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Poster 134: Factors Affecting Rehabilitation Outcome of Congenital Muscular Torticollis
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tion, an impression of adhesive neuritis along the longitudinal operation scar was made. Other identifiable pathologic processes such as effusion or bursitis were excluded by ultrasound. Points of tenderness were accurately identified along the incision site by applying gentle pressure with a sharpened rubber pencil eraser. Extraarticular nerve block injection (1% lidocaine and 20 mL of Kenalog) was conducted along the incision scar and patient tolerated the procedure well without any complications. Setting: University hospital clinic. Results: 7 days after the procedure the patient was seen in the clinic participating in physical therapy, including active and passive flexion exercises and scar tissue mobilization, with minimum pain. After 2 months the patient completed physical therapy with restored full range of knee flexion and improved ambulation. Discussion: Persistent knee pain after total knee joint arthroplasty may be caused by many factors. Adhesive neuritis due to damage in the infrapatellar branch of saphenous nerve is a common but underrecognized complication. This is a rare case of extension contracture caused by inability to flex the knee presumably due to adhesive neuritis, which seems to be related to multiple revisions of total knee joint arthroplasty. It can be clinically diagnosed by localizing the pain area with a common tool such as sharpened rubber pencil eraser. Physical therapy following nerve block can be an effective option for rehabilitation for this type of condition. Conclusions: Persistent knee pain after total knee joint arthroplasty can have multiple etiologies. In cases of adhesive neuritis, conservative treatment is possible with nerve block injection after precisely localizing the pain. Keywords: Rehabilitation, Adhesive neuritis, Infrapatellar branch of saphenous nerve, Total knee joint arthroplasty.
Poster 134 Factors Affecting Rehabilitation Outcome of Congenital Muscular Torticollis. Soo Jeong Han, (Ewha Womans University, Yanchun gu, Seoul, Korea, South); Bomi Shin; Tae Sik Yoon. Disclosures: S. Han, None. Objective: This study explored the factors affecting rehabilitation outcome of congenital muscular torticollis patients and suggested the onset time, method and period of the rehabilitation. Design: Retrospective study. Participants: 211 patients were enrolled that were diagnosed with CMT. We reviewed the patients’ charts and radiologic findings, retrospectively, and excluded secondary torticollis patients resulting from other medical or surgical disorders. Interventions: None. Main Outcome Measures: We reviewed the sex, gestational age, birth weight, diagnosis time, mass size, mass site, plagiocephaly, clavicle fracture, limitation of eye movement and rehabilitation frequencies. Pearson correlation and
POSTER PRESENTATIONS
Student t test were used for evaluation of relationship of respective factors. Multiple regression test was used for evaluation of the relationship of mass size, diagnosis time and rehabilitation frequencies as independent variables and rehabilitation duration as the dependent variable. Results: The patients with a plagiocephaly or a clavicle fracture needed significantly longer rehabilitation and mass size and rehabilitative duration had a positive linear relationship and diagnostic time and rehabilitative duration showed a positive correlation. However, rehabilitation frequency did not equate to a shorter rehabilitation period and mass site did not correlate with rehabilitation duration. Also, the group treated with torticollis exercise combined with ultrasound showed no significant difference relative to the group treated with only torticollis exercise. In this study, 4 patients received surgical treatment, of which 2 patients who were diagnosed as having CMT with intermittent exotropia received surgical resection of the extraocular muscles and the other 2 patients underwent sternocleidomastoid tenotomy of the affected side in conjunction with rehabilitation therapy. Conclusions: This study showed that plagiocephaly, clavicle fracture, mass size, and diagnositic time are clinically significant in determining rehabilitative treatment. Therefore, it is imperative to make a timely diagnosis and objectively evaluate the tilting of the head and neck, as well as checking the mass size and identifying the presence of clavicle fractures. Keywords: Torticollis, Plagiocephaly, Clavicle fracture.
Poster 135 Gait and Balance Analysis Following Spinal Fusion in Adolescent Idiopathic Scoliosis. Judith Sanchez Raya, (Vall d'Hebron Hospital, Barcelona, Spain); Almudena Crespo; Amparo Cuxart, MD PhD; Esther Pages; Susana Rodriguez, MD; Georgia Romero, MD. Disclosures: J. Sanchez Raya, None. Objective: To evaluate changes in gait and balance of the spine as a consequence of spinal fusion in idiopathic scoliosis and to correlate these to distal level of the fusion. Design: Observational prospective study. Setting: Physical medicine and rehabilitation department in a tertiary care hospital. Participants: 25 patients with idiopathic scoliosis reviewed in outpatient clinical rehabilitation unit between June 2007 and December 2008 who underwent spinal fusion more than 2 years earlier. Interventions: Gait and balance analysis with IBV platform. Main Outcome Measures: We collected the data from the patients’ clinical records: curve type (King classification), magnitude (Cobb angle), time since surgery, and gait and balance parameters. The statistical analysis was done with statistical package SPSS 13® and an inferential bivariate analysis was applied. The level of statistical significance used was P ⬍ .05.
tion, an impression of adhesive neuritis along the longitudinal operation scar was made. Other identifiable pathologic processes such as effusion or bursitis were excluded by ultrasound. Points of tenderness were accurately identified along the incision site by applying gentle pressure with a sharpened rubber pencil eraser. Extraarticular nerve block injection (1% lidocaine and 20 mL of Kenalog) was conducted along the incision scar and patient tolerated the procedure well without any complications. Setting: University hospital clinic. Results: 7 days after the procedure the patient was seen in the clinic participating in physical therapy, including active and passive flexion exercises and scar tissue mobilization, with minimum pain. After 2 months the patient completed physical therapy with restored full range of knee flexion and improved ambulation. Discussion: Persistent knee pain after total knee joint arthroplasty may be caused by many factors. Adhesive neuritis due to damage in the infrapatellar branch of saphenous nerve is a common but underrecognized complication. This is a rare case of extension contracture caused by inability to flex the knee presumably due to adhesive neuritis, which seems to be related to multiple revisions of total knee joint arthroplasty. It can be clinically diagnosed by localizing the pain area with a common tool such as sharpened rubber pencil eraser. Physical therapy following nerve block can be an effective option for rehabilitation for this type of condition. Conclusions: Persistent knee pain after total knee joint arthroplasty can have multiple etiologies. In cases of adhesive neuritis, conservative treatment is possible with nerve block injection after precisely localizing the pain. Keywords: Rehabilitation, Adhesive neuritis, Infrapatellar branch of saphenous nerve, Total knee joint arthroplasty.
Poster 134 Factors Affecting Rehabilitation Outcome of Congenital Muscular Torticollis. Soo Jeong Han, (Ewha Womans University, Yanchun gu, Seoul, Korea, South); Bomi Shin; Tae Sik Yoon. Disclosures: S. Han, None. Objective: This study explored the factors affecting rehabilitation outcome of congenital muscular torticollis patients and suggested the onset time, method and period of the rehabilitation. Design: Retrospective study. Participants: 211 patients were enrolled that were diagnosed with CMT. We reviewed the patients’ charts and radiologic findings, retrospectively, and excluded secondary torticollis patients resulting from other medical or surgical disorders. Interventions: None. Main Outcome Measures: We reviewed the sex, gestational age, birth weight, diagnosis time, mass size, mass site, plagiocephaly, clavicle fracture, limitation of eye movement and rehabilitation frequencies. Pearson correlation and
POSTER PRESENTATIONS
Student t test were used for evaluation of relationship of respective factors. Multiple regression test was used for evaluation of the relationship of mass size, diagnosis time and rehabilitation frequencies as independent variables and rehabilitation duration as the dependent variable. Results: The patients with a plagiocephaly or a clavicle fracture needed significantly longer rehabilitation and mass size and rehabilitative duration had a positive linear relationship and diagnostic time and rehabilitative duration showed a positive correlation. However, rehabilitation frequency did not equate to a shorter rehabilitation period and mass site did not correlate with rehabilitation duration. Also, the group treated with torticollis exercise combined with ultrasound showed no significant difference relative to the group treated with only torticollis exercise. In this study, 4 patients received surgical treatment, of which 2 patients who were diagnosed as having CMT with intermittent exotropia received surgical resection of the extraocular muscles and the other 2 patients underwent sternocleidomastoid tenotomy of the affected side in conjunction with rehabilitation therapy. Conclusions: This study showed that plagiocephaly, clavicle fracture, mass size, and diagnositic time are clinically significant in determining rehabilitative treatment. Therefore, it is imperative to make a timely diagnosis and objectively evaluate the tilting of the head and neck, as well as checking the mass size and identifying the presence of clavicle fractures. Keywords: Torticollis, Plagiocephaly, Clavicle fracture.
Poster 135 Gait and Balance Analysis Following Spinal Fusion in Adolescent Idiopathic Scoliosis. Judith Sanchez Raya, (Vall d'Hebron Hospital, Barcelona, Spain); Almudena Crespo; Amparo Cuxart, MD PhD; Esther Pages; Susana Rodriguez, MD; Georgia Romero, MD. Disclosures: J. Sanchez Raya, None. Objective: To evaluate changes in gait and balance of the spine as a consequence of spinal fusion in idiopathic scoliosis and to correlate these to distal level of the fusion. Design: Observational prospective study. Setting: Physical medicine and rehabilitation department in a tertiary care hospital. Participants: 25 patients with idiopathic scoliosis reviewed in outpatient clinical rehabilitation unit between June 2007 and December 2008 who underwent spinal fusion more than 2 years earlier. Interventions: Gait and balance analysis with IBV platform. Main Outcome Measures: We collected the data from the patients’ clinical records: curve type (King classification), magnitude (Cobb angle), time since surgery, and gait and balance parameters. The statistical analysis was done with statistical package SPSS 13® and an inferential bivariate analysis was applied. The level of statistical significance used was P ⬍ .05.