Trials have shown modest clinical improvement in disabilities after stroke with the use of different techniques; however most of the treatment protocols for the paretic upper extremity are either expensive or labour intensive, which makes the provision of intensive treatment for many patients difficult. It has been suggested that mirror therapy is a simple, inexpensive and, most importantly patient-directed treatment that may improve upper extremity function.
A prospective randomised case control study was done on 60 patients of both the sexes in the age group of 19 to 82 years having stroke for the first time. This study was conducted in the Department of Physical Medicine and Rehabilitation of a tertiary care hospital. All the patients who fulfilled the criteria were enrolled for study; patients were randomly allotted to the study or control group. Study group was given mirror therapy in addition to the conventional stroke rehabilitation programme. Patients were assessed in terms of motor recovery (Brunnstrom stages), spasticity (modified Ashworth Scale), and the self-care items of the Barthel index. These indices were measured at 0 month (pretreatment), 1 month (post-treatment), and 6 months (follow-up).
There was a statistically significant difference in spasticity improvement between the study and control groups; however no significant difference was seen in motor recovery and self care items between the groups. The patients had significant improvements within the groups after the therapy for one month.
Mirror therapy can be a useful intervention supplement in rehabilitation of patients; it provides a simple and cost effective therapy for recovery of hand function.
Myositis ossificans circumscripta (MOC) is a form of heterotopic ossification (HO) that is benign in nature but may appear clinically and radiologically as a malignant neoplasm. A 26 years old male patient of traumatic spastic paraplegia, secondary to compression fracture of D8-D10 vertebra presented with severe LBP, more around right buttock with hip movement. During investigations, the presence of large heterotopic ossification mass was noted on rightside of pelvis. Diagnosis was confirmed by blood investigations, x-rays, MRI. Malignancy was excluded by bone biopsy. Case was managed conservatively, the orthosis was changed. Patient was discharged in early July 2012 with significant improvement in pain (VAS-1) and ROM of hip with proper counselling to patient, care-givers and necessary advice for resettlement.
Deformities of the hands and feet in Parkinson's disease (PD) may be mistaken for other more commonly occurring conditions. A case report of a 62 years old lady with Parkinsonism having such deformities is presented here.
The goal of the therapists and patient while selecting an ambulatory aid is to maximise walking ability, manoeuverability and independence, while maintaining safety and stability. Unlike elbow crutches or walker, gutter crutches are not a familiar and well established walking aid in the rehabilitation of persons with incomplete spinal cord injury. In this case report we highlight enhanced ambulation achieved by a 53-year-old man with chronic, incomplete tetraplegia with the use of gutter crutches.