Volume 1:1

 

Application of a Clinical Prediction Rule for Thoracic Spine Thrust Manipulation on a Patient with Acute Neck Pain Following a Motor Vehicle Accident

Craig Swisher PT, DPT

Elon University, Elon, NC

Journal of Student Physical Therapy Research. 2009:1(1)1-11.

 

Study Design: Case Report. Background: Neck pain is one of the most commonly seen impairments in the physical therapy clinic. The purpose of this study is to report a case of a patient with neck pain secondary to a motor vehicle accident who met the criteria for and benefited from a clinical prediction rule (CPR) for thoracic thrust manipulation of patients with acute neck pain. Case Description: The patient was a seventeen year old female with acute mechanical neck pain and decreased cervical active range of motion (AROM) secondary to a motor vehicle accident. The patient's signs and symptoms met the criteria for a CPR for thoracic spine thrust manipulation for patients with acute neck pain. Intervention: Intervention focused on the thrust manipulation techniques described by Cleland and colleagues, and a home exercise program for cervical AROM and scapular stabilization. Outcomes: Significant improvements were noted at discharge, four-week and six-week follow-up for cervical AROM, pain, self-reported medication usage and the Fear Avoidance Beliefs Questionnaire Physical Activity Subscale. Significant improvements for the Neck Disability Index were noted at discharge and six-week follow-up, but not at twelve-week follow-up. Conclusion: This case represents application of a CPR for patients with acute neck pain who should benefit from thoracic spine thrust manipulation techniques. The results confirm the findings that if a patient meets the criteria outlined in the CPR then significant improvements can be anticipated.


 

 

Use of the NeuroCom Balance Master™ Training Protocols to Improve Functional Performance in a Person with Multiple Sclerosis

Jordan Larsen-Merrill SPT; Rolando Lazaro PT, DPT, GCS

Samuel Merritt College, Oakland, CA

Journal of Student Physical Therapy Research. 2009:1(1)12-27.

 

Study Design: Case Report. Background: Decreased functional abilities such as impaired balance, transfers and ambulation and are common problems for people with Multiple Sclerosis (MS). Previous studies have shown that the use of high technology equipment such as the NeuroCom Balance Master™ may be beneficial in examining and improving a patient's functional performance. However, research on the use of the training protocols in people with multiple sclerosis is lacking. The purpose of this Case Report is to investigate the use of NeuroCom Balance Master™ training protocols as an intervention for a patient with Multiple Sclerosis presenting with decreased balance, transfers and ambulation. Case Description: A 30-year-old man with an acute exacerbation of relapsing-remitting MS presented with impaired strength, balance, transfers and gait. His goal was to independently ambulate community distances. A physical therapy intervention was designed using the following NeuroCom Balance Master™ training programs: weight bearing squat, sit to stand, limits of stability and rhythmic weight shifting to improve balance, sit to stand transfers, weight bearing thru right lower extremity and gait. Patient underwent physical therapy three times per week for eight weeks. Outcomes: Patient demonstrated improvements in dynamic sitting balance, static and dynamic standing balance, transfers, gait and functional performance. Conclusions: The use of the NeuroCom Balance Master™ training protocols included a variety of task goals that require propulsive movements of the body's center of gravity, narrowed base of support and high velocity movements and movements on unstable surfaces. The use of the protocols resulted in the improvement of the patient's balance, transfers and gait.


 

 

Physical Therapists' Experiences with Patients with Traumatic Spinal Cord Injury

Esther Smith SPT; Maria Newton Ph.D

University of Utah, Salt Lake City, Utah.

Journal of Student Physical Therapy Research. 2009:1(1)28-38.

 

Study Design: Qualitative design including inductive analysis. Objectives: Understand the experience of physical therapists (PT) when treating individuals with traumatic spinal cord injury. Background: Spinal cord injury (SCI) affects 12,000 Americans each year. Individuals with SCI spend an average of eighteen days hospitalized in the acute care unit, and, on average, an additional thirty-nine days are spent in the rehabilitation unit.1 The relationship that develops between the physical therapist and the individual with SCI is both physical and psychological in nature. Little is known about how physical therapists interpret and experience their interactions with individuals with SCI. Methods: Interviews were conducted with four licensed physical therapists (two males and two females) with an average of 13.25 years experience working with individuals with SCI. The interviews were transcribed and evaluated for similar and unique clusters of statements. The clusters were grouped into similar categories. The categories were collapsed into themes. Results: Three themes emerged relative to the physical therapists' experience treating individuals with SCI: (1) Multifaceted nature of SCI and the inherent challenges it presents to PT and patient; (2) benefits and barriers; and (3) strategies physical therapists use to facilitate recovery. Conclusions: The findings from this study highlight the components of the experience of physical therapists who work with individuals with SCI. Greater knowledge about the complex relationship that exists between the PT and the individual with SCI may help to foster a more effective rehabilitation.