rehabilitation

Systemic arterial hypertension (SAH) is considered an important risk factor for the development of cardiovascular diseases. The aim of the present study was to verify the effects of a short cardiovascular rehabilitation program (CR) in hypertensive subjects. The clinical pilot study involved a sample composed of 11 hypertensive subjects. It was evaluated the weight, height, body mass index (BMI), waist and hip circumference, waist hip ratio, systolic blood pressure (SBP), diastolic blood pressure (DBP) and six-minute walk test (6-MWT) before and after CR. CR was performed twice a week for 60 minutes. The results shown that after CR occurred a reduction of waist circumference (99.86±8.7 to 95.2±8.6 cm, p=0.0002) and hip circumference (110.18±14.75 to 105.00±12.7 cm p=0.01) values. About the mean distance walked in the 6-MWT there was an increase after the CR program (335.9±123.5 m to 554.56±87.9 m, p=0.000). In conclusion, the results suggest that a short CR is an effective for the treatment of hypertensive subjects. After 16 CR sessions, functional and musculoskeletal capacity was improved, evaluated by 6-MWT. Furthermore, the short CR program decreased waist and hip circumferences, being an important option for these subjects. Although. There were no changes in baseline blood pressure levels.

In recent years, the increasing number of patients with upper limb musculoskeletal disorders seeking timely, intensive, prolonged and task oriented hospital- and home- based physical rehabilitation, and the decreasing numbers of trained therapist to provide the needed care, have left a palpable gab. These have resulted in several preventable deformities with associated complications leading to social and economic burdens. Although the introduction of some robotic devices has addressed some of these concerns, the shortfalls from the use of these devices limit their effectiveness. The newly introduced hand rehabilitation board (Dominic’s Board) was prospectively evaluated in 82 patients with ULMDs of different etiologies to assess its therapeutic efficacy in rehabilitation of ULMDs. Additive, but complementary effect was observed when used along with conventional hospital-based therapy and at home, suggesting the effectiveness of this device in preventing or ameliorating the complications associated with ULMDs.

The purpose of this study was to assess the peculiarities of vertebral pain syndrome, parameters of physical performance and quality of life indices in women of older age depending on the presence of vertebral fractures (VF). This study was performed with participation of 215 women aged 50-89 years old which were divided into two groups: first one-women without any previous osteoporotic fractures (n=143), second group - patients with VF in thoracic and/or lumbar spine (n=72). The presence and intensity of pain in the thoracic and lumbar spine were evaluated using the 11-component visual analog scale (VAS), physical performance-with following functional tests: 3-, 4- and 15-meter tests (gait speed), static balance (a side-by-side position, a semi-tandem position and a full-tandem position), 8-feet test and «five timed chair stands» (coordination and strength), hand grip strength (by dynamometer), measurement of arterial pressure (systolic and diastolic), heart and respiratory rates, breath holding, chest excursion (mean and on the inhalation and the exhalation), lateral trunk lean, Schober and Thomayer tests. It was demonstrated that the intensity of vertebral pain (pain at the time of investigation, the most common level of pain, pain in the best periods of the disease) and some physical performance tests (lateral trunk lean and chest excursion (mean index, during the inhalation and exhalation), hand grip strength, 15-meter gait speed test and five-repetition sit-to-stand test) are significantly worse in women with VF than corresponding parameters in persons without fractures. It should be taken into account during the assessment of physical performance and development of rehabilitation programs for older age women with vertebral fractures.

Asthma is one of the most common chronic diseases in the world and affects people of all ages. But having an asthma patient with a good overall fitness level helps reduce the chances of getting a seizure. Aqua-aerobic exercises is appropriate programs for the treatment of asthma. The aim of this study was to propose a rehabilitation program using aqua-aerobic exercises and to determine its effect on some functional parameters (forced Expiratory Volume in first Second Fev1, Peak Expiratory Flow PEF, and the Forced Vital Capacity FVC), and improve the respiratory functions to reduce the intensity and severity of asthma attacks for asthmatic children.

The aim of the paper is to determine the effects of physiotherapy and rehabilitation (PHTR) on a child with Pallister-Killian Syndrome (PKS). Gross Motor Function Measure (GMFM) and duration of grasping ping pong ball were the primary outcome measures which were conducted at the beginning, 12th, and 24th month. Neurodevelopmental Therapy and Sensory Integration Therapy were used as intervention methods. The most increase with around 50% was acquired in Section A of the GMFM. Duration of holding a ping pong ball gradually increased. As a result, this is the first paper presenting a PHTR shedule and its results in a child with PKS.

Despite its high incidence and the great development of literature, there is still controversy about the optimal management of Achilles tendon rupture. The several techniques proposed to treat acute ruptures can essentially be classified into: conservative management (cast immobilization or functional bracing), open repair, minimally invasive technique and percutaneous repair with or without augmentation. Although chronic ruptures represent a different chapter, the ideal treatment seems to be surgical too (debridement, local tissue transfer, augmentation and synthetic grafts). In this paper we reviewed the literature on acute injuries.

The rehabilitation of partially or completely edentulous patients with implant supported prostheses has been widely used, achieving high success rates. However, many studies consider the presence of bruxism as a contraindication for this treatment modality. The purpose of this study was to review the literature and identify risk factors in implant supported rehabilitation planning in subjects with bruxism. The rehabilitation of bruxers using implant supported prostheses, using implants with adequate length and diameter, as well as proper positioning, seems to be a reliable treatment with reduced risks of failure. Bruxism control through the use of a night guard by rigid occlusal stabilization appliance, relieved in the region of implants, is highly indicated. Although it is clear that implant supported rehabilitation of patients with bruxism requires adequate planning and follow-up, well-designed randomized controlled trials are needed to provide reliable evidence on the long-term success of this treatment modality.

Introduction: Temporomandibular joint (TMJ) ankylosis is one of the most disruptive anomaly that affects the masticatory system and is referred as permanent movement disfunction of the mandible caused by bilateral or unilateral fibrous or bony adhesions and create problems. The etiology is congenital or idiopathic and include trauma, arthritis, infection, previous TMJ surgery etc. Management requires extensive resection of the ankylotic mass and reconstruction of the ramus-condyle unit with autogenous or alloplastic grafts. Most of the time, combination of surgical treatment with physiotherapy is needed in order to achieve maximum rehabilitation and functionality of the mandible. Purpose: The aim of this study is to present the surgical management of an unusual case of unilateral TMJ ankylosis and recent of literature review. Case report: A thirty-seven-year old patient reported unable moving his lower jaw. Clinical examination revealed unilateral TMJ ankylosis of congenital cause and the lateral movement of the mandible was impossible. The patient surgical treatment included resection of the newly formed bone mass, replacement of the condyle with costo-chondral graft and replaced of articular disc with the temporal fascia. Since and for ten years after surgery the patient shows no signs of relapse. Conclusion: The development of TMJ ankylosis may be congenital or acquired etiology. In order to manage it required a comprehensive clinical and radiographic examination. Surgical resection of the bone and coronoid process on the entire side is necessary and a graft that mimics the articular disc is placed, while it is necessary the immediate postoperative kinesiotherapy.

Functional and aesthetic rehabilitation of an extremely worn dentition is one of the most challenging aspects of Prosthodontics. A thorough examination and diagnosis & selection of appropriate occlusal scheme are key factors to achieve optimal clinical outcome. Among the variety of techniques suggested in the literature, the twin-stage technique given by Hobo & Takayama has emerged as a popular choice for clinicians in recent times. Instead of the condylar path, it utilizes standard cuspal angle as the main determinant of articulation to produce predictable disocclusion in eccentric movements. It is relatively simple, does not require special armamentarium and can be incorporated easily with commonly used clinical techniques such as face bow transfer. The present case report describes the full mouth rehabilitation of a severely mutilated dentition using Hobo’s twin-stage technique to achieve a functionally and aesthetically favourable outcome.

Background: Orthoses need to support physiotherapy as well as surgical treatment. Related to patient’s rehabilitative goals and pathological gait pattern, orthotists have to produce an orthoses that using an adjustable ankle joint system with preloaded disc springs can store the energy brought in by the body weight and produce a tuning effect on patient’s gait and sense of balance. The purpose of this study was to establish how a personalized proprioceptive individualized rehabilitative treatment could influence the functional response of different AFOs (Ankle Foot Orthoses) in a cohort of patients affected by neurological gait pattern. Methods: Five patients affected by different neurological gait pattern and volunteered to participate to this study were recruited. The comparative spatio-temporal and functional effect on gait pattern of 3 types of AFOs was investigated under 4 study conditions: 1) without AFO or free-walk (FW); 2) wearing a Codivilla spring, 3) wearing a carbon unjointed AFO (“Toe-Off”); 4) wearing an innovative carbon-kevlar dynamic joint DAFO (DAFONS=Dynamic Ankle Foot Orthoses with Neuroswing). In line with our rehabilitative model, patients underwent to a weekly treatment session, 80 minutes duration per session, for 4 weeks. Evaluation was made before (time T3=time of recruitment) and after our individualized rehabilitative treatment course (time T4=1 month from T3) by using: a. G-Walk sensor (by BTS) spatio-temporal measures in different gait performances; b. clinical/functional outcome measures (Modified Ashworth Scale or MAS for the affected upper and lower limb; Medical Research Council or MRC; orthostatic stability evaluation by using the Berg Balance Scale or BBS). Findings: A comparative analysis of clinical and instrumental data, performed in the pre-defined four investigational conditions, showed: √ a statistical insignificant change of MRC and MAS scales at time T4, with a significance trend outcome observed at the same time by using the Wilcoxon Signed Rank Test √ a statistical significant difference between test duration (sec) by using Toe-Off vs DAFONS and by using Codivilla spring vs Toe-Off √ a statistical significant increase of the stride length on the left side (% cycle length) by using DAFONS compared to Toe-Off for patient P1, P3 and P5 with a parameter decrease by using DAFONS compared to Codivilla spring and Toe-Off use for patient P2 √ a statistical significant correlation between BBS trend and test duration (sec) by using Codivilla spring at time T3 and T4 √ a statistical significant correlation between the BBS trend and the double gait support duration on the right side (% cycle) with number of left step cycles by using DAFONS at time T3 and T4 √ in a comparative post-treatment visual gait analysis a modification of each patient’s static and dynamic postural assessment by using 3 different types of orthoses Interpretation: In line with our study design we noted at the end of the proposed rehabilitative treatment an amelioration of gait quality with the use of DAFONS in all those patients (P1, P3 and P5) who showed a neurocognitive competence with a related functional grade of neurorehabilitative re-learning attitude of the physiological gait pattern and with a compromised perceptive control of gait and core stability. The proprioceptive profile of our rehabilitative program could promote the pro-adaptive and facilitation properties of a personalized gait control, induced by an innovative dynamic ankle foot orthoses with a modulable ankle joint system called Neuroswing. In the daily clinical practice, the personalized integration of a neurorehabilitative program and DAFONS can perform an individualized peripheral neuro-facilitation of gait cycle (peripheral perceptive facilitation), a neurorehabilitative re-learning process of physiological gait pattern (peripheral assisted neuroplasticity facilitation DAFONS induced) and an increase of patient’s motor abilities and quality of life in all daily performances.

Background: Telerehabilitation has been identified as an effective treatment that promotes exercise rehabilitation in individuals with multiple sclerosis (MS). Social support is recognised as a core element of such interventions. However further research is needed to consider the role and value of different social support domains. Aim: Review available literature to assess and synthesise the use and value of social support within telerehabilitation interventions for individuals with MS. Method: A narrative synthesis was conducted. A systematic search of included articles was conducted. Electronic databases were searched from inception to January 2017. Other search methods were undertaken. Evaluation and synthesis of included articles utilised risk of bias assessment and a 4-stage synthesis process. Main Results: A total of fourteen studies, involving 718 participants (505 female, 213 male; aggregated mean age 47.6 years) with MS, were included. Esteem support was the most frequently reported method of social support, followed by informational, emotional and tangible. It would appear social support can be beneficial in assisting participants to adhere to treatment interventions. Visual feedback may be directly beneficial to improve impaired balance in individuals with MS. A model for future interventions is provided. Conclusions: Social support appears to increase the adherence of participants with MS to telerehabilitation interventions. Unique findings provide an indication for the direction and content of future interventions. Further research is necessary to ascertain the optimal types and frequencies of social support delivery and its effect on health outcomes for participants with MS.

Background: Proximal humerus fractures (PHFs) are common injuries particularly in older adults. Evidence-based protocols for PHF rehabilitation are lacking and physiotherapists use a variety of interventions. Purpose: To determine practice patterns and perceptions of physiotherapists who treat adults with PHF in Ontario, Canada. Method: A paper and pencil survey asking about respondent demographics and management of Neer Group 1 (minimally/nondisplaced) and complex (displaced 3- and 4-part) PHF was mailed to 875 randomly selected physiotherapists who were registered with the College of Physiotherapists of Ontario in 2013/2014 and working in practice areas likely to be accessed by adults with PHF. Results: The response rate was low (10%); 83 physiotherapists completed the survey - 80% had experience managing PHF. Respondents treated 1-5 individuals with PHF annually; more treated Neer Group 1 PHF (89%) than complex PHF (68%). Most individuals with PHF were older than 60 years (64%), female (76%) and accessed physiotherapy through a doctor’s referral (91%) more than 1 month post injury (33%). Main findings: Physiotherapists manage PHF using multi-component interventions and a minimum of 76% include the following elements: education and progression of passive, active assisted, active range of motion exercises and muscle retraining to build coordination and strength. Use of other elements was variable. The main factors influencing the treatment plan were the ability of the individual with PHF to comply, bone quality, and fracture type. Most respondents were unsure that there is sufficient PHF rehabilitation literature to guide treatment. Conclusions:This environmental scan is the first North American study to document practice patterns and attitudes of physiotherapists providing PHF rehabilitation. Elements used by physiotherapists in Ontario treating small numbers of individuals with Neer Group 1 or complex PHFs each year align well with the limited PHF rehabilitation literature available. Potential implications:Multi-disciplinary collaborations to design and conduct large, high quality, multi-centre prognostic studies and RCTs that evaluate the effectiveness of key aspects of non-surgical PHF rehabilitation in various patient groups are needed. Meanwhile, consensus guidelines should be developed in the context of region-specific physiotherapy service models to inform best practice in PHF rehabilitation management.

Septic Iliac vein thrombophlebitis with associated psoas abscess is a rare and severe entity, which diagnosis is challenging when no risk factor is clearly present. We are presenting a case of severe septic cavitary pulmonary emboli complicated with Acute Respiratory Distress Syndrome (ARDS) that evolved rapidly to respiratory distress and multi organ failure. A 61-year-old Hispanic male, had multiple emergency department visits due to back pain, being most of them intramuscular pain medications and steroids. In the history, he had back pain that worsened accompanied by poor mobility, generalized malaise, fever and chills. Computed tomography (CT) scan showed a paravertebral psoas abscess with L5 - S1 diskitis/spondylitis inflammatory changes, which was then later evidenced by a gallium study. Further imaging studies were done, showed bilateral cavitary lung lesions, consistent with septic emboli. Subsequent blood cultures were positive for Methicillin Resistant Staphylococcus Aureus (MRSA), for which a successful combined therapeutic regimen was used. Transthoracic and transesophageal echocardiogram were not suggestive of endocarditis. Staphylococcus aureus (SA) bacteremia is one of the most common serious bacterial infections with a high risk of metastatic complications, which makes this pathogen a unique one. The combination of factors iliac vein thrombophlebitis, psoas muscle abscess, diskitis/spondylitis with ARDS makes cavitary pulmonary disease a challenging perspective. After a 6-week antimicrobial treatment, full anticoagulation, his clinical condition and image findings improved, and he was recently admitted for physical rehabilitation. Major vessels thrombophlebitis should always be considered, when primary source of septic pulmonary emboli is not clear. This case illustrates the complexity of illness and complications that may arise from a source of infection as the one in this patient. Further therapeutic strategies were tailored accordingly.

Background: Alcoholism is a widespread problem in Kenya and is associated with severe impacts on health and quality of life of the individual. Physical activity is an affordable and sustainable adjunct treatment option for recuperating alcoholics; however its’ rarely used in rehabilitation of alcoholics in Kenya. Objective: This qualitative study sought to elicit facilitators and barriers that influence the practice of physical activity amongst recuperating alcoholics under rehabilitation. Methods: A focus group guide was utilized to gather views and perceptions of 15 alcoholics and 5 health professionals through focus group discussions. Constant comparative approach was used to analyze verbatim transcripts obtained from in-depth interviews. This analysis entailed three stages including open, axial and selective coding. Results: Recuperating alcoholics’ recognized various forms of physical activity to promote mental and physical health during their rehabilitation. Health professionals and significant others considerably supported the recuperating alcoholics to practice physical activity however physical activity facilities and facilitation was lacking in Asumbi rehabilitation center. Conclusions: The rehabilitation centres should have physical activity experts and facilities that can offer individualized physical activity services and support needed by the recuperating alcoholics.

Global drug use has reached epidemic levels, with approximately 269 million drug users worldwide [1]. Problematic drug use may lead to serious physical, social, and mental health problems. An estimated 167,000 deaths attributed to drug-related disorders worldwide in 2017 [2]. The rising global drug use and its severe adverse consequences make the drug treatment/rehabilitation a top priority for policymakers. In modern China, illicit drug use has raised great concern from both the academia and the public. Nearly 2.15 million Chinese were registered as drug users in 2019 [28]. Drug-related crimes and deaths are also increasing [29]. The current drug treatment programs in China are mainly compulsory, addressing coercion and discipline. However, the effectiveness was found to be low [3]. Situated in the fields of social work, public health, and psychology, Chinese scholars and practitioners have conducted some empirical tests for these drug treatment/rehabilitation programs and already found several effective preventive factors in the programs. However, the existing research on the design and evaluation of Chinese drug treatment/rehabilitation programs rarely investigate the theoretical rationales behind these programs. This study would address three criminological theories that have been applied to explain drug treatment and rehabilitation in Western societies: Differential Association Theory, Social Bonding Theory, and Labeling Theory. Similar theoretical rationales could be learnt and adopted by Chinese programs. 

Background: Disabling hearing loss is a prevalent public health issue, with significant impact on patients’ communication. The disability associated with hearing loss depends on the severity of the hearing loss. There are limited rehabilitative measures in resource challenged environment. This study assesses the incidence, the factors for hearing impairment and the management outcome. Methods: A descriptive three-year chart review of patients managed for hearing loss in a tertiary health center in a developing country. The data collected include demographic data, clinical presentation and risk factors for hearing loss, audiometric reports, rehabilitative measures and management outcome. Results: The patients with ear symptoms managed within the study period were 1350, of whom 498 (36.8%) had hearing loss of varying degrees. These included 145 (29.1%) males and 353 (70.9%) females with male to female ratio of 1:2.4. The age ranged from 8 to 80 years (median age of 35.7). Disabling hearing loss in the better-hearing ear occurred in 216 (43.4%) of cases. Increasing age and chronic supportive otitis media were associated with disabling hearing loss. The hearing thresholds improved with hearing aids and ear surgical procedures; nonetheless the patients’ rehabilitation was impaired by limited resources. Conclusion: There is poor rehabilitation of people with hearing loss, though management outcome is commendable in a few of them. Health education will reduce the risk factors for disabling hearing loss and improved rehabilitative measures are needed for these individuals.

Introduction: Bilateral vestibular areflexia is a rare pathological entity whose most frequent etiology is drug ototoxicity. We report an unusual case of bilateral vestibular areflexia complicating acute otitis media through which we raise the difficulties of diagnosis and therapeutic management of this pathology. Case Report: 57-year-old Tunisian patient who consults for a loss balance associated with earache and hearing loss. Initial clinical examination revealed bilateral acute otitis media with a right harmonious vestibular syndrome and normal neurological examination. The diagnosis of post-otitis labyrinthitis was retained. The patient was put on antibiotics and corticosteroids. The evolution was marked by the persistence of instability in darkness and oscillopsia; vestibular explorations concluded with bilateral vestibular areflexia. MRI concluded to posterior labyrinthitis and eliminated central neurological involvement. The patient was kept under betahistine. The tympanic cavity was drained by a tympanic aerator on both sides. Vestibular rehabilitation was started quickly. Gradual improvement was obtained of autonomy with persistent oscillopsia. Conclusion: Bilateral vestibular areflexia poses diagnostic problems based on anamnestic and clinical arguments and vestibular explorations. The therapeutic management is delicate, vestibular reeducation occupies a primordial place.

Background: Corneal abrasions are a common result of eye trauma. Corneal injuries are very common in both the adult and pediatric population and account for a significant proportion of the workload of most emergency departments. Although abrasion heals well with preservative treatment, it still causes pain and job lost. The abrasion result from the scrabble of the corneal epithelium. These injuries cause pain, tearing, lids spasm, light scare, foreign body sensation, decreased visual acuity/blurring, and a gritty feeling. The light, friction & wink was worse the condition. Most abrasion cure within 24-27 hours and seldom proceed to erosion or infection. The study aims to use bandage soft contact lens [BSCL] as a primary treatment for traumatic corneal abrasion [TCA] instead of traditionally use pressure patch [PP]. Patients and methods: The present prospective study has been conducted on 50 patients attending the out-patient department of ophthalmology in an Alyarmouk teaching hospital for six months after taking ethical permission. Before subjecting the patient to the treatment of bandage soft contact lens therapy, a detailed clinical history and thorough local examination have been done. A history indicating the occurrence of recent ocular trauma followed by severe pain, redness, lids spasm, photophobia, and tearing of the involved eye is suggestive of a corneal abrasion. Always we ask about contact lens wear as this can complicate the presence of an abrasion. To confirm the diagnosis of traumatic corneal abrasion we examine the cornea by slit-lamp under cobalt-blue filtered light after the application of tetracaine eye drops & fluorescein strips. The treatment of 50 consecutive patients presenting with traumatic corneal abrasion has been treated with anesthetic eye drop (tetracaine 0.5%) to relieve pain and lids spasm, antibiotic eye drop (ofloxacin 0.3%), therapeutic bandage soft contact lens was applied to provide pain relief and once again act as a splint to promote epithelial healing, then visual acuity was measured by Snellen chart, a cycloplegic eye drop (cyclopentolate 1%) was applied to relieve ciliary spasm & then preservative-free lubricant eye drop were applied lastly. This criterion dramatically relieves most, if not all of the pain the patient may be experiencing (which is a big plus for the patient and earns instantaneous trust), but it also allows the patient to return to work/school or any other daily activities. Patients have been evaluated after 24hours, 72hours and after 1week regarding pain, visual acuity, and complications. Though pressure patch [PP] occasionally advice in abrasion therapy, it does not assist and may prevent recovery. Employ the protective eyewear can preclude the traumatic corneal abrasion. Results: A total of 50 cases were enrolled in our study during the study period of 6 months. Out of 50 patients, there were 30males and 20 females and the male/female ratio was 3:2. The patient’s age was ranged from 5-35years. The commonest cause of injury was direct minor trauma (80% of cases), with cosmetic & optical contact lenses related problems accounting for 20% of presentations, visual acuity was documented correctly in 90% of adult and pediatric group and difficult to documented in children less than 6-year-old 10%. Traumatic corneal abrasion treated with bandage soft contact lens has an apparent advantage over the traditional pressure patch in terms of reduced pain, speedier healing, and an advantage of faster rehabilitation, facilitation epithelial healing, and proper surface hydration. Evaluation of pain revealed sufficient comfort with this regimen, allowing 45 patients (90%) to go back immediately to their occupations. Moreover, visual function is retained without any complication. Healing of the traumatic corneal abrasion occurred within 1 to 3 days in all patients, with minimal or no pain. The infection did not occur at the time of the follow up. We remove the bandage soft contact lens after 1 week to allow epithelial migration and attachment without the interference of the shearing forces of the upper lid. Conclusion: The use of bandage soft contact lens as a primary treatment for a traumatic corneal abrasion is a safe and effective method with anesthetic eye drop (tetracaine 0.5%), antibiotic eye drop (ofloxacin 0. 3%), cycloplegic eye drop (cyclopentolate 1%), preservative-free lubricant drop instead of traditionally pressure patch. Bandage soft contact lens causes dramatic improvement from pain, lid spasm, tearing & visual function is retained without any complication, and patients can immediately resume their regular activities.

Background and Purpose: Transverse myelitis (TM) is a rare neurological diagnosis found in 1-4 per million people. Rehabilitation is recommended secondary to steroid treatment. There is limited clinical research on physical therapy (PT) for TM. The purpose of this case report is to present PT examination and management strategies for a patient with TM. Case Description: A 25-year-old female patient diagnosed with TM was referred to PT. She presented foot drop causing ataxic gait, decreased sensation in bilateral lower extremities, significant fatigue, and low back pain. The patient required significant rest time between all tests and measures due to severely increased fatigue. PT plan of care was focused on therapeutic exercises per patient tolerance, passive range of motion (ROM) administered by the therapist, and gait training when activity tolerance was increased. Outcomes: The patient was able to tolerate bouts of exercise as prescribed through home exercise program. She responded very well to passive ROM treatment during breaks between exercises to maintain ROM and decrease rigidity. Active ROM exercise was used to build activity tolerance while being mindful of limited ability due to fatigue. Upon increased activity tolerance, the patient was able to tolerate gait training with multiple breaks and maintain corrected gait when addressed during treatment. Discussion: PT intervention was helpful for this patient with TM. Breaking down functional activities based on patient tolerance is important when treating people with TM. More experimental research is needed to support the benefits of PT for TM.

Fibrous dysplasia is an osteolytic lesion in which bone is replaced by an instable fibrous osseous tissue. The aim of this case report is to highlight dental rehabilitation (bone grafts to allow dental implant) on patients suffering of this condition. A 39-year-old female with a hard-traumatic event in childhood desired a dental implant rehabilitation on her teeth 19 and 30 after an orthodontic alignment. A Cone-Beam Computed Tomography (CBCT) was performed showing a massive radiopaque lesion of the anterior mandible. The bone grafts and dental implants were successfully managed. A non-invasive treatment with regular follow up was chosen for this case. No evolution was noticed twenty-four month later at the follow up CBCT.