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Intramuscular Electrical Stimulation for Muscle Activation of the Tibialis Anterior After Surgical Repair: A Case Report / Sharon Hollis in Journal of Orthopaedic & Sports Physical Therapy, vol. 47, 12 (Décembre 2017)
[article]
in Journal of Orthopaedic & Sports Physical Therapy > vol. 47, 12 (Décembre 2017) . - p.965-969
Titre : Intramuscular Electrical Stimulation for Muscle Activation of the Tibialis Anterior After Surgical Repair: A Case Report Type de document : article de périodique Auteurs : Sharon Hollis ; Philip Mcclure Année de publication : 2017 Article en page(s) : p.965-969 Langues : Anglais (eng) Descripteurs (mots clés) : [Thésaurus Mesh]:H:Hanche:Hanche / anatomopathologie
[Thésaurus Mesh]:H:Hanche:Hanche / chirurgieRésumé : Loss of voluntary activation of musculature can result in muscle weakness. External neuromuscular stimulation can be utilized to improve voluntary activation but is often poorly tolerated because of pain associated with required stimulus level. Intramuscular electrical stimulation requires much lower voltage and may be better tolerated, and therefore more effective at restoring voluntary muscle activation.
Case Description
A 71-year-old man sustained a rupture of the distal attachment of the tibialis anterior tendon. Thirty-two weeks after surgical repair, there was no palpable or visible tension development in the muscle belly or tendon. Dorsiflexion was dependent on toe extensors. Electrical stimulation applied via a dry needling placement in the muscle belly was utilized to induce an isometric contraction.
Outcomes
Five sessions of intramuscular electrical stimulation were delivered. By day 4 (second visit), the patient was able to dorsiflex without prominent use of the extensor hallucis longus. By day 6 (third visit), active-range-of-motion dorsiflexion with toes flexed increased 20° (−10° to 10°). Eighteen days after the initial treatment, the patient walked without his previous high-step gait pattern, and the tibialis anterior muscle test improved to withstanding moderate resistance (manual muscle test score, 4/5).
Discussion
The rapid change in muscle function observed suggests that intramuscular electrical stimulation may facilitate voluntary muscle activation.
Level of Evidence
Therapy, level 5Permalink : https://bibliotheque.helb-prigogine.be/opac_css/index.php?lvl=notice_display&id= [article]Exemplaires
Cote Support Localisation Section Disponibilité J Périodique Erasme - périodiques Périodiques Disponible Management of a Patient With Acute Acetabular Labral Tear and Femoral Acetabular Impingement With Intra-articular Steroid Injection and a Neuromotor Training Program / Joël Naverson in Journal of Orthopaedic & Sports Physical Therapy, vol. 46, 11 (Novembre 2016)
[article]
in Journal of Orthopaedic & Sports Physical Therapy > vol. 46, 11 (Novembre 2016)
Titre : Management of a Patient With Acute Acetabular Labral Tear and Femoral Acetabular Impingement With Intra-articular Steroid Injection and a Neuromotor Training Program Type de document : article de périodique Auteurs : Joël Naverson ; Matthew Habrel ; Patrick Grabowski Année de publication : 2016 Langues : Français (fre) Descripteurs (mots clés) : [Thésaurus Mesh]:C:Conflit fémoro-acétabulaire:Conflit fémoro-acétabulaire / rééducation et réadaptation
[Thésaurus Mesh]:C:Conflit fémoro-acétabulaire:Conflit fémoro-acétabulaire / thérapie
[Thésaurus Mesh]:H:Hanche:Hanche / anatomopathologie
[Thésaurus Mesh]Conflit fémoro-acétabulaireRésumé : Study Design Case report.
Background
Intra-articular hip pathologies can be difficult to diagnose, and evidence to guide physical therapy interventions is lacking. The purpose of this case report is to describe a clinical pathway for conservative management of a patient with an acute acetabular labral tear and femoroacetabular impingement.
Case Description
The patient was an 18-year-old woman with recent onset of right groin pain who underwent intra-articular corticosteroid injection and therapeutic exercise for the management of an acute acetabular labral tear identified on radiographic imaging. Prior to physical therapy, the patient received an intra-articular hip injection for diagnostic purposes and pain relief. Upon initial evaluation, the patient presented with improved pain but with continued kinesthetic deficits, inflexibility, muscle imbalances, and reproduction of symptoms with end-range hip motions. A physical therapy plan was implemented using neuromuscular re-education to address her continued impairments.
Outcomes
Marked improvements were noted at discharge and 6-month follow-up for pain, strength, and function as demonstrated on the Patient-Specific Functional Scale, global rating of change scale, and International Hip Outcome Tool-33.
Discussion
This case demonstrates a clinical pathway for collaborative medical management of a patient with confirmed intra-articular pathology. Details illustrate the clinical reasoning and rationale used to guide the clinical decision-making process.
Level of Evidence Therapy, level 4Permalink : https://bibliotheque.helb-prigogine.be/opac_css/index.php?lvl=notice_display&id= [article]Exemplaires
Cote Support Localisation Section Disponibilité J Périodique Erasme - périodiques Périodiques Disponible