Background: Amputation is that the removal of injury by, undue constriction, surgical condition or surgery of associate degree extremity. Below-knee amputation (BKA) may be a transtibial amputation that involves separating the foot, ankle joint, and distal shinbone and leg bone from associated soft tissue structures. This surgical treatment carries wide morbidity, but, provided adequate indications; it remains a therapeutic tool with very important clinical price and generally life-saving importance. The majority of transtibial amputations is due to peripheral vascular disease or lower limb circulation disease (60 percent -70 percent).The main goal of rehabilitation procedures is to generally increase healthy and impaired limb strength, patient flexibility, cardiovascular ability, and equilibrium. . Health care is burdened by comprehensive recovery and long-term care. Mobility is essential to independence recovery; however, the effect of multiple comorbidities in this patient population will render mobility recovery a particularly difficult task Clinical Finding: An 65 year old male complains of pain in right foot since 3 month. Swelling was appeared and skin over the black lower leg turned black with foul smelling discharge from foot. He was diagnosed with right lower limb gangrene and referred to Physiotherapy department for prosthetic prescription and rehabilitation after trans tibial amputation. Diagnosis: Duplex colour Doppler study of left lower limb show triphasic flow in CIA, EIA, IIA, SFA, POP, ATA, PTA arteries of right lower limb, dampened flow noted in right dorsalis pedis artery and atherosclerosis wall thickening in the arteries of right lower limb. Conclusion: This case report provides patient with inclusive recovery which help to decide on a patient’s suitability for a prosthetic limb prosthetic fitting.

Background: At some stage in their lives, between 60-85% of adults suffer from low back pain (LBP). Fortunately, symptoms are mild and intermittent for the vast majority of people, with 90 percent subsidization within six weeks. An approximate 15-45 percent of the individuals affected by chronic back pain, defined as symptoms such as pain that last beyond 3 months. The effect on the livelihoods and economic results are significant for the minority with intractable symptoms. Considering the high incidence of low back pain, the diagnostic strategy and treatment options are complex and sometimes conflicting and within the general population. Rising the expense and inconsistency of management throughout the nation. In fact, this is because it is impossible for most patients to establish a particular etiology, with established axial spine-wide nociceptive pain generators identified. Clinical Finding: Patient having complaint of pain in lower back region and Radiated in the posterior part of the thigh, as well as lower limb numbness. Morning stiffness was present. On examination active movement (Range of Motion) of lumbar flexion, lumbar Extension and lumbar lateral flexions lightly restricted and painful at the end of range of motion. Diagnosis: MRI was done, it shows posterior annulus tear on the level of L4-L5, L4-L5 –Diffuse disc bulge with right-sided bulge subarticular is disc protrusion causing indentation on anterior thecal sac with moderate to severe narrowing of bilateral neural foramina with propensity toward right side with compression of traversing and exiting nerve roots. Conclusion: This case report provides patient with inclusive recovery which helped her to relieve pain.

Background: Duchenne muscular dystrophy (DMD) seems to be the most common X-linked muscular dystrophy condition in children marked by proximal muscle weakness and calf hypertrophy and affected mostly in boys. In more than 20 muscular dystrophies                                            the most prevalent form is Duchenne muscular dystrophy. Each 1/3500 male births,                                      the presence of DMD worldwide, indicating that in the UK alone there are approximately 2400 people living with DMD. Assessing improvements in severity, range of motion and                              functional mobility, implementation of therapies and guidance on positioning are important key factors. Clinical Finding: Mostly in proximal muscles around the hips and shoulders, which are those around the trunk of the body, muscle weakness occurs mainly. In the lower extremities, weakness usually begins proximally, and then passes distally. Symptoms typically begin about the age of 1-3 years. To see the child run and get up off the floor while searching for signs of DMD is necessary. Diagnosis: A very common physical finding in boys with Duchenne's is Gower's Sign. In order to get up, it requires using their hands to 'climb' their legs. It is because of a weakness in the boy's hip muscles, which was seen in this patient in progressive in nature. The proper examination and evaluation the symptoms the child presented to the physiotherapy clinic played an important in reaching to the diagnosis of the condition. Conclusion: Prevent the child from developing contracture, correct posture of the child and maintain quality of life these are important criteria in for the child suffered from Duchenne muscular dystrophy.

Accidents on the highway as well as falls have become more common with the expansion of the transportation and construction industries. Patients have traditionally been instructed to use protective weight-bearing during the early rehabilitation phase following a well-fixed distal femoral fracture. Clinical finding: The patient had complained of pain and swelling over the thigh's lateral surface and unable to flex the knee joint and inability to bear weight on left lower limb pain on NPRS 8/10 on movement and on rest 6/10. Diagnosis:The X-ray reveals that comminuted supracondylar femur fracture and the CT report reveal that comminuted displaced fracture in the distal end of the femur, extending to involve lateral, medial condyles, inter condylar region and the articular margin. Conclusion: In this case, the rehabilitation routine helped the patient regain functional independence at home and at work by reducing pain and tenderness while also improving range of motion, muscle strength and endurance.

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