...is located directly under the first metatarso-phalangeal joint. What gait pattern would be expected? What would the effects of their condition be on various parts of the gait cycle? Word Count – 521 The concerned gait in the given case is antalgic gait. Even though there are a number of gaits that exist but this particular gait is the consequence of pain. It may be defined as the manner of walking of the person usually accompanied by a limp in order to minimize pain caused by exerting too much weight. When the patient walks, he tries to minimize the weight put on the area affected and also shorten the time duration especially during the stance phase. Hence in this endeavor of the patient the gait is altered. Further the length of the strides is also shortened on the side of the injury, which alters the posture or the underlying manner of the normal gait cycle of the patient. Antalgic gait may be caused suddenly or get develop over a period of time due to the damage caused to the musculoskeletal system or a particular nerve. Even though this gait can impact a person of any age and sex, but based on empirical researches it has been found that its prominence is more profound amongst seniors and athletes and also males are more vulnerable than their female counterparts (Nirenberg, 2014).[a1] The normal gait cycle is comprised of primarily two phases i.e.[B2] stance phase and swing phase. When the gait is normal, the underlying movements are extremely coordinated and therefore...
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...What are the physical and cognitive benefits of exercise on patients with multiple sclerosis? 1. Bayraktar D, Guclu-Gunduz A, Yazici G, et al. Effects of Ai-Chi on balance, functional mobility, strength and fatigue in patients with multiple sclerosis: a pilot study. NeuroRehabilitation. 2013; 33(3):431-7. This research study was designed to examine the effects of Ai-Chi exercises in a swimming pool on balance and mobility in patients with multiple sclerosis (MS). Poor balance and decreased mobility is a common issue with MS, and the decline often limits daily activities. Researchers recruited twenty-three females affected by MS, and divided them into two groups. The exercise group performed Ai-Chi exercises for a 60 minute session twice a week for eight weeks. The control group did a home exercise program that only involved abdominal breathing and active range of motion exercises. Upon conclusion of the program, subjects were tested on static balance, functional mobility, fatigue, and muscle strength. The exercise group showed significant improvements across all measures, but the control group did not. This shows that the aquatic exercise program is a viable option to combat the negative effects of MS. A strength of this study was the use of aquatic therapy. The researchers stated that although this therapy is widely used, more studies need to be performed to gain more knowledge. Recording results on patients is concrete evidence that these programs work. This study was published...
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...policies are encouraged to visit: http://www.elsevier.com/copyright Author's personal copy Pattern Recognition 45 (2012) 3414–3426 Contents lists available at SciVerse ScienceDirect Pattern Recognition journal homepage: www.elsevier.com/locate/pr Silhouette-based gait recognition using Procrustes shape analysis and elliptic Fourier descriptors Sruti Das Choudhury, Tardi Tjahjadi n School of Engineering, University of Warwick, Gibbet Hill Road, Coventry CV4 7AL, United Kingdom a r t i c l e i n f o Article history: Received 6 September 2011 Received in revised form 15 December 2011 Accepted 21 February 2012 Available online 5 March 2012 Keywords: Gait recognition Human identification Procrustes shape analysis Elliptic Fourier descriptor Silhouette Nearest neighbour classifier Classifier combination Hu moments a b s t r a c t This paper presents a gait recognition method which combines spatio-temporal motion characteristics, statistical and physical parameters (referred to as STM–SPP) of a human subject for its classification by analysing shape of the subject’s silhouette contours using Procrustes shape analysis (PSA) and elliptic Fourier descriptors (EFDs). STM–SPP uses spatio-temporal gait characteristics and...
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...the pain has returned. He has been taking his medication regularly and tolerates them well. Furthermore, he states that his medications are helping with his pain. On examination of the lumbar spine, there is diffuse tenderness over the lumbar paraspinous muscles and right piriformis. There is query muscle tone. There is moderate facet tenderness at the levels of L4 through S1. Sacroiliac tenderness, Fabere’s/Patrick, Sacroiliac Thrust and Yeoman’s tests are positive to the right. Kemp’s and Farfan’s tests are positive bilaterally. Seated and supine straight leg raise is at 70 degrees. Range of motion shows flexion of 55 degrees, extension of 10 degrees and lateral bending of 25 degrees to tehj right. Gait is antalgic on the right. Heel-toe walk exacerbates his antalgic gait on the right. Diagnoses are lumbar disc disease, lumbar radiculopathy, lumbar facet syndrome and right sacroiliac joint syndrome. He has failed conservative treatment in the form of physical therapy, chiropractic manipulation, medication, rest and home exercise program. He was given a refill prescription for Tramadol 100 mg one 1 tablet twice daily #60, Motrin 800 mg 1 tablet twice daily #60, Flexeril 10 mg one 1 tablet twice daily #60 and Prilosec 20 mg 1 tablet daily. Treatment plan includes a right sacroiliac joint rhizotomy/neurolysis, continuation with non-strenuous aerobic activity and follow-up in 4-6 weeks. The patient will undergo a random urinary drug screening on today’s visit. It was...
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...The patient is an 89-year-old female, a patient Dr. Jeffrey Gold, who was seen in the ED St. Joe's Wayne on 11/7/2016 after a fall at home. The workup there was negative for acute fractures. The patient was sent home. The patient is known to have dementia. She is known to have bilateral knee replacements, hypertension, gastroesophageal reflux disease, anemia, dyslipidemia, coronary disease, congestive failure, a fib, history of previous falls, history of previous a prior right proximal humeral fracture and inferior pubic rami fracture. When seen in the office by Dr. Gold he sent the patient immediately back to ED for further eval. As for the health aide who is a 24-hour live the patient was able to walk to the bathroom. Although they...
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...In a musculoskeletal imaging article featured in The Journal of Orthopedic & Sports Physical therapy (JOSPT), (Lamothe, Elliott, & Chang, 2018) wrote about a 23 years old female active athlete triad, with a history of progressive and worsening right groin pain during training for 4 weeks, her primary care physician ordered an x-ray of the right hip, which was negative for fractures, then she was referred to physical therapy for treatment. At the initial visit, the physical therapist notice the antalgic gait and difficulty getting up from the chair, then the physical therapist went on with the initial assessment, a comprehensive series of musculoskeletal testing, which reveals severe pain with single limb stance, pain during passive range...
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...On examination, musculoskeletal strength is 4/5 with lower leg flexion and extension and ankle dorsiflexion and plantar flexion. Patient has antalgic gait. Current medications include docuprene-sodium, Ketamine 5% cream, Protonix, glucosamine sulfate, Prozac, hydocodone-apap, Sildenafil and Wellbutrin. Diagnoses are left foot ankle and joint pain, lumbosacral region intervertebral disc degeneration, cervical and thoracic sprain, chronic pain and pain disorder with related psychological factors. Plan is for urology consultation due to left buttocks pain associated with erection, considering the symptoms have been consistent since his injury. Current request is for 1 Urology Consultation between 12/28/2015 and...
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...Emm at times was irritable and anxious throughout and had a normal casual gait with no antalgic. He had a forward flexion to approximately 80 degrees at which point he reported pain. Extension greater than 10 degrees, causes pain. Straight leg raise is positive on the right and negative on the left. He had full range of motion in bilateral lower extremities. Mr. Emm had tenderness to palpation over the left lumbar paraspinal musculature as well as the left sacroiliac tenderness, none is present on the right. Spasms are noted in the left lumbar paraspinal musculature but no masses are palpable. Dr. Isler impression was that lumbar back pain and left lower extremity radicular symptoms is likely multifactorial. Mr. Emm does have components of left sacroilitis and a questionable left L5 radiculopathy. Dr. Isler recommended EMG and...
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...There is 1+ tenderness noted. There is radicular pain on low back down to left posterior right knee. Motor strength testing shows 4+/5. Patient presents with antalgic gait with cane as assistive device. Patient is using a lumbar brace. Diagnoses include cervicalgia, low back pain and left knee pain. Plan is for PT 3 times a week. On the statement of medical necessity on the MG2 form dated 04/07/16, patient is status post surgery on 03/28/16. Patient shows fair improvement on the affected area. Patient continues to complain of pain, stiffness and difficulty with functional activities. Patient will benefit from PT to attain pre-injury level of function. Requested verification from the PT facility on the number of PT sessions attended to date for the neck and lower back, and post-operative PT sessions for the left knee; however, no callback was received prior to the submission of this request to PA. Is...
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...BS/TUMOR - Type x collagen is important for mineralization (locations include in cartilage deep to the tidemark and in the ZPC of the growth plate) - Myositis Ossificans should not be resected until completely ossified - Desmoid tumors contain E receptors and Tamoxifen is useful in the Treatment - A mutation in CBFA 1 leads to Cleidocranial Dysplasia - Chromium and Tantulum are very resistant to corrosion - Molybdenum is added to cobalt alloys to increase strength - IGN is the sole motor innervation of gluteus maximus - Lipomas are bright on T1 - Osteoarthritis leads to increase water and decreased proteoglycans and collagen in cartilage (very commonly asked) - CD 31 is a sensitive marker for angiosarcoma - AIIS is the origin of Rectus Femoris - Anakinra is an IL-1 antagonist used as Tx of RA - Etaneracept and Adalimumab block TNF alpha in the Tx of RA - TOC for PVNS is total synovectomy - Joint motion improves chondrocyte nutrition - Synovial Chondromatosis is a benign metaplastic process of joints that leads to stippled calcifications and loose bodies - If PE is irradiated in air, catastrophic failure and delamination occur - Osteocalcin is the most abundant non collagenous protein in bone - High Rates of Telomerase results in increased recurrence rates in patients with chondrosarcoma - X linked hypophosphatemic rickets caused by mutation in the PEX gene; MHE caused by defects in the EXT-1 or 2 genes - Synovial Sarcoma a/w translocation of X;18, Ewings...
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...clinical utility of testing functional systems within the central nervous system, compared to testing individual motor nerves with manual muscle testing. Design: Private practice. Study Subjects: Patients were examined by the treating chiropractor from his existing patient pool. Methods: Chiropractic management was decided on by the treating chiropractor. A series of twelve tests were designed to discover disorders of functional systems within the CNS. The tests described were to evaluate the function of 12 systems: 1) spinal cord, 2) myelencephalon/reticular formation, 3) vagal system, 4) trigeminal motor system-muscles of mastication, 5) vestibulospinal system, and bulbo reticular area, 6) reticular formation, 7) diencephalons and gait locomotion system, 8) mesencephalon, 9) cardiac sympathetic autonomic system, 10) pyramidal system, 11) limbic system, 12) sensory system. Results: This chiropractic approach tests the nervous system after provocation of functional systems instead of sensory challenges to more discreet portions of the body. Conclusion: For chiropractic patients who are not responding to discreet treatment programs, this method of evaluation may be valuable as it tests underlying system problems within the CNS. Nearly all the functional systems have a related motor activity that results in inhibition and facilitation patterns. Case series...
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...Primary Care Physician Initial Evaluation: Patient Name: Mrs. Wright (53 years old) Description: Rheumatoid arthritis and osteoporosis HISTORY: Mrs. Wright is a 53-year old female who visited Dr. Curtis on 9/21/2013 for devastating pain dealing with her rheumatoid arthritis. She was diagnosed with rheumatoid arthritis on 4/2/2010 by Dr. Ruppert. She was later diagnosed with osteoporosis on 8/5/2010. Along with her arthritis pain, she has other conditions such as: Raynaud syndrome, irritable bowel syndrome-associated constipation (IBS-C), gastroesophageal reflux (GERD), and chronic urinary tract and upper respiratory infections. She has gained weight because of the lack of exercise she has performing. Wright complains she is too tired to work out and gets tired throughout the day performing normal activities. She also insists she cannot work out because she always gets hot flashes from her menopause and is simply too hot to work out. Wright also explained she lives alone and cannot always go to see a physician because she cannot get someone to drive her there. She is no longer taking the three medications, hydroxychloroquine, methotrexate, and prednisone, prescribed by Dr. Ruppert. She explains she had experienced intolerable side effects, including reflux, alopecia, and severe photosensitivity. Dr. Ruppert ordered a comprehensive laboratory evaluation and identified the following: IgG4 food-specific antibodies, essential fatty acid and amino acid imbalances, nutrient...
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