Case Study – 1

51 year old male patient came with the chief complaint of pain in lower back since 3-4 months. Pt is a hotelier by occupation, and his main job is long hours of sitting. The pt was evaluated under the guidance of Dr.Rachana G. Rai by Mckenzie Protocol for Lumbar Spine. On examination, the pt was found to be responding to extension exercises with the flexion exercises worsening his pain. So the pt was diagnosed in the category of Derangement syndrome for LBP and has been given extension protocol for 2 weeks followed by flexion exercises as his pain subsided. The pt was also advised to use a Mc Kenzie Super Roll while sitting and driving long distances. The pt was discharged with both the sets of the exercises to be performed thrice to four times a day and was asked to use a lumbar roll.

Case Study – 2

58 year old Female patient coming with a chief complaint of restricted mobility in the wrist and fingers following a fall in the bathroom nearly 6 months before, due to which pt sustained a fracture in lower third of radius for which the pt had undergone surgery with closed reduction and k wire fixation. The pt has developed stiffness in her wrist with the ROM restricted to 55 degrees in both flexion and extension of the wrist. The fingers were found to have boutiennere deformity following removal of the plaster cast. The pt is currently undergoing treatment for the same with mobilisation and exercises. Pt has been taking hot-cold fomentation, which is helping her with the stiffness in the fingers.

Case Study – 3

37 year old Male patient was diagnosed with axonal sensory motor polyneuropathy (UL+LL) with evidence of carpel tunnel syndrome (L>R) was found to have muscle power in the proximal ms of both UL and LL to be 2++, elbow & wrist 3 +, knee 3,ankle DF not possible and PF 2. The main aim of the treatment was to maintain the strength of the muscles which are present. The pt was put on strengthening protocol with graded exercises , and also the pt was put on mat exercises which included in all fours positioning: weight shifts and reach outs, coming to kneeling position and than doing the same exercises as in all fours, than to have transition to half kneeling position. The pts main goal remains to minimise the risk of falls and to develop proper balance.

Case Study – 4

52 yr old Male patient diagnosed with discrete infarct in rt medulla came with the chief complaint of blurred vision, balance loss and gait deviation. The pt was evaluated on a proper neurological examination by Dr Rachana G. Rai. The pt had scored 46/56 in Berg Balance Scale and Dynamic Gait Index were 16/32.  The pts strength was 4 on the right side. The pt was then put on strengthening exs for all 4 limbs with 2 kg weight. The pt was given mat exs in all positions, balance and gait training exercises were also started with emphasis on walking on uneven surfaces and on balance board. The pt is currently continuing  the same protocol with improvements in balance and strength.

Case Study – 5

Name Patient no.5
Age 32 years
Gender Male
Treatment Status Completed
Number of Sessions 9

Patient was a case of post operative ACL reconstruction surgery following a history of fall in the bathroom. On observation, swelling (+) above right knee. On examination, painful knee flexion and limited ROM.
Before Treatment, available Knee Flexion was 0° to 100°. Treatment started with US for pain relief and mobilisation and strength training of the knee joint. Patient completed nine sessions of Physiotherapy at the end of which he was completely pain free and knee flexion increased by 15°. Home Exs Programme was given and was asked to do routine follow ups.

Case Study – 6

Name Patient no.6
Age 63 years
Gender Female
Treatment Status Completed
Number of Sessions 10 + 7
  1. Patient came with chief complains of pain in both heels since two months. Left>Right. On occasion, numbness was also present. Patient is k/c/o DM. On observation, – Genu valgum (+). On examination, severe tightness of B/L gastrocnemius and hamstring muscles (+). Treatment started with US+SWD for pain relief and stretching exercises for the plantar fascia, hams and gastroc. Patient completed ten sessions of Physiotherapy at the end of which she was completely pain free. Home Exs Programme was given.
  2. Patient came again to the clinic after four months with complains of sudden onset of low back pain radiating down to the right leg on the posterior aspect. Diagnosed with Sciatica. On observation, patient was walking with an antalgic gait. On palpation, Piriformis tenderness (+). And On Examination – B/L hamstring tightness (+). Treatment started with US+SWD+TENS for pain relief and back strengthening exercises and stretching for the piriformis & hams. Patient completed 7 sessions of Physiotherapy at the end of which she was completely pain free. Home Exs Programme was given.

Case Study – 7

Name Patient no.7
Age 16 years
Gender Female
Treatment Status Ongoing
Number of Sessions 11 till date

Patient came with chief complains of pain in the left scapular region for the past two months. Patient also informed about weakness in the left shoulder since birth. Had received paediatric physiotherapy after which patient was able to elevate shoulder. At present, patient still has weakness in the left shoulder. On examination, weakness of Supraspinatus, middle and posterior fibres of deltoid, infraspinatus, rhomboideus was found. Trick movement during abduction and elevation. Treatment started with Tens+SWD for pain relief and Stimulation and strengthening exercises for said muscles. Patient is currently undergoing the same treatment with increase in the intensity of strengthening exercises. Pain is reduced to minimal.

  • Pre treatment MMT was 2
  • At present MMT is 3

Case Study – 8

Name Mr. Pushparaj Dahiwale
Age 46 years
Gender Male
Treatment Status Completed
Number of Sessions 8

Patient came with chief complains of pain in both heels since 6 months. Right>Left. Diagnosed with Plantar Fasciitis. On examination, tightness of B/L gastrocnemius (+), no other abnormality was noted. Treatment started with US for pain relief and stretching exercises for the plantar fascia, and gastroc. Patient completed 8 sessions of Physiotherapy at the end of which he was completely pain free. Home Exs Programme was given.