CLINICAL CASES

49 Year Old with Multiple Sclerosis

Working with this patient was very interesting and rewarding. He is a hard working man, but can only work half days at work because he knows he cannot overwork himself. We educated him on his disease on and why to not overwork himself, but still staying active as much as possible. He knows that he will be dealing with this diagnosis for the rest of his life, but with where he is in his developmental area and the age that he is at, he knows he needs to continue to stay mobile and positive.

We uses a NewGait setup on him to prevent him from experiencing drop foot, ankle eversion, and to promote hip extension assist, so the NewGait gives his muscles the feedback they need.

During the time that I worked with this patient on land, we worked on reciprocal walking with his NewGait, stretching out his hip adductors and working stairs because he did say stairs were most challenging for him. Most land-based exercises were very difficult for him.

We also were working in the pool with this patient. At my clinic that I worked at, we had an underwater treadmill that was a great warm up for him and great practice for his reciprocal arm and leg movements. He enjoyed being in the water because it made him feel weightless and unstoppable. Because the water adds great resistance, he noted that he was sore the next day every time after treatment. He progressed wonderfully in the aquatic setting and can continue to benefit from aquatic therapy to work on all of the interventions below.

Examples of Treatment:

Aquatic therapy
Underwater Treadmill
Lateral walking
SLS
Adductor stretch
Hip swings
Sit to stands
Step ups
Land therapy
NewGait for dorsiflexion, eversion, and hip extension assist
Walking
Side stepping
Stairs

55 Year Old with Low Back Pain

Since low back pain is becoming such a common problem in today's day, I thought it would be fitting to use this as my case study. This patient of mine is a hard worker and has a hard time knowing when to stop. He rarely is sitting down and is always moving. The pain becomes worse when sitting so he knows to stay busy to avoid the pain.

Adulthood into older adulthood is when developmentally we are seeing this problem.

There are some cases where we are seeing this issue in younger adults, but mostly older adulthood.

As we get older, the fluid between the vertebras become less and less causing bone on bone, which can lead to low back pain. Another issue we are seeing is weak core muscles and back muscles that can put a lot of pressure on part of a disc. We educated this patient on glutes and core strength to help take some pressure off of the back. This patient really enjoyed manual therapy for more than half of his treatment session like massage and cupping, then the rest of the time was trunk stretching and core, hip, and glutes strengthening. Where this patient was developmentally and physically, it is safe to say that getting his pain down then doing some strengthening to all parts of the body, will help for a more enjoyable life and get back to daily tasks/activities.

Examples of Treatment:

Manual therapy
Cupping
Focused on less trunk flexibility and more on hip strengthening
Bike
Open Book
Hook-lying lower trunk rotation
Hip Abd with theraband supine and standing by bar and mirror to watch
Rainbows
Rectus stretch
Hamstring stretch
Sit to stands
LE stretches
Trunk stretches