Case Study | Pace Physiotherapy Centre

Back Pain and Sciatica

● Madam M sought treatment for chronic back pain accompanied by symptoms of sciatica. She described experiencing sharp, shooting pain that radiated from her lower back down through her gluteal region and right leg. The pain often worsened with movement, making it challenging for her to perform daily activities. Additionally, she noted sensations of tingling and numbness along the right lower limb. ● Upon assessment, a comprehensive treatment plan was devised to address Madam M's back pain and sciatica. Initially, the focus was on relieving acute symptoms. This involved a combination of interventions such as lumbar traction, spinal manipulation, heat therapy, and targeted stretching exercises to alleviate muscle tension, reduce inflammation around the sciatic nerve, and provide pain relief. ● As Madam M progressed and her symptoms began to alleviate, emphasis shifted towards strengthening and stabilizing the affected area to prevent risk of recurrent episodes. A tailored exercise program incorporating core strengthening exercises was introduced to improve posture, enhance spinal support, and promote flexibility. ● Through consistent implementation of the comprehensive treatment plan, Madam M experienced significant improvement in her symptoms over time. The combination of targeted interventions effectively reduced her back pain and alleviated sciatic nerve compression, enabling her to resume normal activities with greater ease and comfort.

Cervical Spondylosis with Radiculopathy

● Mr. S presented with complaints of persistent neck pain and numbness throughout the right arm and scapula region. He experienced difficulty extending his neck and suffered from disrupted sleep due to radiating pain. Additionally, muscle weakness was noted in the affected arm. ● For the initial month of treatment, the focus was on addressing the pain and numbness, and improving the neck mobility. This included a combination of cervical stretching exercises, cervical traction, TENS, ultrasound therapy, and laser. ● Following four weeks of consistent treatment, Mr. S began to exhibit progress. At this point, strengthening exercises were gradually introduced. Specifically, a regimen involving sandbag and dumbbell combination weights was implemented to strengthen bilateral hand muscles, with weights ranging from 10kg to 12kg. ● By employing a comprehensive treatment plan tailored to Mr. S's condition, significant improvement was observed. Notably, the incorporation of strengthening exercises contributed to enhancing muscle function and stability, thereby reducing the severity of symptoms associated with cervical spondylosis and radiculopathy.

Post Total Knee Replacement (TKR)

● Madam A, two weeks post-left total knee replacement (TKR) surgery, encountered challenges such as restricted knee mobility, muscle weakness, and an inefficient gait pattern. ● To address these issues, her rehabilitation plan was tailored to include a range of interventions. This comprised specific mobility exercises aimed at increasing knee range of motion, targeted strength training, focusing on key muscle groups like the quadriceps and hamstrings, balance exercises to enhance stability and proprioception, and gait re-education sessions to improve her walking pattern. ● The overarching goal of the rehabilitation program is to not only enhance Madam A's mobility but also to improve her overall quality of life following surgery.

Torn Anterior Cruciate Ligament (ACL) of the knee

● Mr. G, who is an active sport person, presented at Pace Physiotherapy Centre independently, utilizing single crutches and wearing a knee brace on the left lower limb following ACL reconstruction surgery. He reported experiencing pain in the left knee during bending movements, particularly while descending stairs. ● Initial assessment revealed restricted range of motion (0°-75°), diminished muscle strength (mmt 3/5), and notable muscle wasting in the left lower limb. ● The treatment regimen incorporated a multidimensional approach to pain management, including modalities such as cold compress therapy, transcutaneous electrical nerve stimulation (TENS), and ultrasound therapy. Additionally, the patient underwent targeted isometric exercises and specialized VMO strengthening exercises to address the underlying muscular deficits. ● Upon reevaluation one month post-treatment initiation, notable improvements were observed. Range of motion in the left knee had notably increased to 0°-110°, accompanied by significant gains in muscle strength and enhanced knee stability. Importantly, Mr. G demonstrated proficient gait pattern, exhibiting the ability to ambulate without the need for assisted devices, and ready to return to sports.

Geriatric Care and Exercises

● Madam S, a 65-year-old retiree, experienced two falls at home due to imbalance and muscle weakness. During her initial assessment at our physiotherapy center, she required assistance from her walker and daughter to walk, and she was unable to stand independently for more than 30 seconds (Berg Balance Scale BBS score was 32 out of 56, indicating significant balance deficits). ● A customized treatment plan was devised, focusing on strengthening exercises and balance training to address her specific needs. ● Over the course of six visits, Madam S made remarkable progress. She transitioned from needing assistance to walk to being able to walk independently. Additionally, she achieved the milestone of single leg stance for 10 seconds. Her BBS score increased to 52 out of 56, indicating substantial improvement in her balance and functional abilities. ● Through consistent exercises and treatment, Madam S regained her independence and confidence in her mobility. This not only reduced her risk of falls but also significantly improved her quality of life. She can now move around confidently and safely in her home.

Global Developmental Delay (GDD)

● Baby R, a 3-year-old boy was born with congenital lung disease and diagnosed with GDD, which posed significant challenges to his physical development, particularly in achieving the milestone of walking independently. He was presented with limited mobility, only able to crawl and creep during his first visit to physiotherapy session. ● The treatment plan focused on tailored exercises and techniques to enhance his motor skills and promote independent walking. Through dedicated physiotherapy sessions, significant progress has been achieved, enabling him to progress from sitting to kneeling, kneeling to standing, and eventually walking. ● By addressing specific needs and providing personalized care, physiotherapy played a pivotal role in empowering Baby R to achieve walking independence and improve his overall quality of life.