Physiotherapy Commons^™

A Rare Case Of Bilateral Supraspinatus Tendon Tears With Unilateral Musculotendinous Junction Involvement In An Elderly Patient, Kanyamas Poompreecha, Patsaree Pattanasuwanna, Ya-Chu Hsu

Rehabilitation Practice and Science

Rotator cuff (RC) tears are a common cause of shoulder pain in the elderly, though tears at the musculotendinous junction (MTJ) are uncommonly observed. We present a rare case of bilateral supraspinatus tendon tears in a 68-year-old male, with unilateral involvement of the MTJ. Symptoms developed three months after resuming resistance training following left acromioclavicular dislocation surgery. Ultrasound revealed a full-thickness insertional tear on the left and a partial MTJ tear on the right. Conservative treatment led to symptom resolution without surgery. This case highlights the diagnostic value of dynamic ultrasound for subtle rotator cuff and MTJ lesions in elderly …

Safety In Dry Needling: The Role And Contributions Of The International Dry Needling Education & Training Advisory Group (Idnetag), W Mahmoud, J. Dommerholt

Rehabilitation Practice and Science

Dry needling is an intervention that physical therapists use to address various neuromusculoskeletal pain syndromes, primarily through targeting myofascial trigger points (TrPs) in muscle tissue. This technique involves inserting thin filiform needles into specific areas to relieve pain and improve movement. Despite its therapeutic potential, concerns regarding adverse events (AEs) necessitate stringent safety protocols and guidelines. In response, the International Dry Needling Education & Training Advisory Group (IDNETAG) was established in 2023 with members from diverse professions across eight countries. IDNETAG's mission is to enhance global standards of practice, focusing on safety, education, and consistency in treatment protocols. Research indicates …

Assessing How Patients With Spinal Cord Injury Are Affected By Climate Change And Extreme Weather: A Scoping Review, Lien-Chieh Lin, Hung-Chou Chen, Tsan-Hon Liou

Rehabilitation Practice and Science

Climate change and the rising frequency of extreme weather events (EWEs) pose significant challenges to vulnerable populations, particularly individuals with spinal cord injury (SCI). These patients are at greater risk due to impaired thermoregulation, limited mobility, poor sensation, and dependence on caregivers or adaptive equipment, increasing their exposure to climate-related hazards and disrupting healthcare access during disasters. Although climate change impacts on the general population are well-documented, research on specific disability groups like SCI patients remains limited. This scoping review investigates how SCI patients perceive and experience health risks from climate change and EWEs, as well as factors influencing their …

The Effects Of 10-Ml Versus 40-Ml Capsular Dilatation Under Ultrasound Guidance In Patients With Adhesive Capsulitis: A Randomized Controlled Trial, Kollatee Buranarach, Rawipa Khunnarong, Chanasak Hathaiareerug

Rehabilitation Practice and Science

Background: Adhesive capsulitis causes pain and limited mobility. Hydrodilatation is an effective, minimally invasive treatment, but the optimal volume is unclear. This study compares the pain and function improvement from large-volume (40 mL) versus small-volume (10 mL) ultrasound-guided hydrodilatation in patients with adhesive capsulitis.

Methods: This study was conducted at Phramongkutklao Hospital in Bangkok, Thailand, with Thai adults aged 20 and older who had adhesive capsulitis. Participants had a pain score of 4 or higher on the Visual Analogue Scale (VAS) and limited movement in at least two directions. They were divided into two groups. One group received ultrasound-guided hydrodilatation …

Long-Term Benefits Of An Integrative Scoliosis-Specific Rehabilitation Program For High-Risk Adolescent Idiopathic Scoliosis: A Retrospective Cohort Study, Yu-Shan Fu, Lin-Fen Hsieh, Julian Wang, Wei-Chen Chang, Ya-Fang Liu, Hsuan-Han Lin

Rehabilitation Practice and Science

Background/Purpose: Adolescent idiopathic scoliosis (AIS) is a common spinal deformity in adolescents, but the optimal combination therapy remains to be established. Therefore, our purpose is to investigate the long-term benefits of a scoliosis-specific rehabilitation program integrating pattern-specific manual therapy, Schroth Best Practice exercises, and Gensingen brace application for patients with AIS.

Methods: The retrospective cohort study was conducted in an outpatient clinic, including 54 patients with AIS at a high risk of progression who participated in the aforementioned program. The primary outcomes were the angle of trunk rotation (ATR) and Cobb angle, whereas the secondary outcome was the lateral …

Hemiplegic Shoulder Pain: A Narrative Review, Yeh-Kai Liao, Chueh-Hung Wu, Levent Özçakar

Rehabilitation Practice and Science

Hemiplegic shoulder pain is a common post-stroke complication that negatively affects functional recovery. It is caused by both mechanical and neurological factors. Prevention focuses on proper positioning, patient education, and maintenance of motion. Treatment remains largely conservative; with increasing research surrounding injection therapies, including intra-articular corticosteroid injection, subacromial hyaluronic acid injection, suprascapular nerve blocks, and botulinum toxin injection, all of which have demonstrated improved pain control. Functional electrical stimulation appears to be beneficial, and adjunct therapies such as supportive devices and robotic training may further enhance conventional treatment. Herewith, evidence regarding medications and acupuncture remains limited. Emerging treatments including high-intensity …

Unveiling The Role Of The Suprascapular Nerve In Painful Shoulder: A Narrative Review With A Focus On Ultrasound-Guided Diagnosis And Intervention, Hong Hong, Wei-Ting Wu, Ke-Vin Chang

Rehabilitation Practice and Science

Suprascapular nerve disorders are a significant yet often underdiagnosed cause of shoulder pain and dysfunction, stemming from the nerve's critical role in shoulder stability and mobility through its innervation of the supraspinatus and infraspinatus muscles. This review explores the anatomy and clinical relevance of the suprascapular nerve, highlighting the need for accurate diagnosis in cases of pain, weakness, or functional impairment that mimic other shoulder conditions. Among diagnostic modalities, ultrasound has become a vital tool, providing real-time imaging to precisely assess nerve compression or damage. Its utility extends to therapy, with recent advancements in ultrasound-guided interventions—such as nerve blocks, corticosteroid …

Late-Onset Sciatic Nerve Compression Due To Distal Femoral Osteochondroma, I-Fan Hsieh, Tian-Shin Yeh

Rehabilitation Practice and Science

Osteochondroma is one of the most common benign bone tumors, typically asymptomatic, and rarely causes nerve compression. Previous case reports documented nerve compression by osteochondroma arising from the proximal fibula, pelvic bone, and spine. We report a rare case of osteochondroma at the distal femur causing sciatic nerve compression with symptom onset at 42 years old. This case highlights that osteochondroma can develop at any skeletal location, and even though these lesions typically cease to grow after skeletal maturity. Individuals with a history of osteochondroma should consider it as a differential diagnosis for new symptoms even in older age to …

Multidisciplinary Approach To Managing Hypotonia And Developmental Delays Due To A Novel Gtpbp3 Mutation, Fan Mei, Ru-Lan Hsieh

Rehabilitation Practice and Science

Introduction: Hypotonia in early life is often challenging to diagnose due to its diverse etiologies, with genetic disorders accounting for about one-third of cases. A precise diagnosis using a comprehensive, multidisciplinary approach is crucial for determining prognosis, guiding treatment, and providing genetic counseling.

Case Presentation: We report the first case in Taiwan involving compound heterozygous mutations in the GTPBP3 gene. A 13-month-old girl presented with developmental delays and hypotonia despite normal prenatal screenings and a year of rehabilitation therapy. Next-generation sequencing revealed two novel mutations: c.785A>C (p.Gln262Pro), a missense mutation in Exon 5, and c.1175_1181dup (p.Ser395GlufsTer4) …

Effectiveness Of Fu's Subcutaneous Needling In Pain Management And Rehabilitation: A Narrative Review, Po-En Chiu, Chun-Chang Wu, De-Jian Lu, Zhonghua Fu, Li-Wei Chou

Rehabilitation Practice and Science

Fu’s Subcutaneous Needling (FSN) is a modern needling technique distinct from traditional acupuncture, primarily used for musculoskeletal pain, neuropathic conditions, and emerging applications in rehabilitation. FSN is also designated as a kind of dry needling focusing on deactivating myofascial trigger points. This review categorizes FSN-related studies into case reports, clinical trials, and animal studies, evaluating its therapeutic efficacy, safety, and mechanisms. Case reports suggest that FSN provides rapid pain relief and functional improvement, while clinical trials, including randomized controlled trials (RCTs), support its role in reducing pain and enhancing neuromuscular function despite limitations in sample size and protocol consistency. Animal …

Ambulation Challenges Post High-Voltage Electrical Burn Involving Three Extremities, Complicated With Osteomyelitis: A Case Report, Chiang-Hui Huang, Katie Pei-Hsuan Wu

Rehabilitation Practice and Science

High-voltage electrical burns in occupational settings can leave detrimental injuries with immediate impact and long-term sequel. Despite extensive literature on the injury mechanism, comprehensive long-term rehabilitation descriptions for such devastating cases remain scarce. This report presents a significant traumatized high-voltage electrical injury involved three out of four extremities. A late complication with extensive tibial osteomyelitis affecting two-thirds of the bone severely compromised the patient’s ambulation potential, emphasizing the importance of segmental rehabilitation with progressive tolerance in ambulatory weight-bearing. We evaluated the patient’s physical, mental, and social component using Barthel Index, Veterans RAND 12-Item Health Survey (VR-12), and Patient-Reported Outcomes Measurement …

Principles And Practices Of Selecting Screening Tools For Oropharyngeal Dysphagia: A Narrative Review, Yu-Hsuan Lai, Tyng-Guey Wang, Nai-Hsin Meng

Rehabilitation Practice and Science

Oropharyngeal dysphagia is a potentially life-threatening condition, particularly affecting individuals with neurological diseases, head and neck cancers, and age-related issues. Its prevalence in the general population ranges from 2.3% to 16%, with much higher rates among patients with stroke, Parkinson’s disease, and traumatic brain injury. Dysphagia is prevalent in geriatric and long-term care settings, where over 50% of elderly residents may experience swallowing difficulties. Given its high prevalence and serious consequences, early detection through dysphagia screening in at-risk populations is essential. Since the 1990s, numerous screening tools for dysphagia have been developed, with over 160 non-instrumental tools identified in review …

Clinical Application Of Intraoperative Neurophysiological Monitoring During Detethering Surgery Of A Newborn: A Case Report, Mu-Yun Lin, Hsin-Hung Chen, Tsui-Fen Yang

Rehabilitation Practice and Science

Background:

Tethered cord syndrome (TCS) is a rare congenital condition that causes abnormal tension on the spinal cord and often requires early surgical intervention to prevent progressive neurological and orthopedic deficits. However, performing detethering surgery in neonates presents unique challenges due to their immature neural pathways, which complicate intraoperative neuromonitoring (IONM).

Case Description:

We report the case of a 13-day-old neonate with TCS who underwent successful detethering surgery under advanced IONM. Double-train stimulation with a linked quadripolar montage was employed to elicit motor evoked potentials (MEPs), overcoming the challenge of monitoring immature corticospinal tracts. Additionally, subdural strip electrodes were used …

Dysphagia In Becker Muscular Dystrophy: A Case Report And Literature Review, Chien-Ping Chen, Hung-Jui Chuang, Yi-Chi Li, Ming-Yen Hsiao, Tyng-Guey Wang

Rehabilitation Practice and Science

Dysphagia is a recognized complication in patients with muscular dystrophies, but its characteristics in Becker muscular dystrophy (BMD) remain underexplored. This case report describes a man with BMD who developed dysphagia, initially presenting with mild symptoms but later experiencing aspiration pneumonia with respiratory failure. He regained safe oral intake after swallowing training. Three years later, he suffered worsening dysphagia following a severe coronavirus disease-2019 (COVID-19) infection, ultimately losing the ability to resume oral feeding despite months of rehabilitation. Literature on swallowing disorder in BMD reported poor mastication, reduced laryngeal elevation, and increased pharyngeal residue; however, silent aspiration, as observed in …

Influence Of Local Application Of Lidocaine Patch On Peripheral Nerve Conduction – A Pilot Study, Thanh-Nhan Doan, Fang-Yin Liao, Yueh-Ling Hsieh, Li-Wei Chou

Rehabilitation Practice and Science

Background: This study aimed to investigate the effects of a lidocaine patch on peripheral nerve conduction.

Methods: Fifteen healthy volunteers with no symptoms or signs of neuropathy in either upper limb were recruited for this double-blind, placebo-controlled study over a 10-month period. A lidocaine patch or a placebo patch was applied to the volar aspect of the wrist during sleep. The treatment procedure was repeated for 14 consecutive nights. Nerve conduction studies were performed and analyzed at each assessment point. All participants were re-evaluated, with electrophysiological studies of the median and ulnar nerves repeated at 1 week and 2 weeks …

Optimizing Decision-Making In A Cerebral Palsy Model Using Reinforcement Learning, Richard Ampah

Pitzer Senior Theses

This study presents an original interdisciplinary investigation into how reinforcement learning (RL) can model motor and cognitive defects and potentially improve motor and cognitive functions in individuals with cerebral palsy (CP), a non-progressive neurological disorder that impairs movement and adaptability. Integrating computational neuroscience and machine learning, the research applies policy gradient methods and Markov Decision Processes (MDPs) to simulate adaptive learning in agents with and without CP-related constraints.

The central aim is to compare the cumulative rewards of optimal policies, derived from value iteration, and human-like learning policies using the REINFORCE algorithm, both with and without the Bellman baseline. The …

Comparison Of Baumgaertner Reduction Quality Criteria , Chang Criteria And Ap3×Ml3 Classification And Their Ability To Predict Mechanical Complications Of Trochanteric Fractures Fixed With Proximal Femoral Nail, Amr Elhadidy Elhadidy, Ahmed Abdelbadie Ibrahim, Sallam Ibrahim Fawzy, Ehab Youssef Hassanin

Mansoura Medical Journal

Background Trochanteric fractures are common injuries among the elderly. Despite advances in fixation with proximal femoral nails (PFN), Mechanical complication remain significant. Several reduction quality systems have been proposed, but their predictive value and reproducibility remain debated. Aim To evaluate and compare the predictive value and reproducibility of Baumgaertner Reduction Quality Criteria (BRQC), Chang Reduction Quality Criteria (CRQC), and AP3×ML3 classification in patients with AO Foundation/Orthopaedic Trauma Association (AO/OTA) 31-A1 and 31-A2 trochanteric fractures fixed with PFN. Methods A prospective observational study was conducted on 146 patients with 31-A1 and A2 trochanteric fractures treated by PFN. Postoperative radiographs were assessed …

Protocol For Development And Validation Of An Early Intervention Device And Its Influence Using Structured Early Physiotherapy (Preemiestep) Intervention On Neuromotor Development In Preterm Infants, Indira D. B. Naidu Boddapati, Sivakumar Gopalakrishnan, Sonia Khurana, Jayashree Purkayastha, Bhaskar Bhatt, Bhamini Krishna Rao

Rehabilitation Sciences Faculty Publications

Early physiotherapy interventions for Moderate to Late Preterm (MLP) infants often lack continuity of care from hospital to home settings. This research aims to develop an Early Intervention (EI) device for home program and determine its influence using STructured Early Physiotherapy (Preemie STEP) intervention in MLP infants. For phase I, qualitative interviews will be conducted with healthcare professionals and parents, to understand user needs on developed prototype. Based on identified needs, an EI device will be developed using a human-centered design approach and iterative design process. In phase II, usability and validity of EI device will be …

Eccentric-Emphasis Exercise Program For Supraspinatus Partial Tear In Retired Police Officer An Intervention Case Report, German Eduardo Isea Fernandezx

Capstone Showcase

Abstract

Background and Purpose: Eccentric exercise has been shown to reduce pain in patients with multiple comorbidities, orthopedic surgeries, and neurologic conditions, while providing safety for greater loading during resistance training. The purpose of this case report is to describe changes in function and pain of a patient with a partial rotator cuff tear, following rehabilitation exercises focusing on eccentric action.

Case Description: A 65 y/o retired police male officer who presented right shoulder pain secondary to a partial tear of the supraspinatus tendon. The case reported mild to severe pain under the visual analog scale (VAS) of 75mm that …

Functional Recovery Of A Patient In Her Home Environment Following A Stroke Using Proprioceptive Neuromuscular Facilitation And Task-Specific Training: A Case Report, Andrea L. Crawford-Perry

Capstone Showcase

Abstract Background and Purpose: Stroke is a growingly common disability that affects an individual’s bodily function, activity and participation levels and thus impacts the whole livelihood of that individual. Proprioceptive Neuromuscular Facilitation (PNF) and Task-specific Training have been shown to improve the overall functional recovery of a patient and affect neuroplasticity. Most studies tend to compare the individual effect of these techniques; hence the purpose of this case report is to describe how both PNF and task-specific training are used to improve the functional recovery of a patient in her home environment following an acute stroke. Case Description: The patient …