The Effects of Manual Physical Therapy and Therapeutic Exercise on Peripartum Posterior Pelvic Pain: Two Case Reports

Abstract

Peripartum posterior pelvic pain is a clinical enigma commonly encountered by physical therapists. It is hypothesized that the release of relaxin hormone during pregnancy may result in ligament laxity, which could lead to sacroiliac instability resulting in pain and decreased function. The purpose of these case reports was to describe the effects of manual physical therapy and therapeutic exercise on a peripartum patient with reports of posterior pelvic pain. Two patients referred to physical therapy by their obstetrician during their pregnancy were recruited for these case reports. During the initial examination, both patients completed a number of self-report measures including the Oswestry Disability Index, a body diagram, and the Numeric Pain Rating Scale. Both patients were treated with muscle energy techniques directed at pelvic and sacral positional faults and therapeutic exercise consisting of transverse abdominis and multifidus neuromuscular re-education; isometric hip abduction and external rotation; and a force closure sacroiliac stabilization program directed at neuromuscular re-education of the anterior and posterior oblique sling systems (hip adductors-contralateral obliques and gluteus maximus-contralateral latissimus dorsi combinations). At the time of discharge, both patients again completed the self-report outcome measures as well as a global rating of change. Both patients demonstrated a clinically meaningful improvement in their pain levels as well as perceived disability. In addition, both rated their global rating of change as "a great deal better." These case reports provide preliminary evidence suggesting that manual physical therapy and therapeutic exercise may be an effective intervention strategy for peripartum patients reporting posterior pelvic pain.     

国家自然科学基金青年科学基金项目立项前系统化管理研究

文章从科研管理的角度,分析了医院对国家自然科学基金青年科学基金项目立项前系统化管理的方法与措施.提出了项目申报动员、前期研究准备、专业培训辅导、逐份修改项目申报书、形式审查和内容审查相结合等方法和途径,以完善国家自然科学基金青年科学基金项目立项前系统化管理,为医院科技发展提供借鉴.     

我国医学科研项目结题验收评估工作存在的问题与思考

项目验收评估是科研项目管理中的重要一环.本文通过总结分析当前我国医学科研项目管理工作在评估内容、评估方法、评估模式方面存在的主要问题,结合国际科研项目管理实践经验,提出平衡定性与定量的评估、兼顾指标与内容评估、提高同行评议科学性、依托科技信息服务平台、引入第三方评估机制、建立项目全过程评估体系等观点.本研究可为进一步构建科学、客观的医学科研项目验收评估模式,推动医学科研产学研用一体化发展提供理论基础.     

做好草地生态工程监理工作,确保建设项目工程质量

随着西部大开发战略的实施．国家加大了对我国西部地区草地生态环境建设的投资力度,为使项目建设达到预期目标与效益．保证工程建设质量,做好草地生态工程监理工作是关键。     

虚拟人体将为创伤骨科研究提供新技术

“虚拟人体”是一个较新的学术名词，这是当前科技前沿生命科学与信息科学相结合的研究新领域。虚拟人体研究是将人体结构和功能加以数字化，经过计算机技术处理，在电脑屏幕上出现可视的仿真人。虚拟人的全部研究发展包括四个阶段：“虚拟可视人”、“虚拟物理人”、“虚拟生理人”和“虚拟智能人”。当前研究进展情况已构建了“虚拟可视人”，正向后续阶段探索。有很多科学问题和应用开发问题尚有待解决，研究工作方兴未艾，任重道远。本就此项发展前景深远、当前尚未完善的新技术平台与创伤骨科研究工作的关系，进行了初步的分析探讨。     

意大利辅助用具免费供给残疾人体系(英文)

Aids are only one of the instruments with which the disabled person can often reach a good level of autonomy,he can improve his conditions of life and prevent the aggravating of his situation.Aids serve also to facilitate care on the part of the family.The rights confirmed by Law 104 can also be achieved through the use of aids.The Italian state has planned a system of care with regards to aids so that some of them can be purchased with different tax concessions but essential aids,those necessary for the reaching of autonomy goals and prevention defined by an individual rehabilitative project,are supplied free of charge.In Italy essential aids are part therefore of a rehabilitation plan that is identified for each person with disabilities by a team made up of different professionals.     

Manual Therapy in Children

Abstract

It has been proposed that patients with low back-related leg pain can be classified according to pain mechanisms into four distinct subgroups: Central Sensitization (CS), Denervation (D), Peripheral Nerve Sensitization (PNS), and Musculoskeletal (M). The purpose of this study was to determine whether there were any differences in terms of disability and psychosocial factors between these four subgroups. Forty-five subjects with low back-related leg pain completed the Oswestry Disability Index, the Hospital Anxiety and Depression Scale, and the Fear Avoidance Beliefs Questionnaire. Subsequently, an examiner blinded to the questionnaire results classified the subjects into one of the four subgroups, according to the findings of the self-administered Leeds Assessment of Neuropathic Signs and Symptoms questionnaire and a physical examination. It was found that the PNS subgroup had significantly greater disability compared to all other subgroups and significantly greater fear avoidance beliefs about physical activity compared to the CS and D subgroups. This highlights the importance of sub-classification but also the need to take into account disability and psychosocial factors in the management of low back-related leg pain.     

Robotics and telecommunication systems to provide better access to ultrasound expertise in the OR

Summary

Surgery has begun to evolve as a result of the intense use of technological innovations. The result of this is better services for patients and enormous opportunities for the producers of biomedical instruments. The surgeon and the technologist are fast becoming allies in applying the latest developments of robotics, image treatment, simulation, sensors and telecommunications to surgery, in particular to the emerging field of minimally-invasive surgery. Ultrasonography is at present utilised both for diagnostic and therapeutic purposes in various fields. Intraoperative US examination can be of primary importance, especially when dealing with space-occupying lesions. The widening use of minimally-invasive surgery has furthered the development of US for use during this type of surgery. The success of a US examination requires not only a correct execution of the procedure, but also a correct interpretation of the images. We describe two projects that combine robotics and telecommunication systems to provide better access to US expertise in the operating room. The Midstep project has as its object the realisation of two robotic arms, one for the distant control of the US probe during laparoscopic surgery and the second to perform tele-interventional US. The second project, part of the Strategic CNR Project - ‘Robotics in Surgery’, involves the realisation of a common platform for tracking and targeting surgical instruments in video-assisted surgery.     

Trigger Point Dry Needling

Abstract

Trigger point dry needling is a treatment technique used by physical therapists around the world. In the United States, trigger point dry needling has been approved as within the scope of physical therapy practice in a growing number of states. There are several dry needling techniques, based on different models, including the radiculopathy model and the trigger point model, which are discussed here in detail. Special attention is paid to the clinical evidence for trigger point dry needling and the underlying mechanisms. Comparisons with injection therapy and acupuncture are reviewed. Trigger point dry needling is a relatively new technique used in combination with other physical therapy interventions.