This document discusses the management of diastasis pubic symphysis, beginning with an introduction to the condition, epidemiology, etiology, assessment, management, prognosis, and a case study. Diastasis pubic symphysis is defined as the separation of normally joined pubic bones without fracture. It is most commonly caused by pregnancy and delivery. Assessment involves pelvic x-rays and pain/functional scales. Conservative management includes pelvic support, physical therapy, and medications. Prognosis is typically good if addressed promptly with proper management. A case study demonstrates successful treatment of a woman's severe diastasis pubic symphysis over 5 weeks using these conservative approaches.
Pelvic Floor Anatomy and Physiotherapy management Fabiha Fatima
Pelvic floor Rehab is one of the most trending fields of Physiotherapy. For a Physical Therapist, knowledge of the Anatomy and function of the Pelvic floor muscles is utmost important. Here this is explained in brief.
Furthermore, the signs and symptoms of conditions that require physiotherapy are explained briefly, along with Physiotherapuetic Assessment, Goals, Kegle Exercises are explained.
I hope this helps :)
I have taken the pictures from Google Images, and information from Google and various other websites, compiled them for the purpose of class presentation. i do not own any content.
Pelvic Floor Anatomy and Physiotherapy management Fabiha Fatima
Pelvic floor Rehab is one of the most trending fields of Physiotherapy. For a Physical Therapist, knowledge of the Anatomy and function of the Pelvic floor muscles is utmost important. Here this is explained in brief.
Furthermore, the signs and symptoms of conditions that require physiotherapy are explained briefly, along with Physiotherapuetic Assessment, Goals, Kegle Exercises are explained.
I hope this helps :)
I have taken the pictures from Google Images, and information from Google and various other websites, compiled them for the purpose of class presentation. i do not own any content.
To strengthen your pelvic floor muscles, sit comfortably and squeeze the muscles 10-15 times in a row. Don't hold your breath or tighten your stomach, buttock or thigh muscles at the same time. When you get used to doing pelvic floor exercises, you can try holding each squeeze for a few seconds.
To strengthen your pelvic floor muscles, sit comfortably and squeeze the muscles 10-15 times in a row. Don't hold your breath or tighten your stomach, buttock or thigh muscles at the same time. When you get used to doing pelvic floor exercises, you can try holding each squeeze for a few seconds.
A course Review from James Moore's Sporting Hip and Groin Course - February 2016 (Highly Recommend!). Following my attendance of the course, i performed my own research on 'The Sporting Hip and Groin' and incorporated this into the course review which I presented to the Sports Science and Medicine staff at Wigan Athletic FC. Further references available upon request.
Planning and performance of a total hip replacement for a case of neglected acetabular fracture. Surgery performed by Dr.A.K.Venkatachalam of www.hipsurgery.in.
Shoulder Impingement Evidence Based Case Study Rumy Petkov
Used evidence based literature to compare laser therapy treatment versus corticosteroid injections, ultrasound, rehab exercises, and Kinesio taping to treat shoulder impingement.
Crimson Publishers - Efficacy of Core Strengthening Exercise on a Geriatric S...CrimsonpublishersMedical
Efficacy of Core Strengthening Exercise on a Geriatric Subject with Lumbar Spine Degeneration-Evidence Based Study by Subramanian ss* in Research in Medical & Engineering Sciences
Presented an in-service on the evidence behind and the application of thoracic spine manipulation to the Martinsburg VA Medical Center's rehabilitation staff including: 7 PTs, 8 PTAs, 3 OTs, and 4 students.
La hernie du sportif : diagnostic et traitement, technique mini-ainvasive -Dr...VitamineB
La hernie du sportif : diagnostic et traitement, technique mini-invasive
Par le Docteur Ulrike MUSCHAWECK
Lors de la 1ère Journée Européenne de la pubalgie
Clinique du Sport Bordeaux Mérignac
Effectiveness of Progressive Inhibition of Neuromuscular Structures (PINS) an...MusaDanazumi
Abstract- Background and aim: Lumbar disc herniation with radiculopathy has been one of the most difficult conditions to manage in orthopedic manual therapy. While there are many clinical studies concerning the standardization of surgical treatment, there is to date no standardized literatures for the most effective non-operative care for lumbar disc herniation with radiculopathy which suggest that extreme measures to ameliorate lumbar disc herniation with radiculopathy are urgently warranted. In this study, a 35 year old man who was diagnosed with lumbar disc herniation and was planned for lumbar surgery due to failure of medical interventions was successfully treated using non-operative management.
Method: The management of the patient included Progressive Inhibition of Neuromuscular Structures (PINS), Spinal Mobilization with Leg Movement (SMWLM) and Therapeutic exercises inform of lumbar stabilization and stretching exercises. The patient was seen three times in a week over the period of 6 weeks after which the patient was discharged home without having lumbar surgery. Patient was assessed before and after treatments and during one and two year follow-ups using; Visual Analogue Scale (VAS) in the back and leg, Sciatica Bothersome Index (SBI), Sciatica Frequency Index (SFI) and Rolland-Morris Disability Questionnaire (RMDQ) for sciatica.
Results: After six weeks of management the patient had decreased in functional limitation (from 19 to 6), back pain (from 8 to 0), leg pain (from 10 to 2), sciatica frequency (from 18 to 8) and sciatica bothersomeness (from 18 to 8). These outcomes were maintained after one and two year follow-ups.
Conclusion: Progressive inhibition of neuromuscular structures and spinal mobilization with leg movement are effective in the management of patients diagnosed with lumbar disc herniation with radiculopathy.
Implication: Progressive inhibition of neuromuscular structures and spinal mobilization with leg movement may be considered as useful therapeutic non-operative measures for patients diagnosed with lumbar disc herniation with radiculopathy.
Index Terms- Progressive Inhibition of Neuromuscular Structures; Spinal Mobilization with Leg Movement; Lumbar Disc Herniation with Radiculopathy.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
2. Outline
2
Introduction
Epidemiology
Aetiology
Management
Prognosis
Case Study
Conclusion
Reference
3. Introduction
• Rupture of pubic symphysis is uncommon
• Reported incidence: 1 in 300 deliveries (Snow and
Neubert, 1997)
• Mild diastasis: less than 10 mm is considered
physiological in pregnancy
• Greater separation results in tenderness and difficulty
with ambulation (Joosoph and Kwek, 2007).
3
4. Introduction:
Diagnosis can be confirmed rapidly by:
Pelvic X-ray.
Additionally, MRI serves to exclude soft tissue
injury (Graf et al, 2014).
4
5. Figure 1: Normal anatomical structure of a pelvic bone with intact pubic symphysis
5
6. Definition:
Diastasis symphysis pubis is the separation
of normally joined pubic bones, as in the
dislocation of the bones, without a
fracture. According to Kelly et al (2002).
6
7. Figure 2: X ray film of a diastasis pubic Symphysis of about 15mm
(Graf et al, 2014)
7
8. Figure 3: X ray film of a diastasis pubic Symphysis of about 60mm
(Graf et al, 2014)
8
9. Epidemiology
• The incidence of pubic diastasis is 1 out of 800
patients in post partum stage (Scriven et al,
1995).
• In the work of Wu et al (2004), a diastasis of the
symphysis pubis is a cause of pelvic girdle pain
(PGP). Overall, about 45% of all pregnant women
and 25% of all women postpartum suffers from
PGP.
9
10. Aetiology
This injury has also been associated with various
other situations like:
• Pregnancy complication
• Trauma
• Sport Injury
• Inflammatory arthritis following long-term
corticosteroid intake. (Rommens, 1997; Mulhall et
al, 2002; Tsukahara et al, 2007).
10
11. Severity Grading and Outcome Measure
Patient can be assessed and graded pre and
post management using the Clinical Scoring
scale designed by Majeed (1986). The scale is
described below:
11
12. Table 1: Clinical scoring Scale
Patient ability score
Pain
Intense, continuous at rest 0 to 5
Intense with activity 10
Tolerable, but limits activity 15
With moderate activity, abolished by rest 20
Mild, intermittent, normal activity 25
Slight, occasional or no pain 30
Maximum 30
12
13. Sitting
Painful 0 to 4
Painful if prolonged or
awkward 6
Uncomfortable 8
Free 10
Maximum 10
13
15. Walking Aids
Bedridden or almost 0 to 2
Wheelchair 4
Two crutches 6
Two sticks 8
One stick 10
No sticks 12
Maximum 12
15
16. Gait Unaideds
Cannot walk or almost 0 to 2
Shuffling small steps 4
Gross limp 6
Moderate limp Slight limp 8 -10
Normal 12
Maximum 12
16
17. Walking Distance
Bedridden or few metres 0 to 2
Very limited time and distance 4
Limited with sticks, difficult without 6
prolonged standing possible
One hour with a stick 8
One hour without sticks, slight pain or
limp 10
Normal for age and general condition 12
Maximum 12
17
18. Functional outcome (total
score)
Excellent 78 to 80
Good 70 to 77
Fair 60 to 69
Poor <60
Aggarwal et al, 2011
18
19. Table 2: Radiological outcome scores
Outcome Residual displacement
Excellent 0-5 mm
Good 6-10 mm
Fair 11-15 mm
Poor >15 mm
19
Aggarwal et al, 2011
21. Management:
Typically, a conservative treatment is performed
comprising:
• Pelvic girdle,
• Analgesia,
• Bed rest in lateral decubitus i.e. lying on his or
her side, and
• Physical therapy ( Dunbar and Ries, 2002; Jain
and Sternber, 2005; Nouta et al, 2011).
21
22. Rehabilitation
1. Bed rest
2. Deep breathing exercises
3. Isometric quadriceps contraction exercises
4. Ankle pump exercises
5. Cryotherapy
6. Soft tissue manipulation to the low back and hip
regions
7. Transcutaneous electrical nerve stimulation to the
low back and hip regions. (Okafor and Shokunbi,
2009).
22
23. Prognosis
Prognosis depends on severity of injury and it may
resolve in weeks. The condition can take from 11
weeks, 6 months or even up to 2 years postpartum
to subside. If detected on time and proper
management channelled, prognosis is good
according to Larsen et al, (2001).
23
24. A Case Report
Mrs Y was referred on account of severe pain,
inability to stand unaided and inability to neither sit
nor walk due to pain around the pelvic and gluteal
region. The history indicated that she underwent a
caesarean section after a prolonged labour at the
traditional birth attendance clinic.
24
25. A Case Report:
The surgery was done two months before
presentation at the hospital, however, several
interventions had been sought to help in the post
partum symptom of functional loss, which include
medications and help from the traditional bone
setters but to no avail.
25
26. A Case Report:
At presentation, she was helped into the cubicle
carried by two individuals with excruciating pain.
She underwent five weeks intensive physiotherapy.
After the fifth week, the pain had significantly
reduced (VAS: 1/10) and had significant functional
ability with Majeed Scoring Scale increasing to 77/
80.
26
27. Presenting Complaints:
Severe pain on the lower limbs especially the RLL
for 2 months
Inability to sit and rest on the right side of the
buttocks for 2 months
Inability to stand and walk on the right lower limb
Extreme difficulty in lying supine, prefers to lie in
side position especially on the left
27
28. Assessment revealed:
Antalgic gait with very short steps, nil foot drop
observed
Visual analogue scale (VAS): 10/10
Gluteal tenderness greatest on the right
Tenderness on the pubic symphysis
Marked hypotonicity of the right thigh muscles and
gluteal muscles.
28
29. Assessment revealed:
Marked atrophy of the thigh muscles and gluteal
muscles
Range of motion: PROM – Hip flexion/extension limited
with pain
oHip abduction/adduction limited because of
pain
oAROM – Not possible due to pain in all
ranges
Strength: not assessed because of pain.
29
30. Tests:
Walking 10 metres distance: 11 minutes
Hip Compression test: +
Hip Distraction Test: patient unable to lie supine because
of pain, laid on the left side of the body
Hip log roll: not assessed because of her position
Gaeslens’ test: not assessed
Thomas and Patrick’s test: not assessed
Flamingo’s test: not done.
30
31. Radiological Investigation
X-ray: Pelvic x ray revealed widening of
the pubic symphysis to 15mm: (normal >
7mm)
Hip joint spaces are preserved.
31
32. Summary of assessment at first visit
Table 3:Week One assessment profile
S/
N
Outcome Measure Outcome Variables Values
1 Visual Analogue Scale ( VAS) Pain 10:10
2 Clinical Scoring Scale Functional Ability 28:80
3 Walking 10 Metres distance Time 11 minutes
4 Step Length Distance 6 inches
5 Radiological Outcome Scores Residual Displacement 15mm
32
33. Treatment given includes:
• Cryotherapy,
• TENS,
• Muscle setting for quadriceps, hamstrings and
gluteal muscles, ankle pump exercises,
• Soft tissue manipulation using voltaren emulgel,
33
34. 34
Treatment given includes:
• Application of pelvic belt support,
• Ambulation using walking frame,
• Counseling on bed rest,
• Positioning and movement of lower limbs
and Psychotherapy.
35. Treatment given includes:
Treatment was progressed according to patient
tolerance and level of improvement. Patient
improved progressively as shown in the assessment
profile column in tables 4, 5, 6,7and 8. During the
week two of treatment, the gross muscle power of
the lower limbs group of muscles were assessed and
resistance exercises was commenced for all the
weak muscles.
35
36. Treatment given includes:
At the end of the third week, the walking frame was
discontinued and she ambulated unaided with
lesser degree of difficulty; also the pelvic support
was discontinued. At the end of the fourth week,
patient was referred for a check x ray which
revealed reduction in the diastasis gap to 4mm.
36
37. Treatment given includes:
The patient became more stable and highly
independent at the end of the fifth week of
management, and her appointment was
spaced out to once in a month and contact
was kept via the mobile phone.
37
38. Table 4: Week Two assessment profile
S/
N
Outcome Measure Outcome Variables Values
1 Visual Analogue Scale ( VAS) Pain 6:10
2 Clinical Scoring Scale Functional Ability 59:80
3 Walking 10 Metres distance Time 6min,58 secs
4 Step Length Distance 9 inches
5 Radiological Outcome Scores Residual Displacement NA
Further assessment of muscle power was carried out because patient
could move limbs more actively with lesser pain.
38
39. Table 5: Gross Muscle Power chart for the lower limbs
Group of Muscle Tested Lower Limbs
Right Left
Hip Adductors 3:5 3:5
Hip Abductors 1:5 1:5
Hip Flexors 3:5 3:5
Hip Extensors 3:5 3:5
Knee Flexors 3:5 3:5
Knee Extensors 3:5 3:5
Ankle Dorsiflexors 5:5 5:5
Ankle Plantarflexors 5:5 5:5
Management:
Strengthening exercise program was included.
39
40. Table 6: Week Three assessment profile Assessment:
S/N Outcome Measure Outcome Variables Values
1 Visual Analogue Scale ( VAS) Pain 4:10
2 Clinical Scoring Scale Functional Ability 68:80
3 Walking 10 Metres distance Time 38 secs
4 Step Length Distance 27 inches
5 Radiological Outcome Scores Residual Displacement NA
All the assessed gross muscle power increased to 5/5, except knee
flexors, hip abductors, flexors and extensors.
Pain localized only to the anterior pelvic and above the Piriformis
region of the right hip.
40
42. Table 8: Week Five assessment profile Assessment
S/
N
Outcome Measure Outcome Variables Values
1 Visual Analogue Scale ( VAS) Pain 1:10
2 Clinical Scoring Scale Functional Ability 77:80
3 Walking 10 Metres distance Time 23 secs
4 Step Length Distance 27 inches
5 Radiological Outcome Scores Residual Displacement 4mm
Gross muscle power in all assessed muscle group are 5/5.
Pain very mild and limited to above Piriformis region of right hip.
42
43. Conclusion:
Pubic symphysis rupture is an uncommon but often
underestimated injury after vaginal delivery that can
lead to significant chronic disability. Therefore, in case
of peripartum suprapubic pain, it is important to
consider a pubic symphyseal diastasis that requires
interdisciplinary treatment.
43
44. 44
Conclusion:
It is pertinent that clinicians should consider it
when assessing patients in the ante-natal or post-natal
period who complain of pain along the
suprapubic, sacroiliac or thigh regions. Though the
symptoms and clinical presentation are gross and
may be incapacitating, conservative medical
rehabilitation approaches are very effective.
45. References
Aggarwal S, Bali K Krishnan V, Kumar V, Meena D, Sen RK (2011). Management outcomes in pubic
diastasis: our experience with 19 patients. Journal of Orthopeadic and Surgical Research: Vol. 6. pp 21
Alessio P, Roberto B, Remo B, Dante S, Aldo G (2005). Post partum diastasis of the pubic
symphysis: a case report. ACTA Bio Medical; 76; 49-52
Becker I, Woodley SJ, Stringer MD (2010). The adult human pubic symphysis: a systematic
review. Journal of Anatomy. 217(5):475-487
Dhar S, Anderton JM. (1992). Rupture of the symphysis pubis during labour. Journal of
Clinical Orthopeadics; 283: 252-257
Diagnosis of Pelvic Girdle Pain. Available @ www.acpwh.org.uk. Accessed on 6/2/2013
Dunbar RP. (2002). Puerperal diastasis of the public symphysis. A case report. Journal of
Reproductive Medicine; 47: 581-3
45
46. References
Dunbar RP, Ries AM (2002). “Puerperal diastasis of the pubic symphysis: a case report.”
Journal of Reproductive Medicine for the Obstetrician and Gynecologist, vol. 47; no. 7, pp.
581–583
Exercise for Symphysis Pubis Dysfunction @www. mutusystem.com. Accessed on 20/6/2014
Gamble JG, Simmons SC. (1986). The Symphysis Pubis: Anatomic and Pathologic
Considerations . Clinical Orthopaedics and Related Research Feb; No. 203; 261-272
Gräf C, Sellei RM, Schrading S, Bauerschlag DO (2014). Treatment of Parturition-Induced
Rupture of Pubic Symphysis after Spontaneous Vaginal Delivery. Case Reports in Obstetrics
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