This case report describes the management of a 63-year-old woman with sub-acute rib cage pain following a motor vehicle accident. She was treated with 11 physical therapy sessions over 4 weeks involving manual therapy to the cervical spine, thoracic spine, and rib cage. She also received education about fear-avoidance beliefs and a home exercise program. By discharge, her pain, function, and fear had all improved significantly and her range of motion in all areas had increased. This suggests that regional interdependence between the cervical spine, thoracic spine, and rib cage may exist and that a multimodal physical therapy approach can effectively manage rib cage pain. Further research is needed to validate this hypothesis.
This case report describes the management of a 63-year-old woman with sub-acute rib cage pain following a motor vehicle accident. She was treated with 11 physical therapy sessions over 4 weeks involving manual therapy to the cervical spine, thoracic spine, and rib cage. She also received education about fear-avoidance beliefs and a home exercise program. By discharge, her pain, function, and fear had all improved significantly and her range of motion in all areas had increased. This suggests that regional interdependence between the cervical spine, thoracic spine, and rib cage may exist and that a multimodal physical therapy approach can effectively manage rib cage pain. Further research is needed to validate this hypothesis.
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This case report describes the management of a 63-year-old woman with sub-acute rib cage pain following a motor vehicle accident. She was treated with 11 physical therapy sessions over 4 weeks involving manual therapy to the cervical spine, thoracic spine, and rib cage. She also received education about fear-avoidance beliefs and a home exercise program. By discharge, her pain, function, and fear had all improved significantly and her range of motion in all areas had increased. This suggests that regional interdependence between the cervical spine, thoracic spine, and rib cage may exist and that a multimodal physical therapy approach can effectively manage rib cage pain. Further research is needed to validate this hypothesis.
Copyright:
Attribution Non-Commercial (BY-NC)
Available Formats
Download as PPT, PDF, TXT or read online from Scribd
MANAGEMENT OF A PATIENT WITH SUB-ACUTE RIB CAGE PAIN USING MANUAL PHYSICAL
THERAPY TECHNIQUES, FEAR-AVOIDANCE BELIEF EDUCATION, AND EXERCISE
Thomas S Manual Therapy Fellowship Fellow - Regis University Manual Therapy Fellowship Program Physical Therapist, Hamilton Physical Therapy, Baltimore, MD
Purpose: Procedures: Discussion:
The purpose of this case report The patient was seen 11 times over 4 weeks. Treatment The results of this case is to illustrate the potential included thrust and non-thrust manipulations directed to demonstrates the efficacy of interdependence between the the cervical spine, thoracic spine, and rib cage; stretching a multimodal physical spine and rib cage by presenting of cervical and chest wall musculature; fear-avoidance therapy treatment approach the results of a multimodal education; deep cervical flexor endurance training; and integrating education, physical therapy treatment specific exercises aimed at improving joint mobility and exercise, and manual approach directed at the range. physical therapy directed to cervical spine, thoracic spine, the cervical spine, thoracic and ribcage in the management spine, and ribcage in of rib cage pain. improving traumatic sub- acute rib cage pain in E.M. Subject: Results: E.M. was a 63 year-old woman By discharge all outcome measures including pain, Clinical Relevance: with post-MVA intense burning function, and fear had improved. And the patient reported pain in the left anterior chest The results of this case her condition to be a “great deal better” (i.e. Global study suggests that regional wall region, aggravated with Rating of Change score = +6). coughing and inhalation. interdependence between Active Range of Motion Measurements the cervical spine, thoracic Physical examination revealed Cervical Cervical Cervical Cervical Cervical Cervical Thoracic Thoracic Thoracic Thoracic spine, and rib cage may Flexion Extension Sidebend Sidebend Rotation Rotation Flexion Flexion Sidebend Sidebend limited cervical and thoracic Right Left Right Left (Level of (Level of Right Left exist. Further research is AROM and therapist perceived scapular Inferior necessary to validate this spine) scapula) cervical and thoracic segmental hypothesis. Initial 54 43 40 38 62 57 10 8 15 20 hypomobility. (degrees) D/C 60 60 60 55 70 80 20 8 20 25 (degrees)
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