Manual therapy
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Case Reports
Diagnostic work-up of an elderly patient with unilateral head and neck pain. A case report.
Headache patients frequently contact physiotherapists and manual therapists. In case of elderly patients with unilateral headache, neck and facial pain clinical practice guidelines recommend further referral for medical investigation to exclude red flags. The present patient was seen in a multidisciplinary headache clinic. ⋯ Since palpation of the temporal artery proved to be painful, laboratory examination and biopsy of the temporal artery were thereafter performed, this time revealing GCA. Appropriate treatment (high dose steroids) was initiated promptly, with a good clinical evolution. The presented case shows the potential of a multidisciplinary collaboration in the clinical diagnostic work-up of patients with head and neck pain.
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Cervical radiculopathy is an unusual presentation for patients with neck pain. Its diagnosis and management is uncertain. This case report presents an example of a patient with cervical radiculopathy who responded to Mechanical Diagnosis and Therapy, and whose MRI findings changed over time.
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The main aim of the case series was to inform further experimental research to determine the effectiveness of myofascial trigger point (MTrP) therapy for the treatment of triceps surae dysfunction. ⋯ This case series suggests that a brief course of multimodal MTrP therapy would be helpful for some patients with sub-acute or chronic calf pain. Important preliminary data was gathered, that will inform more rigorous research in this under investigated area.
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Slumped sitting is a commonly used reference posture when comparing effects of upright sitting in both clinical and non-clinical populations alike. The exact nature of slumped sitting has not been clearly defined, including regional differences within the posture, and how the passive nature of slumped sitting compares to an active-flexion posture. Kinematic and electromyographical (EMG) data were collected from 12 males during three repeats of slumped sitting and seated maximum forward flexion. ⋯ Comparison of slumped by %STAND-FF showed the upper- and mid-thoracic regions to have high variability and large values (over 100%STAND-FF). Muscle activation showed a significant 3%MVC reduction in the lower-thoracic erector spinae muscle when moving from upright to slumped sitting. These data highlight the postural differences occurring within different spine regions, and interpretations that could be drawn, depending on which normalization (sit or stand) method is used.
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Physiotherapists perceive upright, lordotic sitting postures to be important in the management of non-specific chronic low back pain (NSCLBP). Little is known about the perceptions of the wider community about seated posture, despite this being an important consideration before attempting to change seated posture. This study investigated perceptions of the best and worst sitting postures among members of the community, both with (n = 120) and without (n = 235) NSCLBP. ⋯ The choice of best and worst sitting postures was not significantly influenced by gender, the presence of NSCLBP, or measures of pain, disability or back pain beliefs. Interestingly, a very upright sitting posture was the second most popular selection as both the best (19%) and worst (15%) posture. Overall, lordotic lumbar postures were strongly favoured among members of the community, which is broadly in line with the previously reported perceptions of physiotherapists.