The purpose of the current case report was to describe the course of care and specific therapeutic interventions for the management of recurrent patellar subluxations in a 72-year-old female with relapsing-remitting MS. She demonstrated with improvements in ROM and strength of bilateral LE. Improved strength of the quadriceps and decreased muscle atrophy improved the patients ability to complete sit to stand transfers, stand for prolonged periods and ambulate greater distances. From the initial evaluation the patient exhibited advancements in scores on the BBS, 2mWT and LEFI. Improvement of patellar tracking was attained however, patellofemoral pain was not completely resolved and when the knee was unsupported she continued to experience pain on the lateral groove of the left knee when ambulating. Collectively these results provide clinicians with a framework to effectively manage patients with orthopedic impairments complicated by underlying neuromuscular disorders.
Individuals with orthopedic impairments complicated by an underlying neuromuscular disorder can be treated however, the duration of care required to achieve functional improvements and goals is greater. Previous reports have highlighted surgical treatment and outcomes of patients with MS and coexisting orthopedic conditions. One study reported on 14 patients with coexisting MS and spinal cord compression secondary to cervical spondylosis or cervical disc disease. After decompressive surgery, half the patients
Lumbar puncture- Check for any abnormal antibodies that might reside in the CSF. Also to rule out other infections that mimic MS.
As a senior this year, I am looking forward to several endeavors, such as leading my team in my last year of cheerleading, participating in a Senior Engineering Design Project, and continuing to volunteer with VSVS, a program that allows Vanderbilt student to teach science lessons in local elementary schools. Moreover, I spent this past summer working on my research at the Vanderbilt Institute of Imaging Science and will continue my projects throughout the school year. I am excitingly close to finishing the project I have been working on that involves a magnetic resonance imaging study of patients with multiple sclerosis. We have employed quantitative magnetization transfer techniques at 7-Tesla field strength to obtain indices reflective
At the event, I worked with a returning female MS patient. She has come to the MSFit clinic since it started earlier this year. While gathering her patient history and re-examining her goals, I was able to gather more information about some nagging pain she has experienced. From our conversation, I was able to discover that she had elbow pain, ankle pain and weakness in addition to her previously documented limitations. I completed ROM examination, MMT, and special testing of the involved joints to evaluate for pathology. I completed a valgus stress test and pronator teres test at her elbow, and then an anterior drawer test and talar tilt test at the ankle. Along with addressing her pain, I also took vital signs, evaluated her gait and addressed her
Incurable disease? No not me. At the young age of only fourteen I had been diagnosed with an incurable disease that would change my life FOREVER. This disease called, Multiple Sclerosis, is a non-curable neurological disease that impacts the nerves in your brain and spinal cord. It can be hereditary in some ways, but doctors have yet to find a direct cause of the disease itself. Symptoms can range from tingling or pinprick feelings, to blurred vision, and even the loss of mobility in your limbs and in other areas of your body. This disease has impacted me more than physically, it has impacted me emotionally and spiritually as well. Although, this is a serious medical condition, I have overcome and learned to accept the fact that I am a little different than everyone else.
MRI of the cervical spine obtained on 06/26/13 showed mild degenerative spondylitic changes and status post posterior fusion.
Multiple sclerosis (MS) is an acquired demyelinating disease of the central nervous system (CNS) that typically is diagnosed in the second or third decade of life. Normally, nerves are enclosed in myelin sheaths that help facilitate transmission of nerve impulses within the CNS and the peripheral nervous system throughout the body. In patients with MS, the myelin sheath is damaged and eventually degenerates, causing patches of scar tissue called plaques or lesions to occur anywhere randomly on the myelin sheath (Ruto, 2013). This results in impaired nerve conductivity, which interferes with message transmission between the brain and the other parts of the body. As a result, impulse transmission is altered, distorted, short-circuited,
Physical therapy saw the patient, and the result of the examination are as follows; 6/10 left knee pain at rest and during activity (0 no pain, 10 worst pain), manual muscle testing for both upper and lower extremities were 4/5 except left knee flexion/extension 3+/5 due to pain, sensation on both UE/LE were intact to light touch, Stephen requires a moderate assistance of one person for both functional mobility and gait activity. He uses a front wheeled walker up to 35 feet due to decreased balance and antalgic gait from the left knee
Based on the progress report dated 08/23/16, the patient complains left knee pain upon walking. Discomfort was described as aching, tingling, intense, severe, continuous, pain, discomfort, increasing with movement and varying with activity. Pain is rated as 5/10 without medications and 4/10 with medications.
The claimant has a past medical history significant for multiple sclerosis, hypertension, gastroesophageal reflux disease, arthritis, and hyperlipidemia.
Multiple sclerosis (MS) is autoimmune, inflammatory disease involving the central nervous system (CNS). This disease is a result of the immune system attacking myelin proteins. Usually affecting younger people between the ages of 20 and 50 years, multiple sclerosis slowly destroys the myelin sheath that are located in the CNS causing them to eventually create scleroses, or hardened lesions. Symptoms of multiple sclerosis can be different, but visual, sensory, and motor signs are usually affected with this disease. Some early symptoms care problems like blurred or double vision, numbness, loss of balance, and weakness in arms or legs, as well as fatigue, muscle spasms, speech problems. Approximately 400,000 people in the United States and 2.5 million people worldwide are affected by multiple sclerosis (Hersh and Fox, 2014). Educating ones self about multiple sclerosis is important because it has many unanswered questions. There are many theories and treatments that may seem like they work, but there is no cure or definite reason why MS happens. Multiple sclerosis is also a disease that affects many people and is very hard to treat.
IW was diagnosed with sprain of the ligaments of the cervical spine. Patient has received chiropractic care. Response has been good and IW is encouraged with gains being made. Improved function and functional restoration are expected with additional treatments. Plan is for chiropractic treatment, 2 times a week for 3 weeks.
action potentials in the brain and spinal cord due to areas of inflammation, demyelination and
Imagine a disease that has the potential to disrupt and ultimately destroy the human nervous system by attacking the myelin sheath. This is not a rare disease. In fact, it affects over 350,000 people in the United States alone (Nordqvist). The ratio of women to men that contract the disease is 2 to 1 and it is a leading cause of disability in young adults (Olek). This disease is not only widespread, it is chronic and has no known cause or cure. If disease activity is suspected an MRI is performed and, if lesions on the central nervous system are identified Multiple Sclerosis (MS) is the likely diagnosis. Despite the devastation that may follow such news, there is hope for those diagnosed
The patient was compliant to all aspects of treatment and the home exercise program. There are no known alternate explanations of the outcomes of this case report. However, in comparison to the case report by Caldwell et al25., the patient in this case report displayed a faster decrease in pain and return to normal function indicated by 0/10 VAS, 0% neck disability and ability to perform all tasks for work at the last day of treatment, 3 weeks from the first day of physical therapy. Possible explanations for the faster recovery could be due to the slight difference of impairments as well as the addition to grade IV and V manipulations to the cervical and thoracic spine as suggested to have high correlation with decrease in pain and normalization
Patellofemoral syndrome, often called “runner’s knee”, is deep pain anterior to the patella usually caused by excessive running, especially downhill. This may be due to a multitude of abnormal biomechanics or tendencies. Although running is a common and popular exercise, the knee joint is an extremely mobile and unstable joint. And those who initially develop patellofemoral pain usually end up with chronic knee pain (Willy et al., 2012). The patella, only being held in place by ligaments and tendons, is easily manipulated by the pull of muscles attached to these ligaments and tendons. However, there are gender differences between males and females in how they each develop patellofemoral tracking and pain.