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Physical Rehabilitation - Science topic

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Questions related to Physical Rehabilitation
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What tool do you use to make clinical decisions?
Example:
a)sum of criteria (signs - symptoms);
b)the weighting of clinical scales;
c)use of RPS form and application of a CORE set ICF and thus obtain an operating profile?
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I suggest going through the down-mentioned article, which was published in the American Journal of Physical Medicine and Rehabilitation in 2020. The article argues that several factors (related to the service organization and health system, besides the contextual personal/environmental factors) have a relevant influence on the decision-making in evidence-based practice in rehabilitation.
Good luck!
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How to develop, produce and create new research ideas. Especially in rehabilitation sciences perspectives, some thing to improve treatment or assessment of our patients.
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The research gaps provide new research ideas.
From a thorough desk research a researcher can identify the existing research gaps. Then the identified research gaps need to be filled (for example using hypothetico deductive approach). So there should be a link between the research objectives, research questions and the identified research gaps.
You can get an idea about the research gaps in the article by Iddagoda & Opatha (2017). This is available in the ResearchGate and the reference is given below.
Reference
Iddagoda, Y. A., & Opatha, H. H. D. N. P. (2017). Identified Research Gaps in Employee Engagement. International Business Research, 10(2), 63.
Good Luck
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Conservative
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Treatment for shoulder impingement is based around reducing pain and inflammation, increasing mobility and strength whilst identifying and correcting the possible causes to ensure it does not reccur.
Apply the PRICE principles of protection, rest, ice, compression and elevation. Rest the shoulder from any painful activities or movements. Pain indicates increasing inflammation and delaying the healing process. Apply ice or a cold therapy and compression wrap to the painful area for 10-15 minutes per hour initially reducing to 3 or 4 times a day as symptoms reduce. Remember to use an ice bag or a towel wrapped around the ice to protect against ice burn.
A doctor may prescribe anti-inflammatory medication such as Ibuprofen to reduce pain and inflammation. A professional therapist may use electrotherapy such as ultrasound to help reduce pain and inflammation as well as advise on a suitable rehabilitation and exercise program.
Specific tests to confirm the diagnosis including X-Rays to what is causing the impingement. They may discuss the option of directly injected steroids into the subacromial space to reduce inflammation and reduce inflammation in the local area although this is not usually an early option. It is usually recommended after a period of at least 6-12 months
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I am working on the history of arthrodesis in the upper extremity.
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Thank you, Dr.Langer. I am looking forward to hearing from you.
Regards, 
Panayot 
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I am looking for all systems proposed that use a Kinect
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I am developing a CAT paper and am hoping to find some great articles. I have the following already:
Shaarani S, O'Hare C, Quinn A, Moyna N, Moran R, O'Byrne J. Effect of Prehabilitation on the Outcome of Anterior Cruciate Ligament Reconstruction. The American Journal of Sports Medicine. 2013; 41(9): 2117-2127.
Failla M, Logerstedt D, Grindem H, Axe M, Risberg M, Engebretsen L, Hutson L, Spindler K, Snyder-Mackler L. Does extended preoperative rehabilitation influence outcomes 2 years after ACL reconstruction?: A comparative effectiveness study between the MOON and Delaware-Oslo ACL cohorts. The American Journal of Sports Medicine. 2016; 44 (10): 2608-2614.
Kim et al Effects of 4 weeks preoperative exercise on knee extensor strength after ACL reconstruction.
Grindem, H, Granan, L,Risberg, M, Engebretsen, L, Snyder-Mackler, L, Eitzen I. How does a combined preoperative and postoperative rehabilitation programme influence the outcome of ACL reconstruction 2 years after surgery? A comparison between patients in the Delaware-Oslo ACL Cohort and the Norwegian National Knee Ligament Registry. British Journal of Sports Medicine. 2015; 49(6):385-389.
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Hello Kristina,
You could also read this article:
Evidence-based clinical practice update: practice guidelines for anterior cruciate ligament rehabilitation based on a systematic review and multidisciplinary consensus Nicky van Melick et. al.; Br J Sports Med bjsports-2015-095898Published Online First: 18 August 2016
Good read about ACL and also  part about the evidence of pre-operative physical therapy.
Kind regards,
Peter
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I wonder what would be the best rehabilitation for a ruptured anterior cruciate ligament by impact in a fall during a basketball game. After trying to rehabilitate by exercises with trx does not improve. which method should be used to improve this?
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ACL reconstruction followed by ACL protocol of strengthening Hamsrings and gradual Knee bending and Quadriceps build up. Hmsrings strenghthening is more important than Quadriceps which most of the Physiotherapists do not do
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Using VICON system, wich model do you recommend to study knee varus/valgus during barefoot walking in patientes with tka?
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Very good -- in our area of work we would certainly not get back to more reduced models; whilst adding some more markers might increase set-up time slighly, we have found that the collection and processing of the data using a functional approach is straight foreward with a decent camera and marker set-up, and that is certainly also down to the current analysis/processing framework available from Nexus incl. rather effort/painless marker labelling.
To get the best results it is useful though to have some understanding of the methodology and how the details of using these tools might impact on your results.
For example, in order to identify the location of the hip joint centre from motion data, it is not advisable to maximise e.g. hip ab/adduction. Our algorithm (SCoRE) is able to identify the CoR from a rather limited range of motion (ROM) already, and a large ROM might induce substantially more, non-recoverable soft-tissue artefact.
On a related matter, we tend to standardise the ROM that is considered for the determination of a functional knee axis rather strictly, both in terms of the minmum but also the maximum flexion angle.
I hope these suggestions help to get you started .
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I've got subjects with very limited ankles in DF who can hardly get to touch the wall with their knees
What are your thoughts of using Plurimeter versus Bennell’s knee to wall on stiff ankles in terms of accuracy and practicality?
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In orthopedics the range of motion (ROM) is measured by means of goniometer in degrees using the so-called Neutral-Null-System. Each joint has normal values of ROM. I do not see any reason not to use this measuring system  for the ankle joint. It is is exact and replicable.
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Introducing Hand Therapy Service at divisional branch CRP-Rajshahi newly expansion. So i would like to develop research on this project.
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Hey Sumantha,
I am researching therapeutic strategies in upper limbs of patients with Parkinson´s disease (PD). 
I have a paper to be published on Journal of Hand Therapy validating TEMPA in PD.
If you want, we can talk about this topic, ok?
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looking for any papers
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Hi,
I think that each situation is very particular and requires a specific analyse, mainly to conduct the adequate treatment. In general, a primary role of MRI in the management of the patient with an ACL injury lies in allowing confident diagnosis or exclusion of a tear in patients with equivocal physical examination findings. It should be emphasized, however, that ACL injury management is critically dependent on accurate diagnosis of other coexisting knee internal derangements, in particular tears of the lateral collateral ligament (LCL), posterior cruciate ligament (PCL), and the menisci. In this way, patients with combined LCL/ACL or PCL/ACL injuries often have profound instability requiring aggressive surgical management. In the instance of a coexisting LCL tear, intervention may be hastened as LCL injuries are optimally repaired within 1-3 weeks. An unoperated LCL tear predisposes an ACL graft to early failure. With regards to clinical diagnosis, in general a physical diagnosis is particularly difficult in large patients, in patients with strong secondary muscular restraints, and in patients with an acute injury and soft-tissue swelling and guarding. Partial ACL tears are also difficult to diagnose on physical examination. However, MRI may provide pivotal diagnostic information about the ACL in all of these settings.
I hope this helps.
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I am looking for a BWS harness for children compatible with Vicon on the treadmill. 
if you are using any BWS harness now which doesn't disturb the hip marker, would you recommend me it, please?
Which one is better based on your experience, Maine Anti-Gravity systems or BonMed harness?
Thank you in advance!
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Hi,
Maybe you can try with the harness made by Biodex for their Offset BWS System
See link below:
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The patient is four years old,Strabismus surgery was made in May 2015.But  the doctor said the recovery is not good,and told us to do 3D rehabilitation training.But I think this 3D training effect is not good,and my girl dont like this.
So,if there are other Strabismus rehabilitation trainings which is more suitable for children?!
Thanks for the answer.
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If there is amblyopia (lazy eye), that is also a problem to be rehabilitated. For this, the eye other than the amblyopic eye should be covered for a couple of hours each day. This may be done by just patching the eye. But children do not like patching. Now there are new technologic smart glasses. It has lcd glasses , transparency of which is controlled digitally. It has algorithms inside to cover the eye for certain periods.
You may check the link below.
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We would like to compare the coordination of drummers and healthy people. Thank you.
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Thank you!
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Any specific treatments to avoid other than stressing the plantarflexors until 6 weeks?  Everything I have read has said to focus on ROM to patient tolerance and to WB in a boot until the 6 week mark.  I am currently following the protocol for the Strayer method listed in this attachment.  Any input would be helpful, thanks.
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What you are describing Is safe, as the goal is to protect the surgical wounds aand repairs. The mobilisation of the ankle is correctly started about 15-21 days after surgery. removal of protective boot can be done about 6 weeks post op.
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useful details: 5 year old that had a Hemispherectomy... paralysed on the right side. Thinking about trying Motor Imagery. Any thoughts or tips on how or if this would work? 
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Have you considered combining motor imagery with action observation as they have shared motor representations and the action observation element may make it easier for the 5 yr old? This combination has been used with some success with stroke patients and has been suggested to overcome reduced/limited imagery ability.
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The effect of high-intensity strength training as compared to standard medical care on muscle strength, physical function and health status, in patients with Rheumatoid Arthritis Functional Class II. Which one is more effective?
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Dear Shadab,
see the following paper…
Biggs M, Yap C. The effect of high-intensity strength training as compared to standard medical care on muscle strength, physical function and health status, in patients with Rheumatoid Arthritis Functional Class II (2014). PT Critically Appraised Topics. Paper 44. http://commons.pacificu.edu/cgi/viewcontent.cgi?article=1039&context=ptcats
Best wishes from Germany
Martin
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Bench alignment measures could be done by PROS.A. Assembly or L.A.S.A.R Assembly from Ottobock. but I still don't know how to the find the socket axis and do these measurements:
socket AP shift
socket AP tilt
socket ML tilt
socket rotation
Could someone explain how can we measure these parameters and define the socket axis
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Spine Mouse device is useful for measurement of all joints too. It can be possible for prothesis but you must determinate exactly the axis of prothesis or standarised  it.
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I am especially interested in the way the latissimus dorsi can relearn its new function. Is the fact that the patient already had a reversed shoulder prosthesis of any influence? 
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Thank you very much for the  protocol. I agree that mirror therapy or motor imagery might be useful. 
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I would like to show this to people outside the field to demonstrate what happen when body representations are altered. Preferably in English. Thank you
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As early as 1976 there was research stating that subjects suffering from whiplash trauma were unable to reproduce a targeted position of the cervical spine. How useful is that knowledge in evaluating the severity of whiplash injuries?
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Hello Chris,
you should check the systematic review by Daenen et al J Rehabil Med 2013; 45: 113–122.. They refer to the predictive validity of joint position error tests in whiplash patients.
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The term non-specific (or a-specific) back pain is very confusing. For many it suggests that the pain has no specific cause. In fact, if this was the case we could't treat such pain, because the cause is unknown (only fight symptoms). Actually the term 'non-specific' only indicates that no relation can be found between structural changes and pain. In present literature there are for example, many indications of disturbances in neuromuscular control that may be related to (chronic) pain.
I would like to suggest to be more precise in naming the backpain. If we would do this, which kinds of backpain should we distinguish?
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Low back pain or lumbago is a common disorder involving the muscles and bones of the back which affects about 40% of people at some point in their lives. Low back pain is pain, muscle tension, or stiffness localized below the costal margin and above the inferior gluteal folds, with or without sciatica, and is defined as chronic when it persists for 12 weeks or more. Nonspecific low back pain is pain not attributed to a recognizable pathology (e.g., infection, tumor, osteoporosis, rheumatoid arthritis, fracture, inflammation).
Here I totally agree with Alexia that pain is purely a sensory response which should be always specific to the affecting structures. Unable to locate or identify the pain prodicing structure should not be easily replace by naming it is non-specifi LBA.
Instead of misnomer, I would recommend to improve the method of assessment inorder to identify the pain producing structure (musculoskeletal, referred pain from internal organs, psychosomatic etc...). More over the choice of treatment also would be always specific. Diagnosis as non-specific should not have any specific interventions which may be a questionable whether the LBA will improve or not.
Regards
Ratan
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Following spine surgery for trauma or degenerative cause achieving working ability is difficult. Provided stable spinal structures, what are the most important factors and are there time related objective reliable criteria for measuring working ability?
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1. Monitor pain based on nerve irritability
2. Physical fitness testing based on home fitness tests
hope this helps