attention given to secondary injuries that result from the chronic disease process. As these individuals age, the risk of secondary injuries increases. This is costly and adds to the caregiver burden. The purpose of this case report was to investigate a comprehensive physical therapy (PT) program focused on rehabilitation for a female with chronic disease who sustained a femoral fracture following her most recent fall. Case Description: A 42-year-old female presented to outpatient PT following a right femoral …

Tissue Plasminogen Activator Effects On Stroke And Physical Therapy Outcomes In Acute Care: A Case Report, Lindsey Leboeuf

Case Report Papers

Background and Purpose: An ischemic stroke occurs when blood flow to an area of the brain is restricted and can cause numbness or weakness on one side of the body, facial droop, trouble speaking, and trouble walking. Patients who seek medical attention for symptoms within three hours of their onset can be eligible to receive tissue plasminogen activator (tPA). These patients often have less resultant disability than their counterparts who did not receive the drug. The purpose of this case reports is to display the positive effects of tPA and physical rehabilitation following a stroke in the acute care setting. …

Combining A Comprehensive Physical Therapy Program And Electrocorpeal Shockwave Therapy For Plantar Fasciitis: A Case Report, Kathryn Piersiak

Case Report Papers

Background and Purpose: Plantar fasciitis (PF) is present in 2 million Americans a year, and in 10% of the population over a lifetime. Conventional physical therapy (PT) for PF has included strengthening of foot and hip musculature, and lower extremity stretching. Extracorporeal shockwave therapy (ECSW) has also been utilized with success in treatment of PF. While these two treatments have been used individually, their combined effect has not been studied. The purpose of this case report investigated a combined plan of care utilizing conventional PT, targeted hip strengthening, and ECSW. Case Description: The patient was a 48-year-old female who presented …

Treatment Of A Work-Related Superior Glenoid Labral Repair: A Case Report, Alexandra Touri

Case Report Papers

Background and Purpose: A superior glenoid labrum tear anterior to posterior (SLAP) is a common injury in the shoulder although they are less commonly seen in the workplace. There are many resources for SLAP lesions concerning overhead throwing athletes, however, there are not specific details on return to work rehabilitation activities for the workers’ compensation population. The purpose of this case report is to explore the post-operative physical therapy management of a workers’ compensation patient with a superior glenoid labrum lesion. Case Description: This patient was a 45-year-old Hispanic female diagnosed with a superior glenoid labrum lesion of the left …

A Hip Strengthening Protocol For A Patient Following Achilles Repair: A Case Report, Matthew Morris

Case Report Papers

Background and Purpose: The Achilles tendon is the strongest, yet most frequently ruptured, tendon in the body. Hip strength has been associated with various lower extremity (LE) conditions. However, there is a lack of literature regarding hip strengthening and its impact on Achilles injuries. Therefore, the purpose of this case report was to describe the rehabilitation of a patient following a left Achilles tendon repair utilizing a comprehensive hip strengthening protocol. Case Description: The patient was a 32-year-old female who ruptured her Achilles playing tennis. She underwent surgical repair three weeks later and was immobilized and non-weightbearing for a total …

Restoring Functional Mobility For A Geriatric Patient Following Open Repair Of A Ruptured Abdominal Aortic Aneurysm: A Case Report, Grace Laughlin

Case Report Papers

Background and Purpose: Each year 200,000 people are diagnosed with an abdominal aortic aneurysm (AAA) in the United States and the mortality rate for ruptured AAA is estimated to be 80%. There are two surgical options to treat ruptured AAA, an open repair and an endovascular aneurysm repair (EVAR). The incidence of rupture following an EVAR is 0.9%. The purpose of this case report was to describe the physical therapy (PT) plan of care of an elderly patient following an open repair of a ruptured AAA with a history of EVAR. Case Description: The patient was an 86-year-old female admitted …

Physical Therapy Management Of Low Back Pain In A Young Female With Ankylosing Spondylitis Associated With Hla-B27 Antigen: A Case Report, Jake Adkins

Case Report Papers

Background and Purpose: Ankylosing spondylitis (AS) is a form of arthritis characterized by chronic inflammation of the axial skeletal system that causes back pain and loss of mobility with strong potential for slow, eventual spinal fusion. The condition affects 0.2-0.5% of the United States population. There is no known cure for AS and the cause is unknown. The purpose of this case report is to describe a comprehensive approach for physical therapy (PT) management of AS in order to assist clinical reasoning and clinical decision-making and enhance care management in this patient population. Case description: A 27-year old female referred …

Gait, Strength, And Balance Training For A 43-Year-Old Male Following An Acute Right Middle Cerebral Artery Stroke: A Case Report, Victoria Dwyer

Case Report Papers

Background and Purpose: Although many patients who have had a stroke receive inpatient rehabilitation treatment, there is limited literature that investigates the interventions utilized to treat this population. The purpose of this case study was to describe the inpatient rehabilitation treatment interventions including body weight supported treadmill training (BWSTT), functional electrical stimulation (FES), balance, and lower extremity (LE) strengthening on a patient with a sub-acute right middle cerebral artery (R MCA) stroke. Case description: The patient was a 43-year-old male who recently had a R MCA stroke. He presented with significant expressive aphasia, left-sided hemiparesis, balance and transfer deficits, and …

Functional School-Based Physical Therapy Management For A Child With Pallister-Killian Syndrome: A Case Report, Cheryl R. Espinosa

Case Report Papers

Background and Purpose: Pallister-Killian Syndrome (PKS) is a rare genetic disorder resulting from an additional short arm in chromosome 12. This condition leads to varying levels of multi-system impairments that impact a child’s development in gross motor skills yielding functional limitations. Pediatric physical therapy (PT) management is crucial for these children to facilitate improvements in sitting, standing, and ambulation. The purpose of this case report was to describe functional school-based PT management for a child with PKS. Case Description: The child was a seven-year-old male diagnosed with PKS at 20 weeks’ gestation. The child was seen for PT five times …

Muscle Activation Patterns During Movement Attempts In Children With Acquired Spinal Cord Injury: Neurophysiological Assessment Of Residual Motor Function Below The Level Of Lesion., Darryn A Atkinson, Laura Mendez, Natalie Goodrich, Sevda C Aslan, Beatrice Ugiliweneza, Andrea L Behrman

Physical Therapy Collection

Introduction: Characterization of residual neuromotor capacity after spinal cord injury (SCI) is challenging. The current gold standard for measurement of sensorimotor function after SCI, the International Society for Neurological Classification of Spinal Cord Injury (ISNCSCI) exam, seeks to determine isolated intentional muscle activation, however many individuals with SCI exhibit intentional movements and muscle activation patterns which are not confined to specific joint or muscle. Further, isolated muscle activation is a feature of the neuromuscular system that emerges during development, and thus may not be an appropriate measurement standard for children younger than 6.

Methods: We utilized neurophysiological assessment …

Regaining Independence In Ambulation For A Visually Impaired Patient With Rhabdomyolysis: A Case Report, Brandon Bourgoin

Case Report Papers

Background and Purpose: Rhabdomyolysis is a myopathic condition that causes significant muscle wasting following an acute onset. This condition elevates creatine kinase in the bloodstream, and commonly causes the patient to have muscle pain, swelling, and weakness, as well as dark “tea” colored urine. The purpose of this study was to describe physical therapy (PT) interventions used treating a legally blind (LB) elderly male with rhabdomyolysis and multiple comorbidities. Case Description: A 78-year-old male referred to PT with a diagnosis of rhabdomyolysis following a fall in the home. He presented with muscle soreness, decreased lower extremity (LE) strength, and impaired …

Gait, Strength, And Balance Training For A 43-Year-Old Male Following Acute Right Middle Cerebral Artery Stroke: A Case Report, Victoria Dwyer

Case Report Posters

A cerebrovascular accident, commonly known as a stroke, is caused by an ischemic or hemorrhagic event affecting arteries that lead to the brain causing them to burst or be occluded. The middle cerebral artery is the most commonly occluded artery involved in a stroke. The four most common risk factors involved in having a stroke are: high blood pressure, diabetes, heart disease and pervious strokes. Common impairments associated with having a stroke include: hemiparesis, loss of sensation in the face and/or extremities, and difficulties with speech, vision, and gait. The purpose of this case report was to describe the physical …

Early Mobilization And Functional Mobility Training For A Patient With Triple Vessel Coronary Artery Bypass Grafting: A Case Report, Cody Hall

Case Report Papers

Background and Purpose: Coronary artery disease (CAD) is the buildup of plaque in coronary blood vessels and is the most common type of heart disease in the United States. Coronary artery bypass grafting (CABG) is an invasive surgical procedure used to provide alternate blood supply to cardiac tissue in individuals with CAD using autografts. The goals of the surgery are often to prolong life, reduce symptoms, improve functioning, and improve vocational status. The purpose of this case report was to document the outcomes of a physical therapy (PT) plan of care for a complex patient after undergoing CABG. Case Description: …

Comprehensive Physical Therapy Management Of Chronic Low Back Pain With Associated Remote Right Hamstring Injury: A Case Report, Emily Larson

Case Report Posters

Low back pain (LBP) is a health condition associated with back, core, and hip muscle dysfunction as well as reduced lumbar range of motion. Core muscle stabilization, hip abductor strengthening, and lumbar range of motion are all effective techniques for treating patients with chronic LBP. Lumbar muscular imbalance can lead to hamstring injury because of change in the functional load. The purpose of this case report was to review a therapeutic exercise approach to the treatment of chronic low back pain after a remote hamstring injury, including a focus on lumbar and core stabilization, lumbar and hamstring stretching and hamstring …

Functional Mobility In A Patient With Antiphospholipid Antibody Syndrome Following A Femoral Neck Fracture Surgical Repair: A Case Report, Mckenna Young

Case Report Posters

Antiphospholipid Antibody Syndrome is an autoimmune disease which causes the body to produce antibodies that attack phospholipids, a type of fat. It leads to high rates of blood clot formation in arteries and veins. High rates of blood clots cause stroke, which can lead to balance concerns and increased falls. Fall rates among individuals with chronic disease peak between age 45-64. Fall risk factors include reduced mobility level, imbalance, age, number of co-morbidities, duration of diagnosis, and sex. The purpose of this case report is to investigate a comprehensive physical therapy program that focused on increasing independence and reducing fall …

Combining A Comprehensive Physical Therapy Program And Electroshock Therapy For A Patient With Plantar Fasciitis: A Case Report, Kathryn Piersiak

Case Report Posters

Plantar fasciitis (PF) affects 2 million Americans per year and 10% of the population over a lifetime. PF is inflammation to the thick, fibrous connective tissue originating on the medial calcaneal tubercle extending to the metatarsal heads of the foot. A comprehensive physical therapy (PT) plan of care (POC) of proximal strengthening, distal stretching and soft tissue massage (STM) has been shown to improve PF symptoms. Extracorporeal shockwave therapy (ESWT) is a non-invasive modality that uses sound waves to create a controlled microtrauma to the impaired tissue to stimulate a healing response and microvascularization. ESWT has shown to be effective …

Conservative Management Of A Massive Rotator Cuff Tear And Partial Tear Of The Long Head Of The Biceps: A Case Report, Jessica Diggins

Case Report Posters

A rotator cuff tear (RCT) is a common injury to the shoulder musculature that increases in prevalence with age. RCT’s can be classified into five categories determined by the muscular involved: Type A: supraspinatus & superior subscapularis; Type B: supraspinatus & entire subscapularis; Type C: supraspinatus, superior subscapularis & infraspinatus; Type D: supraspinatus & infraspinatus tears; Type E: supraspinatus,infraspinatus & teres minor. Massive RCT is classified as >5cm in size, or complete tear of two or more tendons. Some massive tears may be considered irreparable due to the extent of tendon retraction, atrophy, arthritis and mobilization. Current literature supports the …

Blood Flow Restriction Therapy For The Treatment Of An Acl Reconstruction With A Meniscal Repair: A Case Report, Nicole Victor

Case Report Posters

ACL tears make up ~50% of all knee injuries. Meniscal tears are second to ACL injuries in regards to prevalence. Following an ACL reconstruction, high-load resistance training is often used to increase muscle strength. However, rehabilitation after a meniscal repair calls for a longer period of immobilization in order to prevent early loading of the meniscus. Blood Flow Restriction Therapy (BFRT) used in conjunction with low intensity resistance training can produce increased muscle mass of the quadriceps muscles without adding load and stress to the meniscus. While evidence has shown positive results with the use of BFRT after an ACLR, …

The Effects Of Dry Needling In The Management Of Sub-Acromial Impingement Syndrome: A Case Report, Kaitlyn Radice, Lindsey Bramlette, Kristin Fenstermaker

Miami, Fall 2019

The purpose of this study was to evaluate the effectivness of dry needling to an active trigger point in the anterior deltoid musculature in conjunction with physical therapy. This case study presents a 77-year-old male with traumatic pull into flexion injury. In addition to being given RTC and postural musculature strengthening exercises, PROM, joint mobilization, and soft tissue mobilization, dry needling was performed at week 2 and week 4 of treatment.

From this case study, we can conclude that TrP-DN to an active TrPin the anterior deltoid can yield statistically significant improvements in ROM, strength, pain, and functional abilities when …

Physical Therapy Management Of Stress Urinary Incontinence In The Pediatric Population: A Case Study, Debra Dy, Maureen Egizii

Miami, Fall 2019

The purpose of this study was to determine if external pelvic floor examination and treatment can be an effective, non-invasive intervention for urinary incontinence in the pediatric population. The case study examines the effectiveness of exercise therapy for an 11-year-old female with pelvic floor dysfunction. This case demonstrates that pelvic floor strengthening exercises can help to resolve incontinence symptoms without the implementation of internal examination or treatment. Although commonly used to address incontinence in adults, pelvic floor physical therapy may also be an effective, non-invasive intervention option for children who are experiencing urinary incontinence.