Dr Satyajit Mohanty blogs

A Chinese epidemiological study on cervical spondylosis Wang B et al (2004) investigated 1009 Chinese people. They study consisted of Questionnaires and X-rays of people with different occupations, ages, and sexes. High and middle pillow-lovers occupied 80.03%. Imaging features: most of the degenerative changes of cervical spine were located between C5-6 (40.79%), C4-5 (26.29%), and C6-7 (18.20%). Patients with vertebral osteophyte were 65.75%, intervertebral space narrow 36.87%, intervertebral foramen narrow 29.19%, and physiological curve change 31.03%.

Erfanian P et al (2004) a group of private physio-practitioners found a experimental semi-customized cervical pillow was effective in reducing low-level neck pain intensity, especially in the morning following its use in a 4 week long study.

An epidemiological study of obesity in Shimla town was conducted by Sood RK et al in 1996 published in Indian journal of medial science. The study explored prevalence of obesity, its relation to age and physical activity in Indian context. The authors concluded Primary prevention is required to tackle this disease risk factor through health education focussing on promotion of moderate regular physical activity.

Capsular patterns at different joints: A) Joints spanned by muscles: 1. TM joint: increasing limitation of opening the mouth. 2. Shoulder joint: limitation in the following order from maximum to minimum, lateral rotation (most limited)- abduction- medial rotation (least limited). 3. Elbow joint: flexion more limited than extension. Rotations free and painless. For each 90-degree limitation of flexion there is 10-degree limitation of extension. 4. DRU joint: full range of motion with pain only at the limits of motion. 5. Wrist joint: equal degree of limitation of flexion and extension. 6. Trapezium-first-metacarpal joint (1st CM joint): more limitation of abduction than extension, flexion is full. 7. 2nd to 5th CM joint: limited motion in all directions. 8. IP joints of all the fingers: more limitation of flexion than extension. 9. Hip joint: limitation in the following order from maximum to minimum, Medial rotation and flexion (most)- abduction- addu...

step-1: SLR test on involved must be more than60-70 degrees step-2: compression & distraction test, Wilson- Barstow maneuver step-3: long sitting test (leg length from short to long or from long to short?), sitting flexion test step-4: by the step 3; i am almost sure whether the pain is because of innominate dysfunction or due to sacral dysfunction step-5: trial treatment & mobility and pain assessment

According to Brukner PD et al (2006, medical journal of Australia) advancement of imaging and other diagnostic techniques such as magnetic resonance imaging and arthroscopy; have shown the commonest causes of the hip pain & dysfunction are due to labral injuries, chondral injuries, rim lesions, synovitis and tears of the ligament teres in sports arena.

Snoezelen therapy is controlled multisensory stimulation. The combination of the two therapeutic approaches i.e. hydrotherapy and Snoezelen therapy enhances the treatment effect by utilizing the unique characteristics of each approach and thus creates a new intervention approach. Beit Issie Shapiro is a non-profit community organization of Israel is providing a range of services for children with developmental disabilities and their families with this combined approch. The organization provides direct services for nearly 6,000 children and adults each year.

Spinal instability caused by disease or trauma is treated by spinal fusion. Following the operative procedure electrical stimulation therapies are given to enhance spinal fusion. Three types of technologies are available clinically: direct current, capacitive coupling, and inductive coupling to enhance spinal fusions. The mechanisms of action of each of the three electrical stimulation therapies are different. The latter is the basis of pulsed electromagnetic fields and combined magnetic fields. Scientific studies support the validity of electrical stimulation treatments. New data demonstrates that the up-regulation of several growth factors may be responsible for the clinical success seen with the use of such technologies.

Bobath concept : The Bobath concept, based on the work of Berta and Karel Bobath, offers therapists working in the field of neurological rehabilitation a framework for their clinical interventions. It is the most commonly used approach in the UK. According to Lennon S et al (2000) Bobath concept and its main theoretical assumptions had changed since 1990. Although they recognize that over the last half-century the concept has undergone considerable developments, proponents of the Bobath concept have been criticized for not publishing these changes. The Bobath concept, usually known as neuro-developmental treatment (NDT) in America, is one of the major approaches used to rehabilitate patients following stroke; however since the last publication of Bobath (1990), the concept has been taught via an oral tradition on postgraduate courses. Bobath method is to improve quality of the affected body side's movements in order to keep both sides working as harmoniously as possible. While appl...

An analysis of neurodynamic techniques and considerations regarding their application is done by Coppieters MW in journal of manual therapy, Australia (2008). This study was a cadaveric biomechanical study. It measured longitudinal excursion and strain in the median and ulnar nerve at the wrist and proximal to the elbow during different types of nerve gliding exercises. The results confirmed the clinical assumption that 'sliding techniques' result in a substantially larger excursion of the nerve than 'tensioning techniques' (e.g., median nerve at the wrist: 12.6 versus 6.1mm, ulnar nerve at the elbow: 8.3 versus 3.8mm), and that this larger excursion is associated with a much smaller change in strain (e.g., median nerve at the wrist: 0.8% (sliding) versus 6.8% (tensioning)). The findings demonstrate that different types of nerve gliding exercises have largely different mechanical effects on the peripheral nervous system. Hence different types of techniques should not be...

Hosoe H et al (2008) analysed a number of radiological measurements in an attempt to clarify the predisposing factors for degenerative spondylolisthesis of the lumbosacral junction. They identified 57 patients with a slip and a control group of 293 patients without any radiological abnormality apart from age-related changes. The relative thickness of the L5 transverse process, the sacral table angle and the height of the iliac crest were measured and evaluated. They found that: 1. The transverse process of L5 was extremely slender + 2. the sacral table more inclined + 3. And the L5 vertebra was less deeply placed in the pelvis in patients with a slip compared with the control group. They concluded that the L5 vertebra is predisposed to slip when these above mentioned factors act together on a rigidly-stabilised sacrum. This occurs more commonly in women, probably as a result of constitutional differences in the development of the male and female spine.

In past cranial electrotherapy stimulation (CES) has been reported to be effective in tinnitus, anxiety etc. In another study by Lichtbroun AS et al (2001) cranial electrotherapy stimulation (CES), micro-current levels of electrical stimulation are passed across the head via electrodes clipped to the ear lobes with an aim to gauge the effect of this treatment on fibromyalgia. In a double-blind, placebo-controlled study in which 60 randomly assigned patients were given 3 weeks of 1-hour-daily CES treatments, sham CES treatments, or were held as wait-in-line controls for any placebo effect in the sham-treated patients. Treated patients showed improvement in tender point scores, and self-rated scores of general pain level. In addition, there were significant improvement in quality of sleep, self-rated feelings of well-being and quality of life, plus gains in six stress-related psychological test measures. No placebo effect was found among the sham-treated controls. A role of CES in affect...

Physiotherapy-induced prevention of ankylosis in terms of radiographic signs still remains uncertain. Physiotherapy is regarded as a major form of treatment for patients suffering from seronegative spondylarthropathies. Proper systematic review on the efficacy of physiotherapy in this group (seronegative spondylarthropathies) is not available. Pain reduction by treatment with either heat or cold in peripheral and spinal joints is one of the major areas of clinical attention in physiotherapy. Decreased inflammation in controlled studies using thermotherapy, electrotherapy, magnetic fields, or laser-light has been reported. Exercise therapy has additive beneficial outcome. The efficacy of physiotherapy may be underestimated because of the lack of the means for comprehensive assessment of seronegative spondylarthropathies.

Harte AA (2003) reviewed the efficacy of traction for patients with low back pain (LBP) with or without radiating pain from data sources of MEDLINE, CINAHL, AMED, and the Cochrane Collaboration was conducted for randomized controlled trials (RCTs) 1966 to December 2001. They concluded evidence for the use of traction in LBP remains inconclusive because of the continued lack of methodologic rigor and the limited application of clinical parameters as used in clinical practice.

During my graduation days in 1993, prescribing splints to the hemiplegic foot and hand was a crime because it would provide stimulus to ball of Gt. toe and similar anatomic area of hand that ware thought to increase spasticity in the respective region. Similarly giving ES (electric stimulation) to spastic muscles for example extensors of wrist and finders or DF of ankle was a crime. After graduation I followed the same path it I my self decided to go against it and see if it helps I found marked changes in function of extensors of wrist and finders or DF of ankle with ES.

Side posture lumbar manipulation if successful is followed by a audible click. Form where that originates is a question? After one successful side posture lumbar manipulation, if another side posture lumbar manipulation is tried immediately then one may not hear another click. There is a refractory period between another click is heard with a successful side posture lumbar manipulation. What is the duration of that refractory period? The answers are the audible "crack" heard during side posture lumbar manipulation is believed to originate from the zygapophyseal joints. And according to a recent study by Bereznick DE et al the average refractory period is 68.33 minutes.

Holtzman DA et al (2008) reported dysmenorrhea may be alleviated with treatment of motion segment restrictions of the lumbosacral spine with drop table technique (a specific chiropractic technique) Their study spanned over a 4-week period. 16 females were screened for symptoms of primary dysmenorrhea and motion restrictions of the lumbosacral spine. Thirteen subjects were enrolled into the study. Bilateral and unilateral lumbosacral flexion and extension restrictions were treated using drop table manipulations 3 times during each of the 2 consecutive menstrual cycles.

There is a consensus on treatment strategies for temporomandibular disorders (TMDs) being reversible. Among therapies, physiotherapy is often chosen for the treatment of TMD pain and dysfunction because it is simple and non-invasive, it has a low cost as compared with other treatments, it allows an easy self-management approach. Recent reports and clinical experience, however, suggest that this approach can be promising, particularly if it is tailored towards the individual patient. The favourable cost benefit ratio over other treatment modalities seems to indicate that physiotherapy can be regarded as a first choice approach in selected TMD patients.

A special orthosis named 'rucksack type orthosis' has been devised and is used for patients who have back pain due to anterior bending posture of the trunk. So-called rucksack type orthosis (RO), has been used to relieve low back pain and fatigue during prolonged standing and walking for the elderly with spinal deformities. However, little is known about the RO's kinematical effects. Studies have found that Lumbar curvature and the trunk angle of inclination during standing improved significantly when the RO was used. Back extensor muscle activities (T9, L3, and L5) during standing and walking decreased significantly when the RO was used. There were no significant differences in the activities of the upper trapezius and vastus lateralis during standing and walking. Elderly with lumbar deformities might be able to stand and walk more efficiently with the RO. The RO could prove to be valuable in preservation therapy for the elderly with decreased lumbar lordosis or lumbar kyp...

Superior labral anterior posterior (SLAP) tears are an abnormality of the superior labrum usually centered on the attachment of the long head of the biceps tendon. Tears are commonly caused by repetitive overhead motion or fall on an outstretched arm. SLAP lesions can lead to shoulder pain and instability. Clinical diagnosis is difficult thus imaging plays a key diagnostic role. The normal anatomic variability of the capsulolabral complex can make SLAP lesions a diagnostic challenge. Concurrent shoulder injuries are often present including rotator cuff tears, cystic changes or marrow edema in the humeral head, capsular laxity, Hill-Sachs or Bankart lesion.