Journal of Physiotherapy & Physical Rehabilitation

Objective: To investigate the therapeutic effect of the combination of extracorporeal shock waves (ESWs) and Etidronate sodium (EHDP) on post-traumatic Myositis Ossificans (MO) in the quadriceps muscle.

Case description: A 26-year-old male ice hockey player complained of left thigh pain and stiffness, 4 weeks after a direct blow to the thigh from the knee of an opponent in a game. A firm mass with tenderness was palpated at the antero-mid area of the Rectus Femoris. Movement of his left knee was restricted to 50 degrees of flexion from full extension. A radiograph showed a lacy pattern of new bone formation in the anterior aspect of the left femur at 4 weeks after the injury. The injury was thus diagnosed as post-traumatic MO in the left quadriceps muscle. Indomethacin was administered for the first 7 days of hospitalization. EHDP was given orally for 3 months. ESW therapy was performed for the treatment of MO without any anesthesia: 3500 pulses at an energy density of 0.03 to 0.36 mJ/mm² per week, in seven sessions. Pain in the muscle improved with 2 weeks of complete rest with immobilization, and thereafter by moving the knee actively and passively within pain-free limits. A normal range of pain-free motion of the affected knee was achieved in 8 weeks. The athlete then started various rehabilitation exercises, such as stretching and walking. He returned to full sporting activity 5 months after the initial treatment.

Conclusion: Combined therapy of ESW and EHDP was useful for the treatment of post-traumatic MO in the quadriceps muscle.

Objective:

The aim of this study was to evaluate the effectiveness of Modified hold-relax on stair ambulation in stroke patients.

Methods:

In this study, 35 stroke patients were recruited based on the inclusion criteria. The the rapist performed Modified hold-relax for quadriceps i.e.4 repetitions in each session, 5 days a week for 4 weeks, total of 20 sessions. Quadriceps tightness wasassessed using Duncan-Ely’s test, the impact of stroke in individual’s health and life was analyzed using Stroke Impact Scale (SIS) and ability to ambulate the stairs efficiently was analyzed by Timed Up and Down Stairs test (TUDS) before and after the intervention.

Results:

In this study, there was mean difference of 69.63±15.50 in pre-test and 105.94±11.80 in the post-test score of Duncan-Ely’s test i.e.62.9% improvement. There was mean difference of 113. 80 ± 37.27 in pre-testand76.63±27.88 in post-test of TUDSi.e.31.4% improvement and mean difference of 38.69 ± 11.86 in pre-test and 54.94 ±10.35 in post-test of SIS i.e.48.7% improvement.

Conclusion:

Modified hold-relax technique for knee extensors had a positive effect in improving stair ambulation in stroke patients.