Plantar Flexion

Patients will report to physical therapists with a multitude of impairments throughout the progression of the disease. The most prominent impairments will present during cerebellar testing. Patients will show signs of dysmetria, dysphasia, dysdiadochokinesia, and ataxia primarily as a result of the atrophy and damage to the cerebellum. Instability and lack of postural control will be demonstrated during the Romberg's test. Additionally, cranial nerve testing will have positive results for many cranial nerve palsies such as CN III, V, VII, IX, and XII. Patients show weakness in their trunk and extremities during the manual muscle testing. Vestibular testing will result in abnormal VOR, saccades, smooth pursuits and nystagmus. As a result of these impairments, patients experience functional limitations. Primarily, these patients are considered to be “high fall risks,” which ultimately decreases their independence due to weakness, instability and decreased postural control. These patients will feel uncomfortable in many situations and be unable to function independently in the community. This creates an increased risk for further injury. Due to the dysmetria and weakness, patients will also experience difficulty with their daily living skills, such as maintaining proper hygiene; They will have trouble bathing themselves and brushing their teeth without assistive equipment. PT interventions can help minimize and control these limitations. The implementation of balance training and assistive devices will be imperative interventions for an individual to modify and adapt to their gait

This therapy may be used for a variety of pain and disability states especially involving the hands and feet.

The background of Proprioceptive Neuromuscular Facilitation (PNF) is traced back to the late 1940s/early 1950s with Herman Kabat (MD), Margaret Knott (PT), and Dorothy Voss (PT) being the developers of this method. PNF was developed to treat neurological dysfunctions (such as multiple sclerosis and cerebral palsy) . “This was an attempt to gain better control in a population of neurologically impaired instead of just offering the standard treatment at the time which was range of motion exercising and gate belt training”(Knott and Voss, 1968). Even though PNF was developed for neurological dysfunctions overtime it also became principle used in others areas of life such as with athletes and personal/physical trainers. The common misconception with

Interferential current (IFC) electrical stimulation is vastly used in the physical therapy and athletic training settings to control pain. This can be done via the gate control theory or opiate release mechanism and on the sensory or motor level depending on the parameters set. IFC is commonly thought of when trying to reduce acute pain in athletes, but there have also been studies using this modality for chronic pain in individuals. As an athletic trainer, it is important to determine whether IFC can effectively control or limit chronic pain in order to decide how to implement successful treatment to athletes who have chronic orthopedic conditions such as persistent low back, or knee pain.

Electrical Muscle Stimulation is an exceptional method of helping the body boost and work with its natural healing process. This is often accomplished by sending a very tiny electrical current into the affected injury or problem area. The EMS therapy utilizes this current in an effort to help reduce swelling and release trigger points that will have the muscle seized up. It accomplishes this by assisting the body with releasing natural pain reliever usually referred to as endorphins.

Muscle strength and neuromuscular control is compromised. This could develop into long-term muscle weakness and motor planning dysfunction. Transcutaneous electrical nerve stimulation (TENS) could be utilized to help control pain and improve muscle weakness related to arthrogenic muscle inhibition. Evidence shows that TENS is effective in improving maximal voluntary torque and electromyographic signals of muscles (Konishi, McNair, & Rice, 2017). Mr. Versace may benefit from TENS on quadriceps femoris muscle to minimize muscle strength deterioration

In the past, approaches to managing spasticity have been tactics that have a series of ascending steps that range from the least invasive to the most invasive option. This entails the use of more conservative and less invasive measures that are often temporary, such as range of motion exercises and muscle stretching, before more invasive measures are considered. New research suggests that with the many management options currently available, a more dynamic, integrated approach is recommended to better manage spasticity. This is often comprised of the usage of a combination of treatments, or using more invasive intervention before trying a more conservative option. Because every child requires a personalized assessment and management

Future work in this area will focus on the use of EEG with exoskeleton assistance to maximize cortical activity during gait rehabilitation. The next step for the exoskeleton is use over extended periods of time, outside of the clinical environment, to determine if maintained muscle activity and improved kinematics translate to effects in normal walking.

Functional electrical stimulation (FES) is when electrical current is used to elicit a response from an excitable nerve in order to regain motion and function. It is used with those who have upper motor neuron damage such as spinal cord injuries (SCI), strokes, multiple sclerosis, cerebral palsy, and traumatic brain injuries. Consequently it cannot be used with lower motor neuron injuries as the peripheral nerves are not excitable. FES units are designed to improve tissue health and increase voluntary function which often produce results that can be carried over when the devices are not applied. FES units can be worn throughout the day or are used in conjunction with therapy in cases of FES bikes. Motor use and sensation in many

There were several different interventions performed aimed at increasing range of motion, balance/proprioception, and to increase strength of the right lower extremity. Following the initial examination and evaluation a brief therapeutic exercise period ensued. The gastrocnemius and soleus were both stretched against a wall each for two sets of 60 seconds to help increase dorsiflexion range of motion (Radford, Burns, Buchbinder, Landford, Cook, 2006). Active range of motion for dorsiflexion, plantarflexion, inversion and eversion was performed on a wobble board while seated for 20 repetitions in each directions to increase range of motion, but more importantly to improve proprioception (Bernier and Perrin, 1998). Plantar flexion strength was addressed by utilizing green thera-tubing around the forefoot with the patient holding the other end of the tube. This was performed for one set of 20 repetitions. Body weight squats using a railing for support were chosen as they are a closed kinetic chain exercise that challenges the gluteus muscle group as well as hamstrings while also causing dorsiflexion of the ankles (Gryzlo SM, Patek RM, Pink M, Perry J, 1994). Closed chain exercises were started initiated at the first visit as they cause an increase in joint compressive forces which can lead to increased stability, increased muscle activation, and decreased joint shearing forces (Harter, 1996). Supine bridges on a 55 cm theraball were performed for 20 repetitions to address the

Shoulder instability is commonly seen in rehabilitation settings. Many patients come in either with shoulder pain, spasticity, subluxation, decreased range of motion(ROM), stiffness, or instability. Exercise is an effective key component in achieving stability of the shoulder. Therapeutic rehabilitation relies on evidence-based practice to provide the best care to improve function and stability. The purpose of this research study was to investigate the effects of stretching and joint stabilization exercises applied to spastic shoulder joints on improving shoulder dysfunction in hemiplegic patients using three groups of hemiplegic patients (Young Youl You, Jin Gang Her, Ji-Hea Woo, Taesung Ko, & Sin Ho Chung, 2013).

Plantar fasciitis pain is a commonly occurring foot complaint. Stretching is frequently utilized as a treatment, yet an assessment focusing only on its effectiveness has not been published. This study aimed to assess the effectiveness of stretching on pain in people with plantar fasciitis. Method: Patients (n=36) diagnosed as having plantar fasciitis were included in our study at our out-patient department and they were advised to stretch the calf muscle for at least 5 minutes over a given wooden ridge. Their pain before and after calf stretching exercises was recorded on pain visual analog scale and analyzed. Results: According to visual analog scale (VAS) which ranges from zero ( NO PAIN ) to 100 (WORST POSSIBLE PAIN), the average

There are available interventions to employ during rehabilitation but this is dependent on the type, symptoms and severity of the neuropathy. For instance, the physical therapist can introduce nerve gliding activities. The said therapy gives emphasis on the nerves so as it can move

David et al. (2004) did a study using “intramuscular neuromuscular electric stimulation (NMES)” for supraspinatus, posterior deltoid, middle deltoid, and trapezius for 6 hours/day for 6 weeks and using a cuff-type sling in the control group for 6 weeks. They found pain reduction in the higher proportion of the participants in NMES group at the end of the treatment (65.6%:24.1%) and it persisted up to 6months.

Plantar fasciitis is a common condition that causes foot pain. It is inflammation of the band of tough fibrous tissue on the bottom of the foot that runs from the heel bone (calcaneus) to the ball of the foot.