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Fractures of the hand
Published in Peter Houpt, Hand Injuries in the Emergency Department, 2023
Fractures of phalanges and metacarpals are the most common fractures seen in the Emergency Department. The treatment focuses on anatomical reposition and early mobilization, possibly under the supervision of a hand therapist. Spiral fractures bear the risk of rotational deformities. Oblique and comminuted fractures can cause shortening and angulation deformities. Avulsion fractures at the base of the phalanges can be an indication of more complex injuries.
Delivery of Effective Acute Pain Management
Published in Pamela E. Macintyre, Stephan A. Schug, Acute Pain Management, 2021
Pamela E. Macintyre, Stephan A. Schug
Patients should know why effective analgesia is important for their recovery as well as their comfort. The benefits of physiotherapy and early mobilization should be explained and that adequate pain relief with movement is a key aim. They should be assured that every attempt will be made to make them as comfortable as possible but that pain is unlikely to be eliminated. Instead, they should be informed that the main purpose is to provide enough analgesia to enable restoration of good physical function after surgery or injury, during which time some discomfort may be experienced (Frederickson & Lambrecht, 2018; Lee & Wu, 2020). The patient should also be encouraged to tell their doctors and nurses if analgesia is inadequate or if they are experiencing side effects. If intermittent opioid regimens are being used, the importance of asking for the next dose as soon as they begin to feel uncomfortable should be explained. They should not feel they are “bothering” busy nursing or medical staff.
Functional Rehabilitation
Published in James Crossley, Functional Exercise and Rehabilitation, 2021
The gentle rhythmic movement of joints creates a pumping effect that stimulates fluid flow. Gentle, unloaded mobilization of local joints can be very useful in assisting lymphatic flow. Mobilization involves taking joints smoothly through a full, pain-free range of motion. Mobilization can be either passive, i.e. performed by the trainer with the client relaxed, or active, with the client gently mobilizing joints in a safe and secure manner.
Acute effects of lumbosacral mobilization on balance and functional activities in idiopathic Parkinson’s disease:A randomised controlled trial
Published in Neurological Research, 2023
Büşra Seçkinoğulları, Ayla Fil Balkan, Gül Yalçın Çakmaklı, Songül Aksoy, Bülent Elibol
Mobilization techniques are frequently used methods in physiotherapy and rehabilitation programs. Joint and soft tissue mobilizations affect tissues with various neurophysiological mechanisms, providing relaxation, pain inhibition and increase in joint range of motion [11]. In the literature, studies with different procedures including lumbar and sacral mobilization have reported that mobilization application reduces pain, increases spinal flexibility, lower extremity muscle strength, balance and quality of life [12–15]. Moreover, some studies have reported that spinal mobilizations have regulatory effects on the sympathetic and parasympathetic systems [16,17]. The effect of the autonomic nervous system on muscle tone is known [18]. In this case, it is possible that mobilization (grade B) is applied on the lumbosacral region, increasing the mobility of this region, regulating muscle activation and balance. Considering the muscle tone (rigidity) and axial symptoms seen in PwPD, positive effects of lumbosacral mobilization may be expected. The aim of our study was to examine the acute effects of lumbosacral mobilization on balance and functional activities in patients with idiopathic Parkinson’s Disease. For this purpose, the following hypotheses were tested;
The effectiveness of pain neuroscience education combined with manual therapy and home exercise for chronic low back pain: A single-blind randomized controlled trial
Published in Physiotherapy Theory and Practice, 2022
Ismail Saracoglu, Meltem Isintas Arik, Emrah Afsar, Hasan Huseyin Gokpinar
Pharmacological treatments, invasive treatment methods, biophysical and electrotherapeutic modalities, exercise therapy, and manual therapy (MT) are among the therapeutic approaches frequently used in CLBP (Grabois, 2005; Savigny, Watson, and Underwood, 2009). Mobilization is one of the MT techniques and involves a continuum of skilled passive movements to the joint complex that are applied at varying speeds and amplitudes with the intent to restore optimal motion, function, and/or to reduce pain by increasing the extensibility of articular and periarticular structures (Mintken, DeRosa, Little, and Smith, 2008). Mobilization also has neurophysiological effects such as altered alpha motor neuron activity and autonomic response systems and increased blood levels of b-endorphin and serotonin, which have been shown to occur throughout the nervous system via peripheral, spinal, and supraspinal mechanisms (Bialosky et al., 2009). In addition, evidence-based guidelines for the management of CLBP emphasize the importance of a physically active lifestyle and active rehabilitation; as a result, patients are typically prescribed home exercise programs (HEP) (Savigny et al., 2009). However, non-surgical conservative treatments including MT and HEP for CLBP have small to moderate effect sizes (Keller, Hayden, Bombardier, and Van Tulder, 2007). Since these treatment methods mostly target the painful anatomical region and focus on the biological aspect of pain, there is a need to develop more effective interventions (Bialosky et al., 2014; Coulter et al., 2018; Louw, Nijs, and Puentedura, 2017; Scholten-Peeters et al., 2013).
Occupational Therapy’s Role with Oncology in the Acute Care Setting: A Descriptive Case Study
Published in Occupational Therapy In Health Care, 2022
Stacey Morikawa, Yasaman Amanat
Patients undergoing cancer treatment and management requiring hospitalization may be at increased risk for complications. A multicenter observational cohort study including 24 European countries found that patients with solid tumor cancer had higher frequency of sepsis compared to non-cancer patients. In addition, it was found that one in 16 cancer patients require intensive care during treatment, with outcomes being comparable with other conditions (Tan et al., 2019). Prolonged intensive care has been associated with various effects including increased risk for weakness, brain dysfunction, skin breakdown, and depression and anxiety. It has been identified that early mobilization, such as can be provided by occupational and physical therapy, may lessen the severity of many of these complications (Nelson et al., 2010).