Study design: This is a pilot prospective cohort study.
Part of the book: Innovations in Spinal Deformities and Postural Disorders
Scoliosis is prevalent in elderlies over the age of 60. Of the different curve types, the thoracolumbar curve is the most common curve type operated upon, as it is associated with marked trunk shift and disability. Current physiotherapy treatments consist of electrotherapy, aquatic exercises, core-strengthening exercises, and dry needling. Outcome of these treatments has not been satisfactory. Long-term successful rate of conservative treatment of symptomatic adult scoliosis is low, as the treatment addresses symptoms but not the biomechanics involved in adult scoliosis. Recent studies have shown that physiotherapeutic scoliosis-specific exercises (PSSE) and bracing stabilized the curves in 80% of the subjects. Thus PSSE and bracing should be added to the standard physiotherapy care in the management of symptomatic adult scoliosis. For asymptomatic patients with thoracolumbar curve that has an increased risk of progression, PSSE should be considered as preventative exercises. Patients who do not respond to conservative treatments and have significant spinal stenosis should be referred for surgery.
Part of the book: Different Areas of Physiotherapy
Various methods have been used to treat Bell’s palsy, ranging from physical therapy, medications, to decompression surgery. The standard treatment is currently a prescription of corticosteroids with antiviral agents. All these medical approaches yield mixed results, and there is a need for additional investigation on treatment options. Recent studies have shown that facial palsy responds positively to phototherapy treatment, in particular the low-energy infrared laser. In the present report, we attempt to review the current clinical application of phototherapy, representing a conservative and safe medical approach in the treatment of Bell’s palsy. A literature review was performed. The results of the included studies suggested that low-level laser therapy (LLLT) is a significant treatment modality for patients recovering from Bell’s palsy. However, the risk of bias of the included studies was relatively high, and further research could change the estimate of effect of this treatment option. In conclusion, there is currently a moderate evidence to support the effectiveness of low-level laser therapy in the treatment of Bell’s palsy. Further randomized double-blind placebo-controlled trials and high-quality studies are needed to determine with certainty the benefits of this treatment option for Bell’s palsy.
Part of the book: Selected Topics in Facial Nerve Disorders
Degenerative lumbar scoliosis (DLS) is commonly seen in people over the age of 50 years. The prevalence increases with age. Patients with DLS often complain of low back pain and radiculopathy. Neurological complaints are rare. Current treatments are generally targeted at pain relief. Effects are temporary; this is understandable as the spinal deformities which are the cause of the pain are not addressed. A few studies have shown that scoliosis specific exercises and lordotic bracing stabilize or reduce the rate of curve progression in patients with DLS. Patients should also be instructed in performing corrective movements in daily activities. In the presence of sarcopenia or decreased bone mineral density (BMD), resistance exercises and nutritional supplements should also be prescribed, as reduction in paraspinal muscle mass and BMD are risk factors of DLS. In the presence of neurological involvement or when the symptoms are refractory to conservative treatment, referral for surgery is required.
Part of the book: Spinal Deformities in Adolescents, Adults and Older Adults
Bell’s palsy (BP) is a common condition; its incidence rate has increased during the COVID-19 pandemic. The standard treatment for facial nerve palsy includes corticosteroids alone or in combination with antiviral agents. However, the treatment is contraindicated in some patients, including hypertensive or diabetic patients. Also, the medication combination may result in inadequate recovery when complementary and alternative approaches are indicated. This chapter reviewed the literature on managing BP with different types of photobiomodulation (PBM) therapies. Fourteen papers were included. The results show that despite the different kinds of photo energy used, varying laser parameters, and the heterogeneity of patients, the outcome of PBM was similar among studies. Of interest is that acute and subacute BP respond more favorably to PBM than chronic cases. Hence, it is suggested to apply PMB as a complementary treatment in the early stage of the disease to enhance the recovery rate of BP patients. However, the risk of bias in these studies was relatively high. Therefore, further randomized, double-blind placebo-controlled studies are needed to determine the effectiveness of PBM in treating BP.
Part of the book: Facial Nerve Palsy