Dr Satyajit Mohanty blogs

In year 2000 Henricus MV et al found End-range mobilization techniques with adhesive capsulitis of the shoulder increases glenohumeral mobility, but in the absence of a control group, they could not be sure what led to reduced impair as it is debated that natural course of the disease (FS) is self limiting. In 2006 Henricus MV et al found HGMT proved to be more effective than LGMT in the management of adhesive capsulitis of the shoulder; however, subjects improved significantly with both treatment strategies, and the differences were small. DESCRIPTION OF THE MOBILIZATION TECHNIQUES (AS ADVOCETED IN THE STUDIES OF HERNICUS MV ET AL) Each session must start with assessment of the ROM. All 3 affected physiologic movements of the glenohumeral joint are assessed passively. At each position of the shoulder, the end-feel of the movement are assessed in order to apply the mobilization techniques into the stiffness zone (HGMT group) or within the pain-free zone (LGMT group). 1. The treatmen...

Waldburger et al (1992) of Switzerland subjected 50 cases of frozen shoulder across 3 Swiss medical centres to a radioisotope bone scan (99 mTc diphosphonate) study. They included 3 separate aetiological groups: post-traumatic (40%), neurological (14%) and idiopathic (46%). The findings are interesting: a. The so-called idiopathic frozen shoulder showed a scapulo-humeral increase in radioisotope uptake in several areas (in 82% of cases) without involvement of the ipsilateral carpus. b. Clinically, the neurological type was associated with a shoulder-hand syndrome with positive bone scan of the shoulder and the wrist in all cases. c. The post-traumatic type showed a diffuse (in 50% of the cases) or at several circumscribed areas (also in 50%) increase in radioisotope uptake in the shoulder. In 45% of the post-traumatic type, there was also a shoulder-hand syndrome with uptake in the wrist also. These findings made the resesrchers to intervene the FS subjects with calcitonin adm...

Types of FS: Idiopathic FS- When no secondary causes are attributed or no cause can be assigned to the onset. Secondary FS: FS as a result of diabetes, cardiac problems, stroke, rheumatoid arthritis, or trauma. Phases of FS: Reeves documented 3 phases with which to address the progression of FSS: the pain phase, the stiffness phase, and the recovery phase. To regain the normal extensibility of the shoulder capsule and tight soft tissues, passive stretching contrast to active stretching of the shoulder capsule and soft tissues by means of mobilization techniques has been recommended. The in-vogue techniques encompasses 1. Midrange mobilization (MRM)- recommended by Maitland 2. End-range mobilization (ERM)- recommended by Kaltenborn 3. Mobilization with movement techniques (MWMs)- recommended by Mulligan However these above recommended techniques for FS base are not based on research they are rather suggestions. Yang et al investigated the effect of mobilization treatment and to...

I. Asymmetry 3-dimensional motion patterns in Chr. LBA Chronic LBP patients exhibited motion patterns altered from those of the normal population. 3D motion analyses reveal 3 distinct patterns of motion observed in each principal direction of movement in LBA cases. They are reflected as: 1. Differences in the extension-flexion ratio (asymmetry between flexion and extension). 2. Lateral bending asymmetry and 3. Differences in coupled axial rotation-lateral bending ratio. II. Lumbar-hip flexion motion in LBA A. Hip movements in normal healthy patients without LBA during forward bending of the lumbar spine: 1. Earlier reported values for lumbar spine motion during forward bending vary from 23.9 degrees to 60 degrees and hip motion during forward bending ranges from 26 degrees to 66 degrees. 2. Esola & colleagues found mean total forward bending to be 111 degrees: 41.6 degrees from the lumbar spine and 69.4 degrees from the hips. B. The lumbo-coxa contribution to forward bendi...

Introduction: Subtle pelvic asymmetry (exhibited as either lateral pelvic tilt or iliac rotational asymmetry), which is common among normal individuals, has not been convincingly linked to abnormalities in back. Given the difficulty in diagnosing most LBA, a classification using pelvic asymmetry and patterns of movement are helpful in establishing a rational treatment plan (2). I. Impact of pelvic asymmetry in work-stations: Structural and functional asymmetries are factors that may be considered in the seating design and work environment (1). A study consisting of 59 subjects revealed that significant: (1) Correlations between pelvic asymmetry and asymmetric trunk motion performed in sitting. (2) Differences between the LBP and control groups in patterns of trunk motion performed in a sitting posture. (3) Differences between kinematics of motions performed in sitting versus standing postures. This study concluded that in LBA cases pelvic asymmetry and altered trunk motion in...

Modern manual therapy techniques focus on asymmetry in anatomy & mobility and lateralization. Wylick HV et al recommend a 3 Minuit test battery by 8 tests. How ever following are 10 tests to know the asymmetry in spine: 1. Dominant eye 2. Phoria of eye 3. Scooping 4. Step forward 5. Finger crossing 6. Step on platform 7. Axis rotation 8. Tailor’s position 9. Step backward 10. Arm crossing