Volume 5:1

 

Comparative Review of Interactive Gaming versus Traditional Rehabilitation Methods in Balance Training Post Stroke

Ashley Bailey, BS, SPT; Kathryn Jordan, BS, SPT; Astin Laferriere, BS, SPT; Terah Turner, BS, SPT; and Deborah Edmondson, PT, Ed.D

Tennessee State University – Nashville, TN

Journal of Student Physical Therapy Research. 2012:5(1)1-10.

 

Study Design: This research report is a systematic review of literature pertaining to the effectiveness of interactive gaming versus traditional rehabilitation methods in balance training post cerebral vascular attack(CVA). Objective: To determine if interactive gaming is an effective balance rehabilitation treatment in treating patients sixty-five years and older who had experienced a CVA. Background: Interactive gaming (IG) is a technology that uses real–life scenarios, allowing a patient to use multiple sensory systems. This technology has been effective in many areas of study such as aerospace, engineering, and various medical fields. IG provides an enriched environment in which people who have experienced a CVA can safely perform activities of daily living. Minimal research has been published comparing the use of IG and traditional techniques in stroke rehabilitation, specifically for balance retraining. Methods & Measures: Databases were electronically searched from May 2010 to January 2011 by using specific keywords. Articles that met the study’si nclusion criteria were required to: (i) consist of a subject population over the age of sixty-five, (ii) pertain to patients post CVA, interactive gaming, virtual reality, balance rehabilitation, or traditional CVA rehabilitation, (iii) freely accessible journals in the English language. Results: Twenty–seven articles met the inclusion criteria and were ranked based onThe Oxford Centre for Evidence–based Medicine. Evidence supported the use of interactive gaming in balance rehabilitation with minimal adverse effects. Conclusion: In all reviewed articles that compared the use of IG therapy with traditional CVA rehabilitation, IG was shown to be an effective treatment when compared to traditional stroke rehabilitation, in patients who can improve functionally from additional benefits offered. In balance rehabilitation, IG increases cognitive and physical functioning, while also providing the patient with supplemental motivation, immediate feedback, and entertainment throughout physical rehabilitation. In addition, IG provides the patient with a safe environment in which functional activities are simulated.


 

 

Passive Stretching and its Effect on Spasticity and Range of Motion in Children with Cerebral Palsy

Mallory Groppe, Doctor of Physical Therapy Intern; Katrin Mattern-Baxter, PT, DPT, PCS; Todd E. Davenport, PT, DPT, OCS

University of the Pacific, Department of Physical Therapy – Stockton, CA

Journal of Student Physical Therapy Research. 2012:5(2)11-23.

 

Study Design: Only research studies published in peer-reviewed journals in the last two decades and published in the English language were included. Studies centered on surgical or pharmacological interventions were not included. To examine the strengths and weaknesses of these studies, the Physiotherapy Evidence Database (PEDro) scale and Sackett’s levels of evidence were used. Objectives:The aim of this paper is to analyze literature published in the past two decades, which explores the effects of stretching when used to reduce spasticity and increase range of motion in children with spastic cerebral palsy (CP), as well as to address the effects of manual versus positional stretching as provided by physical therapists. Background: Physical therapists believe we can decrease joint degradation due to abnormal posture, as well as increase mobility and independence with a focus on the reduction of spasticity during posture and gait. A consensus in current literature seems to be that passive stretching is used widely to reduce spasticity in children with CP, but without scientific evidence to provide a justification for its use or to dictate the conditions in which to administer this treatment. Methods and Measures: The literature search for stretching in children with CP was conducted using the following key words: stretching, positioning, serial casting, spasticity, range of motion, cerebral palsy, and children. The following databases were used: Academic Search Complete, CINAHL, Cochrane Library, PEDro, Pubmed, ScienceDirect, SCOPUS, and SPORTDiscus. Results: A total of 13 articles on stretching in children with cerebral palsy were found from the years 1990 to 2011. Two individual studies were found in which manual stretching was the intervention. Nine individual studies were found in which positional stretching was the intervention, four of which serial casting was the intervention. Two systematic reviews exist in the last two decades that explore the effect of stretching in children with CP, however, neither encompass all of the studies reviewed in this paper nor do they discuss serial casting as a form of positional stretching. Conclusion: Taken together, the individual studies using positional stretching and the small randomized controlled trial using electrical stimulation in addition to manual stretching led to better outcomes for reducing spasticity and increasing passive range of motion compared to manual stretching alone.


 

 

Acetabular Labral Tear: a case study of clinical diagnosis in an active female college student

Erica R. Michaud, DPT/s­; Mary J. Hickey, PT, DPT, MHP, OCS

Journal of Student Physical Therapy Research. 2012:5(3)24-32

 

Study Design: Case Report Background: Recent literature has shown arthroscopic management to be the gold standard for diagnosing and treating traumatic and non-traumatic acetabular labral tears. The purpose of this case report is to explore the accuracy of clinical physical therapy diagnosis and its effectiveness in treating patients with this complaint more efficiently and effectively. Case Description: The 21 year old patient presents with complaints of left anterior hip pain centralized over the hip flexor tendon, clicking, inability to sit for greater than 30 minutes, and an inability to perform recreational activities. The patient also complains of pain with deep squatting, during hip extension, and changing directions while walking. The symptoms are of insidious onset. Outcomes: The clinical diagnostic exam showed (+) provocation tests, grossly decreased strength and limited/painful ROM in flexion, abduction, and internal rotation. The patient noted most pain with eccentric loading of the hip flexor and joint loading. Diagnostic imaging tests were ordered, which were positive for an anterior superior acetabular labral tear. Discussion: The validity or accuracy of clinical diagnosis performed by a physical therapist without diagnostic imaging has yet to be established. Physical therapists are an important part of screening and diagnosing these types of injuries so that treatment can begin as soon as possible. This particular diagnosis requires the attention of the orthopedic field due to the rising frequency of this sort of complaint and the long average length of time which these patients must wait before receiving an accurate diagnosis.