study group for aspiring pce,npte students

[jess]

ok then, here we go.
my topics for the day include the following:
-classification of fractures
-fracture healing (pathology and healing times)
-management of fractures- reduction, immobilsation, rehab
-complications of fracture healing
-contraindications to rehab eg, THR (remember fractures only!)

kindly add comments, suggestions, rehab ideas?!!

jess

[jess]

joint replacements
complications related to these
post op assessments
rehab issues of specific replacements
...replies appreciated
jess

[swapnil_handa85]

hello jess,
nice to see you again.where had you been so long. i almost lost all hope of meeting you again.

i hope even we about can continue with our group n benefit ourselves if others are not interested.

once again thanks for comming back.


swapnil

[swapnil_handa85]

jess could you please tell me about pyogenic osteomyelitis and tublercular osteomyelitis and how they constitutes to pathological fractures.

secndly explain ollier's disease and relate with fratures.


which fractures unite faster spiral or oblique and why?

effect of electrical stimulation on fractures?

[swapnil_handa85]

jess i feel our older way of discussion is not so worth. i think we should discuss one one topic and when everybody endulged in that topic feel satisfied and get full out of it than choose another.

jess please tell what you think as ill only go with you being most regular to my group.

thanks to be there and please always be there.

regardz

swapnil

[bhuvneshshah]

hi swapnil
would be interested in joining your forum

let me know what's next

with regards
Bhuvnesh Shah

[jess]

‘Osteomyelitis’ indicates inflammation of the bone caused by infective organisms.
PYOGENIC OSTEOMYELITIS
Infection can reach the bone by the following routes:

a. Through the blood stream from a focus of infection elsewhere (Haematogenous).
b. Direct invastion from the atmospheric air as in open fractures.
c. Spread from a neighbouring focus e.g. mastoiditis from middle ear infection, osteomyelitis of mandible from dental root abscess.

Clinically pyogenic osteomylities can present as follows:

1. Acute osteomyelitis.
2. Chronic osteomyelitis.
3. Primary sub-acute osteomyelitis.
4. Acute flare up of chronic osteomyelitis.
initial focus on metaphyseal region of bone. accomplanies altered vascularisation, bone production, nutrition ect. infection starts in the medullary tissues and spreads to overlying soft tissues. (on extension to the joint can cause spetic arthritis)
destruction of underlying bone...becomes weaker...malnourished...ect...hence more prone to fractures.

[jess]

to be honest i dont know about the thrid q.
often clinicians diagnose spiral fractures as oblique and vice versa. the oblique however id in one plane only....dnt know if that makes a difference in healing. let me know if you find out.

[jess]

as for the rest, tublercular osteomyelitis, olliers disease...i think it'd be easier and efficient if you just google it.

right now i am under pressure to get through the workload so do not have time to 'organise' such a working group as was before.

i am happy to continue with regular topics and difficult areas to discuss daily. however simple pathological features ect i dnt think are appropriate and quite frankly i havent got the time to go over it all individually.

hence, i think difficult areas and things ppl dnt understand fully, are more appropriate and better practice, both professionally and acedemically.

jess

[jess]

ok since you've probably fugured ive post msk topice....
help/advice/suggestions with these would be appreciated please:

-desensitising techniques
-management of complex regional pain syndrome
-treatment ideas (in priority) for myofacial pain syndrome
-treament ideas for thoracic outlet syndrome
-contraindications for acl/pcl repairs i.e. avoidance activities and time lines for activity
-treament ideas, precautions for meniscal injuries...time lines??


(personally, i think this is a better way to do it and bounce ideas off eachother rather than go through specific pathologies which we can find out individually)

replies appreciated...feel free to join in

jess

[jess]

no one has really helped out with my initial queries??

[bhuvneshshah]

hi jess
the line of treatment i know is spray with vasocoolent and stretch the muscle with trigger point (Myofacsial pain syndrom). If refractory, the point can be injected with the local anaesthetics

Myofacsial pain syndrome: triggerpoint mannual by travell and simons provides an excellent account for myofacial pain map for the individaul muscle and with position of stretch and injection technique

[bhuvneshshah]

hi jess
the line of treatment i know is spray with vasocoolent and stretch the muscle with trigger point (Myofacsial pain syndrom). If refractory, the point can be injected with the local anaesthetics

Myofacsial pain syndrome: triggerpoint mannual by travell and simons provides an excellent account for myofacial pain map for the individaul muscles, positions for stretch and injection techniques

cheers
Bhuvnesh Shah

[jess]

(btw excuse my typing errors! really not acceptable i know)
ok...flexor and extensor tendon repairs, post op regimes, secondary and final stages of rehab. how to progress and when?

jess

[swapnil_handa85]

im unfortunate to inform you that ill not be able to be on net for three dayz.i promise ill be in regular contact after than.


nice to see you again mr. bhuvnesh where had you been so long.

thanks to you n jess for filling strength in our group

keep going ill rejoin you soon

[jess]

can anyone help out with what exactly are 'frenkels exercises', how they are done, basic principles?

thanks, jess

[bhuvneshshah]

hi

Originaly designed to help the patient with loss of the funciton of the dorsal colume of the spinal cord and proprioception, the main principal of the frenkel's is teach the patient to substitute the proprioception with the visual cues during the movements.

hope u find it help full

regards
Bhuvnesh shah

[jess]

thanks for thaat. do u know of any websites, references that are useful for more detail?

jess

[physiobob]

can anyone help out with what exactly are 'frenkels exercises', how they are done, basic principles?

thanks, jess

I found this on the web which gives a practical idea of what Frenkel's Exercises are and how you might use them in the clinic:

Frenkel's Exercises for Ataxic Conditions

These exercises prepared by Curative Services -- Courage Center

This program consists of a planned series of exercises designed to help you compensate for the inability to tell where your arms and legs are in space without looking.

The exercise routine takes about 1/2 hour and should be done 2 times daily.

1. Exercises are designed primarily for coordination; they are not intended for strengthening.
2. Commands should be given in an even, slow voice; the exercises should be done to counting.
3. It is important that the area is well lit and that you are positioned so that you can watch the movement of your legs.
4. Avoid fatigue. Perform each exercise not more than four times. Rest between each exercise.
5. Exercises should be done within normal range of motion to avoid over-stretching of muscles.
6. The first simple exercise should be adequately performed before progressing to more difficult patterns.

Exercises While Lying:

Starting position: Lie on bed or couch with a smooth surface along which the feet may be moved easily. Your head should be raised on a pillow so that you can watch every movement.

1. Bend one leg at the hip and knee sliding your heel along the bed. Straighten the hip and knee to return to the starting position. Repeat with the other leg.

2. Bend one leg at the hip and knee as in #1. Then slide your leg out to the side leaving your heel on the bed. Slide your leg back to the center and straighten your hip and knee to return to the starting position. Repeat with the other leg.

3. Bend one leg at the hip and knee with the heel raised from the bed. Straighten your leg to return to the starting position. Repeat with the other leg.

4. Bend and straighten one leg at the hip and knee sliding your heel along the bed stopping at any point of command. Repeat with the other leg.

5. Bend the hip and knee of one leg and place the heel on the opposite knee. Then slide your heel down the shin to the ankle and back up to the knee. Return to starting position and repeat with the other leg.

6. Bend both hips and knees sliding heels on the bed keeping your ankles together. Straighten both legs to return to starting position.

7. Bend one leg at the hip and knee while straightening the other in a bicycling motion.

Exercises While Sitting:

Starting position: Sit on a chair with feet flat on the floor.

1. Mark tine, raising just the heel. Then progress to alternately lifting the entire foot and placing the foot firmly on the floor upon a traced foot print.

2. Make two cross marks on the floor with chalk. Alternately glide the foot over the marked cross: forward, backward, left and right.

3. Learn to rise from the chair and sit again to a counted cadence. At one, bend knees and draw feet under the chair; at two, bend trunk forward; at three, rise by straightening the hips and knees and then the trunk. Reverse the process to sit down.

Exercises While Standing:

Starting position: Stand erect with feet 4 to 6 inches apart.

1. Walk sideways beginning with half steps to the right. Perform this exercise in a counted cadence: At one, shift the weight to the left foot; at two, place the right foot 12 inches to the right; at three, shift the weight to the right foot; at four, bring the left foot over to the right foot. Repeat exercise with half steps to the left. The size of the step
taken to right or left my be varied.

2. Walk forward between two parallel lines 14 inches apart placing the right foot just inside the right line and the left foot just inside the left line. Emphasize correct placement. Rest after 10 steps.

3. Walk forward placing each foot on a footprint traced on the floor. Footprints should be parallel and 2 inches from a center line. Practice with quarter steps, half steps, three-quarter steps and full steps.

4. Turn to the right. At one, raise the right toe and rotate the right foot outward, pivoting on the heel; at two, raise the left heel and pivot the left leg inward on the toes; at three, completing the full turn, and then repeat to the left.

5. Walk up and down the stairs one step at a time. Place the right foot on one step and bring the left up beside it. Later practice walking up the stairs placing one foot on each step. At first use the railing, then as balance improves dispense with the railing.

Upper Extremity Exercises:

When the arms are affected use a blackboard and chalk. Change a minus sign to a plus sign; copy simple diagrams (straight lines, circles, zig-zag lines, etc.) Various coordination boards may be used to improve eye-hand coordination.

[jess]

oh thanks very much! that was wonderful and greatly appreciated
jess

[jess]

...ok just a little confused. contraindications to TENS- decreased or altered sensation... so why is it a treatment modalitiy used to control neuropathic pain where the nerves are quite obviously damaged to some point? is it that the TENS is used elsewhere on the body? or is 'decreased/altered sensation' just a 'precaution' to use TENS?

i know its advised to use in trigeminal neuralgia, but physiologically if you think about the principles of TENS, wouldnt this aggravate the pain?

cheers,
jess

[vincent123]

Anyone can help to advise on job in Ireland

[loretef]

Hello I need to prepare for thr NPTE, is there a study group? If not does anyone want to study with me?

Thanks

[Pooneha]

hi
are you preparing for the clinical component?
I live in Toronto and am looking for a group for the clinical part.