No abstract

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.

Spinal cord injury (SCI) is rare and has a profound impact on an individual's life. Traumatic SCI are cause due to Road Traffic Accident (RTA), gunshot, falls etc. It alters the motor, sensory and autonomic functions. The SCI can be categorized in tetraplegia and paraplegia. Presented case is a 26 year old male came in casualty with the complain of loss of power over bilateral lower limb, with history of trauma due to which he had T11-L3 for L1 vertebrae fracture and was operated for the fixation of the same. He was diagnosed as traumatic SCI based on symptoms, physical examination, outcome measures, MRI. Early physiotherapy management was initiated and after 15 days, the functional status of patient was improved. We conclude that the early physiotherapy management is effective in acute stage of traumatic SCI patient.

The commonest type of motor neuron disease is ALS. Amyotrophic lateral sclerosis (ALS), which is also known as Lou Gehrig's disease, is a degenerative disease that affects the neurons and includes features of gradually increasing motor neurons degeneration that controls voluntary muscles functions. Early signs of ALS include gradual onset of stiffness of muscles, muscular spasms, progressive weakness, and muscle wasting. C9orf72 (chromosome 9 open reading frame 72) is the commonest gene that undergoes mutation in ALS, promoting the loss of motor neurons in multiple ways. This case is of a 47 years old male patient who presented with complaints of asthenia in the lower limb for 2 years, asthenia in the upper limbs for 1½ years, dyspnea for the last 5 months, and dysphasia, dysphagia, sialorrhea for the last 3 months. He underwent various interventions like MRI, CT scans, EMG (Electromyography), and NCV (Nerve Conduction Velocity). He was then diagnosed with Motor neuron disease after ruling out another probable diagnosis like upper and lower motor neuron disease, Syringomyelia. The disease-specific outcome measures for ALS are ALSFRS and ALSAQ-5. Physiotherapy treatment that is modulated according to the patient's need plays a vital role in improving the quality of life and helps in delaying the worsening of symptoms henceforth helping in increasing the life span of the patients diagnosed with Amyotrophic Lateral Sclerosis.