PMID- 27252581
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20160602
LR  - 20190226
IS  - 1066-9817 (Print)
IS  - 2042-6186 (Electronic)
IS  - 1066-9817 (Linking)
VI  - 24
IP  - 1
DP  - 2016 Feb
TI  - Manual physical therapy combined with high-intensity functional rehabilitation 
      for severe lower extremity musculoskeletal injuries: a case series.
PG  - 34-44
LID - 10.1179/2042618614Y.0000000076 [doi]
AB  - OBJECTIVES: Severe lower extremity trauma accounts for large healthcare costs and 
      often results in elective amputation and poor long-term outcomes. The purpose of 
      this case series is to describe an orthopedic manual physical therapy (OMPT) 
      approach combined with a return to run (RTR) clinical pathway consisting of 
      high-intensity functional rehabilitation with a custom energy-storing orthosis. 
      METHODS: Three consecutive male patients, aged 21-23 years, with severe lower 
      extremity musculoskeletal injuries were treated with a combined intervention that 
      included a mean (SD) of 12 (2.1) OMPT sessions and 24 (8.7) functional 
      rehabilitation sessions over a mean of 6 weeks (1.0). Additional training with a 
      custom energy-storing orthosis consisted of a mean of 15 (1.2) additional 
      sessions over 4 weeks. Patient self-report outcome measures and a variety of 
      physical performance tests captured change in function. RESULTS: Baseline lower 
      extremity functional scale (LEFS) and foot and ankle ability measure activities 
      of daily living subscale (FAAM-ADL) scores indicated severe disability. All 
      patients exceeded the minimal clinically important difference (MCID) in at least 
      one self-report outcome or physical performance test without a brace. Two of 
      three patients exceeded the MCID for at least two physical performance tests 
      after training with and utilizing a custom energy-storing orthosis. DISCUSSION: 
      Clinically meaningful changes in self-reported function or physical performance 
      were observed in all patients. A multi-modal approach, including manual therapy 
      and functional exercise, may address the entire spectrum of impairments in 
      patients with severe lower extremity trauma, resulting in improvements in both 
      braced and un-braced function.
FAU - Crowell, Michael S
AU  - Crowell MS
AD  - Keller Army Community Hospital, West Point, NY, USA; Army-Baylor University 
      Sports Physical Therapy Doctoral Residency, West Point, NY, USA.
FAU - Deyle, Gail D
AU  - Deyle GD
AD  - Army-Baylor University Doctoral Fellowship in Orthopedic Manual Physical Therapy, 
      San Antonio Military Medical Center, Fort Sam Houston, TX, USA.
FAU - Owens, Johnny
AU  - Owens J
AD  - The Center for the Intrepid, San Antonio Military Medical Center, Fort Sam 
      Houston, TX, USAA.
FAU - Gill, Norman W
AU  - Gill NW
AD  - U.S. Army-Baylor University Doctoral Program in Physical Therapy, Fort Sam 
      Houston, TX, USA.
LA  - eng
PT  - Case Reports
PL  - England
TA  - J Man Manip Ther
JT  - The Journal of manual & manipulative therapy
JID - 9433812
PMC - PMC4870039
OTO - NOTNLM
OT  - Functional rehabilitation
OT  - Lower extremity trauma
OT  - Manual physical therapy
EDAT- 2016/06/03 06:00
MHDA- 2016/06/03 06:01
PMCR- 2017/02/01
CRDT- 2016/06/03 06:00
PHST- 2016/06/03 06:00 [entrez]
PHST- 2016/06/03 06:00 [pubmed]
PHST- 2016/06/03 06:01 [medline]
PHST- 2017/02/01 00:00 [pmc-release]
AID - yjmt-24-34 [pii]
AID - 10.1179/2042618614Y.0000000076 [doi]
PST - ppublish
SO  - J Man Manip Ther. 2016 Feb;24(1):34-44. doi: 10.1179/2042618614Y.0000000076.