Barrett, The Honors College Thesis/Creative Project Collection

This case study describes an adult patient whose brachial plexus injury was treated with various modalities and exercise. The participant of this study was a 76 year old female who sustained a brachial plexus injury during an elective reverse total shoulder arthroplasty. The initial evaluation reported only passive range of motion with 90 degrees shoulder flexion, 85 degrees abduction, and 30 degrees external rotation. Muscle testing yielded significantly limited wrist and digit extension strength. Testing of sensation found diminished protective sensation along the median nerve distribution, including the thumb, index finger, and middle finger. Occupational therapy was initiated for postoperative treatment of the shoulder as well as treatment of the brachial plexus palsy. Therapy consisted of static splinting for healing structures and sensory reeducation through massage, finding objects with the eyes occluded, and fluidotherapy. Additionally, various exercises and modalities for improving motion and strength were initiated, including proprioceptive neuromuscular reeducation, passive/active assist/active exercises, dynamic splinting, muscle stimulation, kinesio tape, functional activities, and tendon glides. After five months, active range of motion in the shoulder, elbow, and wrist was finally achieved and median nerve sensation had improved. After nine months, elbow motion was within normal limits and wrist motion had significantly improved. Upon muscle testing, the elbow, forearm, wrist, and hand had made significant gains in strength. However, shoulder strength and motion was still limited. Overall, treatment made a significant improvement in the patient’s functionality.

The purpose of this Barrett Thesis Project is to review the existing literature on ACL injuries specifically regarding their risk factors, prevention, and recovery options. The content of the review has been placed into four sections: physiological factors, biomechanical factors, surgery and recovery factors, as well as training factors. Physiological factors look at static structures and their impact on ACL injuries, more specifically, the role that variations on physical structure values can have on injury incidence. Biomechanical factors focus on the ways that movement can contribute to injury and the ways that incorrect movement or unanticipated movement can have on the structures of the knee. Surgery and recovery factors look at surgical techniques that have been used to correct ACL injuries and the details of their function as well as certain surgical techniques that have differing rates of success and how they can impact re-injury and rehabilitation rates. Finally, training factors analyze techniques that can be used in both pre-injury or post-injury situations therefore, this section looks at the ways that training can minimize re-injury as well as work towards preventing the initial injury. Overall, this research review looks at how these factors come together to contribute to an ACL injury and the ways that injury incidence can be minimized. Risk factors come together in order to create an undesirable situation in which the ACL ligament ruptures. These risk factors are either physiological or biomechanical in nature. As a result of injury, certain surgical techniques can be used that impact the success of a patient. Evidence for the benefit of training factors can then be applied in order to reduce injury risk or prevent future injuries.

The purpose of this Barrett Thesis Project is to review the existing literature on ACL injuries specifically regarding their risk factors, prevention, and recovery options. The content of the review has been placed into four sections: physiological factors, biomechanical factors, surgery and recovery factors, as well as training factors. Physiological factors look at static structures and their impact on ACL injuries, more specifically, the role that variations on physical structure values can have on injury incidence. Biomechanical factors focus on the ways that movement can contribute to injury and the ways that incorrect movement or unanticipated movement can have on the structures of the knee. Surgery and recovery factors look at surgical techniques that have been used to correct ACL injuries and the details of their function as well as certain surgical techniques that have differing rates of success and how they can impact re-injury and rehabilitation rates. Finally, training factors analyze techniques that can be used in both pre-injury or post-injury situations therefore, this section looks at the ways that training can minimize re-injury as well as work towards preventing the initial injury. Overall, this research review looks at how these factors come together to contribute to an ACL injury and the ways that injury incidence can be minimized. Risk factors come together in order to create an undesirable situation in which the ACL ligament ruptures. These risk factors are either physiological or biomechanical in nature. As a result of injury, certain surgical techniques can be used that impact the success of a patient. Evidence for the benefit of training factors can then be applied in order to reduce injury risk or prevent future injuries.