Background and Purpose: Lymphedema is a chronic inflammatory lymphostatic disease known as the buildup of lymph fluid in the fatty tissues that can cause swelling and discomfort in the arms, legs, face, neck, trunk, abdomen, and genitals [1]. Failure of the lymphatic system causes lymphedema [1]. Lymphedema may reduce the quality of life and may progress as well as cause other complications such as cellulitis if untreated [1]. Although there is no cure for lymphedema, there are interventions to reduce or manage the swelling and the discomfort [1]. The purpose of this study is to show that a patient with lymphedema can improve their quality of life significantly with adequate lymphedema therapy interventions using Complete Decongestive Therapy (CDT). Method and Procedures: A 47-year-old African American female patient presented to outpatient physical therapy with a report of experiencing bilateral lower extremity swelling for about ten years. To determine the effects of the treatments, the lymphedema therapist examined the patient using the following tests and measures and outcome measurement tools: Bilateral Girth Measurements, the Lymphedema Life Impact Scale Version 2 (v2), and the Global Rating of Change (GRoC) Scale. The patient attended physical therapy sessions 2 times per week for 3 weeks not including the date of initial evaluation. Thus, the patient attended five treatment sessions. The patient actively participated in the creation of the current goal: to decrease bilateral lower extremity swelling. Results: On discharge assessment (6th visit), the patient reported a reduction in pain to (3/10). The patient scored a 12/68 on the Lymphedema Life Impact Scale (v2) indicating that her quality of life had improved significantly within the past three weeks since receiving lymphedema therapy services. The patient made excellent progress, demonstrated marked improvements with involved extremities lymphatic circulation, and decreased swelling with girth measurements. The patient reported significant improvements with functional activities of daily living such as standing, sitting to standing, and walking. The patient also reported that her quality of life improved significantly.
Background and purpose: It is paramount that physical therapists assess and/or treat primary and secondary muscles of breathing that could be dysfunctional or impaired resulting in low back pain. The purpose of this case study is to highlight the clinical relevance and outcomes of assessing and treating primary and secondary muscle of breathing with patients who have been referred to physical therapy with a medical diagnosis of low back pain. Method and procedures:A 66-year-old male patient presented to outpatient physical therapy with a report of low back pain. To determine the effects of the treatments, the patient was examined using movement analysis and outcome measurement tools such as the Global Rating of Change (GRoC) scale and the Oswestry Low Back Pain Questionnaire. The patient attended physical therapy sessions over the duration of 4 weeks as needed (PRN) including the date of initial evaluation. The patient actively participated in the creation of the current goal: Eliminate pain, resume exercise. Conclusion:On discharge assessment, the patient reported a reduced pain level during movement analysis. The patient made excellent progress and demonstrated marked improvements with thoracolumbar spine and proximal extremities functional range of motion.
Background and Purpose: The hallmark presentation of coccydynia is localized pain over the coccyx. Patients typically report having tailbone pain; yet, the exact etiology of coccydynia is unknown. Factors such as obesity and female gender increase the risk of developing coccydynia with women being 5 times more likely to develop coccydynia than men. The purpose of this case report is to share the outcomes (results) of using Primal Reflex Release TechniqueTM (PRRTTM) to treat coccydynia. Method and Procedures: A 34-year-old Euro-American female patient presented to physical therapy with a complaint of recurrent, chronic tailbone pain with prolonged sitting on hard surfaces and surfaces with mild cushion.To determine the effects of the treatments, the patient was examined using the following tests and measures and outcome measurement tools: The 1 Minute NocioceptivExamTM, Two-Minute Walk Test (2MWT), Chair Sit and Reach Test (CSRT), the Numeric Pain Rating Scale (NPRS), the Modified Oswestry Low Back Pain Disability Questionnaire, and the Global Rating of Change (GRoC) Scale. Results: On discharge assessment (6th visit), the patient reported no (0/10) tenderness and pain during The 1 Minute NocioceptivExamTM with coccyx palpation and sidebending mobilizations. The PRRTTM coccyx release techniques decreased the patient's worst coccyx pain to 1/10 with prolonged sitting after 1 hour on the NPRS at discharge versus 8/10 worst coccyx pain with prolonged sitting after 1 hour on the NPRS at initial examination. Discussion: The results support the effectiveness of using PRRT to treat coccyx pain. Using PRRTTM, an intervention model aimed at treating an up-regulated autonomic nervous system, may have contributed to the positive patient outcomes. Conclusion: The results showed that the PRRTTM paradigm's coccyx release techniques can be effective in treating a case of coccydynia if not some or most cases. The results are not generalizable to all patients who may present to physical therapy with a complaint of coccyx pain including the male sex. Further research could include a large, diverse sample size.
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