Background: In today's world, the upper cross syndrome is growing more common and becoming very prevalent among dental undergraduate practitioners. One of the most important conditions for which dentists seek physiotherapy treatment is neck pain. It is characterized by overactive pectoralis and trapezius muscles. It is frequently linked to poor posture in dental students' daily life, causing them to miss their work.Objectives: The first objective of our study was to find the efficacy of myofascial rollers and post-isometric relaxation technique along with conventional therapy for pain relief and correction of postural deviation in undergraduate dental students. And, the second objective of the study was to compare the effect of myofascial rollers and post-isometric relaxation techniques in upper cross syndrome.Methods: The study was conducted with pre-test and post-test methods. The study consisted of 80 participants who were included based on our inclusion and exclusion criteria. The study sample was randomly assigned into two groups. Each group consisted of a total of 40 participants. Group A was treated using myofascial rollers and hot packs, and Group B was treated using the post-isometric relaxation technique and hot packs. Patients were asked to mark their intensity of pain on the Numerical Pain Rating Scale and an assessment of postural deviations (in mm) was noted through a plumb line in the posture grid. Posture assessment was done in lateral view. The protocol covered four weeks of treatment based on the defined protocol. Finally, the t-square test and Chi-square test were used to compare the difference in the result. Also, the level of significance was kept at <0.05.Result: Statistical analysis was done using descriptive and inferential statistics using student paired, unpaired, and chi-square test. IBM SPSS Statistics for Windows, Version 27.0 (Released 2020; IBM Corp., Armonk, New York, United States) was used. The Numerical Pain Rating Scale showed mean deviations of (4.15±1.29) for Group A and (3.30±1.01) for Group B. Plumb line assessment showed mean deviations of (9.09±4.31) for Group A and (6.33±2.36) for Group B. Also, Numerical Pain Rating Scale showed (t=3.26, p=0.002) and Plumb line deviation showed (t=3.57, p=0.001).Conclusion: Through our study, we conclude that statistically no significant differences were found in preintervention and post-intervention, but myofascial rollers gave better results as compared to the postisometric relaxation technique in alleviating pain and correcting postural deviation.
Basilar invagination is a rare pathology of the occipital bone, along with prolapsing of the vertebral column. It is a narrowing in the opening of the foramen magnum of the odontoid process. It is a well-known cause of pain and tingling in the upper limbs. However, only a few afflictions requiring physiotherapy rehabilitation in basilar invaginations have been reported. Thus, this study was carried out to investigate a case of basilar invagination. A 51-year-old female visited the neuro-outpatient department. The chief complaints of the patient were restricted overhead activities, restricted neck and shoulder movements, upper limb weakness, and tingling of bilateral upper limbs for the past two months. Clinical examination revealed pain thresholds for the neck and shoulder at nine by ten on activity and five by ten on rest. Manual muscle testing revealed a significant reduction in the strength of muscles around the neck and shoulder at three by five on bilateral upper limbs. The patient was advised to have computed tomography (CT), magnetic resonance imaging (MRI), and a bone density test to confirm the diagnosis of the condition. Investigations revealed a case of basilar invagination. But due to the financial burden, surgery couldn’t be opted for; therefore, she opted for physiotherapy rehabilitation. The patient was managed with neuro-physiotherapy rehabilitation exercises like neural tissue stretch, which included nerve gliding and nerve stretching exercises, vestibular rehabilitation exercises, and gaze stabilization exercises. The strengthening of weakened muscles was done using Delorme's technique. Cervical traction, electrotherapy, and moist heat modalities like interferential therapy and hydrocollator packs were given. It also included deep breathing exercises like diaphragmatic breathing and thoracic expansion exercises. The exercise was planned according to the frequency, intensity, time, and type (FITT) principle. Frequency: five days/week; intensity: slow to moderate pace with rest intervals; time: 60 minutes/day; type of exercise: strength training along with other exercises for a total of thirty days. The patient was able to resume her job after receiving physiotherapy rehabilitation, which played a pivotal role in decreasing her symptoms.
Decubitus ulcer seems to be the most typical side-effects seen in chronic patients due to postspinal cord injury, various neurological conditions and prolonged periods of immobilisation. This is a type of skin and soft tissue lesion that develops as a result of prolonged or continuous skin pressure. All of the pressure sensitive sites are the occiput, trochanters, sacrum, malleoli and heel. A 43-yearold male patient experienced road traffic accident that resulted in cervical spinal cord injury and was bed ridden for the past five months, developing grade 4 bed sores over bilateral buttocks and sacral region. Magnetic Resonance Imaging (MRI) of the dorsal spine revealed cervical canal stenosis with neural forminal stenosis and neural impairment at C3-C4 to C6-C7 disc levels. Braden score and functional independence measures were the outcome measures used to evaluate patient condition. Physiotherapy was initiated to deal with symptoms such as lower limb weakness, bed sores in the bilateral buttock and sacral region and hand activities. It entailed a variety of therapeutic approaches aimed at teaching patient transfers and bed mobility as well as making the patient functionally independent. Laser therapy had been used to speed wound healing and to explore if it is beneficial in combating massive, chronic pressure sores. In this case, it was also demonstrated that advanced physiotherapy rehabilitation, which included laser therapy, was advantageous to the patient and led to significant outcomes after a spinal cord injury.
Diffuse axonal injury (DAI) is a condition that involves damage to axons at a microscopic level. The most common mechanism involves sudden accelerating/decelerating motion that leads to shearing forces in the white matter tract of the brain. The gross damage to axons in the brain occurs at the junction of gray and white matter. Clinical management is a framework for increasing organizational capacity, assimilating evidence-based best practices, and improving the quality of outcomes in physical therapy. A 17-year-old male reported to the hospital with a history of head injury after a fall from a bike. Magnetic resonance imaging (MRI) of the brain revealed the possibility of grade II diffuse axonal injury. Since physiotherapy is used to gain maximum functional independence, the treatment's consistency becomes the most crucial component. The physiotherapy management was provided with various integrative approaches such as passive stretching, task-oriented approaches, and bowel-bladder retraining exercises. Outcome measures such as Glasgow Coma Scale (GCS), Tardieu Scale, Rancho Los Amigos Scale (RLAS), and Functional Independence Measure (FIM) were used to assess the progress of the patient. Hence, we conclude that consistency in performing physiotherapy exercises aids in achieving maximum functional independence and further aids in improving the quality of life of patients.
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