Congenital muscular torticollis (CMT) is a deformation characterized by unilateral shortening of the sternocleidomastoid muscle resulting in lateral inclination of the neck associated with contralateral torsion. The purpose of this study was to assess the role of physical therapy in infants with CMT according to the age when treatment was started. The study was conducted in the Physical Therapy Clinic “Therapy” in Pristina for a period of 1 year from June 2016 to June 2017. The number of infants diagnosed with a CMT was 130 (71 girls and 59 boys). The infants were examined two times during the study period. The first visit was at the baseline and the second after the intervention. Three comparative groups are created based on time to start treatment. The infants were treated for 3 consecutive weeks with five sessions per week with the same therapeutic procedure. In the first examination of infants, there was no significant difference between the groups (chi-square test = 0.78, p = 0.08), whereas in the second examination after the 15 therapeutic sessions there was significant difference in the improvement of all the groups treated with physical therapy. Significant result was achieved in mean range of motion in infants of the group aged 3.1 to 6 months (mean = –35.9 ± 12.3, 95% confidence interval [CI], –39.3 to –32.4, p < 0.001) and in the mean side flexion of group aged 3.1 to 6 months (mean difference = –24.5 ± 7.9, 95% CI, –16.9 to –9.7, p < 0.001). While exercises in the 6- to 9-month age group have shown less success, because the time of appearance for physical therapy has been delayed (mean difference = –23.5 ± 10.7, 95% CI, –15.6 to –8.4, p < 0.001). From the results obtained from this study, we can conclude that the early start of the physical therapy gives much better results.
Objective: Ischemic cerebrovascular accident (ICA) is characterised by the rapid deterioration of brain function due to vascularization disorders. The ischemic cerebrovascular accident may arise as a consequence of ischemia or hemhorrage in brain tissue, but the optimal treatment approach is unclear. In this study, we examined ICA rehabilitation goals, implementation of rehabilitation plans, management of sensomotor deficits and functional status, improvement of independence, prevention and treatment of complications, functional status monitoring, and planning recommendations, as well as education of ICA patients and their families.Methods: This study considered 69 ICA patients who were classified as suitable for rehabilitation intervention among a total of 231 patients who were evaluated for a diagnosis of ICA following hospitalization at the Clinic of Neurology, University Clinical Center of Kosovo (UCCK) in Prishtina. From the statistical parameters, we used the structure index, whereas testing results were evaluated using the Chi-square test with significance established at p<0.05. Results:For the 69 ICA patients, most ICA incidents occurred in patients who were older than 40 y-old. Mobility decreased from 42.9% to 8.6% when rehabilitation began at release instead of admission. Meanwhile, the ability to perform daily activities decreased from 48.6% to 11.4% when rehabilitation began after release as opposed to immediately after stabilization. Transfers and balance showed similar decreases (48.6% to 11.4% and 48.6% to 11.4%, respectively Chi-test=59.7, p<0.001.). The rehabilitation of patients in the early acute stage after ICA should begin as soon as possible after the diagnosis is made and the patient's condition is stable. During rehabilitation intervention, priority should be given to preventing complications and recurrent stroke, as well as enhancing patient mobility and improving patient morale. Conclusion:ICA is a medical emergency that can cause permanent neurological lesions and other complications that may be fatal or associated with permanent disability. The most affected age group is individuals older than 40 y old. Neurological deficits can cause motor, sensory, functional and emotional disability in ICA patients. Rehabilitation after ICA should begin immediately after the patient has stabilized to minimze functional losses.
Objective: Torticollis is a deformity characterized by the lateral flexion of the head to the arm on the side of the localization of deformity and its rotation on the opposite side. The aim of this paper is to identify the clinical characteristics that have an impact on the progression of the congenital muscular cramping, as well as to show the role of kinesitherapy in the treatment of torticollis. Methods:The research was conducted in the "Therapy" -Physical Therapy Clinic in Pristina, in the 2-year period since February 2014 until 2016. The total number of infants diagnosed with torticollis is 160, ranging from 0 to 9 months. At the beginning of the research, the examinations of all infants were performed, all the necessary tests, measurements, and motor functions. Afterward, they were rehabilitated for 3 consecutive weeks with 5 sessions per week, a total of 15 sessions for each. After the rehabilitation was completed, over again, the same tests were made as it was done in the beginning. Questionnaires were completed on the first and last visit for all infants. Results:In the first visit of the infants' examination, there was no significant difference between the groups (Chi-test=0.96, p=0.1), whereas in the second examination, after 15 rehabilitation sessions, there was a significant difference in improvement of all the treated groups with kinesiotherapy. Significant result was achieved in mobility where at the beginning of the treatment, there was a very large limitation of neck mobility (different mean = −31.0±10.0.95% CI: 33.7-−28.2, p<0.001). A small limitation of mobility remained only among some third-degree infants in the 6-9 month age group because of the time appearance for physical treatment was delayed (different mean = −27.8±12.6, 95%, CI: 31.2-−24.4, p<0.001). Conclusion:From the results of our research on kinesiotherapy with infant toddlers with torticollis, we conclude that kinesitherapy has a primary and very successful effect on the treatment of babies with muscular torticollis.
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