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Biomedical subjects

K R Flowers

Publications and source records attributed to K R Flowers.

13 recordsLinked to original sources
PubMed1996

Management of a patient with lacerations of the tendons of the extensor digitorum and extensor indicis muscles to the index finger.

The purpose of this report is to describe the management of a 30-year-old male truck driver following a zone-VI (metacarpal level) laceration of the tendons of the extensor digitorum and extensor indicis muscles to the index finger. Surgical repair was performed 6 days after the injury and was followed by a 32-day period of short-arm cast immobilization. Physical therapy was begun immediately following cast removal. At about 8 to 10 days into the rehabilitation process, we became concerned about an increasing extensor lag (active extension less than passive extension), which affected the treatment program. We hypothesized that the scar at the tendon repair site had become excessively lengthened, and we therefore discontinued all flexion stretching and emphasized active extension. Additionally, we rested the joint in extension using a static splint except during exercise. As the patient's extensor lag improved, we increased the vigor of active extension exercise to promote tendon gliding and elongate restricting adhesions. The patient regained full range of motion and was able to return to work at full duty. The immobilization period implemented postoperatively in this case represents a traditional, conservative approach. The case emphasizes the need for careful monitoring and interpretation of both active and passive range of motion following tendon repair.

Adult↗
PubMed1992

Treatment of limited shoulder motion using an elevation splint.

This article describes the management of a patient with limited shoulder range of motion (ROM) by use of an elevation splint. The limited ROM was believed to be due to structural changes in the tissues surrounding the glenohumeral joint following a Magnuson-Stack repair for anterior glenohumeral instability. The patient's ROM plateaued approximately 6 months postoperatively and did not improve with a variety of physical therapy techniques. Use of an inexpensive, easily fabricated elevation splint was begun 8 months postoperatively, and subsequent improvements in ROM were observed. The rationale and suggestions for clinical use of the splint are discussed.

Female↗
PubMed1992

Treatment of limited shoulder motion: a case study based on biomechanical considerations.

This article describes the management of a 57-year-old female patient following a fracture and dislocation of the right humeral head. The treatment of the patient involved the use of thermal agents, manual therapy, continuous passive motion, and splinting of the arm in an elevated position. We describe an approach to treatment of limited shoulder motion that is focused on identifying and applying tension to restricting structures rather than restoration of translatory gliding movements of the humeral head. Our treatment approach is based on recent data from biomechanical studies that challenge the concave-convex theory of arthrokinematic motion first described by MacConaill. We believe that tension in capsular tissues, rather than joint surface geometry, may control the translatory movements of the humeral head. The rationale for treatment involving low-load prolonged stress to tissues in the form of continuous passive motion and splinting is discussed as well as potential limitations of more brief forms of stress such as joint mobilization and manual stretching.

Biomechanical Phenomena↗
PubMed1988

String wrapping versus massage for reducing digital volume.

The purposes of this study were 1) to compare the relative effectiveness of two common methods of treating hand edema, retrograde massage and string wrapping, and 2) to compare these two methods with two techniques of combining them. Fifty-six digits of the hands of 14 subjects were studied. Because all of the subjects demonstrated generalized hand edema, comparisons of different digits of the same subject could be made on each visit. Effectiveness rankings of the treatment methods were made after each visit. A clear pattern of effectiveness emerged that suggested that superimposing massage on an already-wrapped digit was more effective than either massage or string wrapping alone. Average circumferential reductions of digits further supported the hypothesis that a combination of string wrapping and massage would be more effective than the individual string-wrapping or massage techniques. No significant difference in effectiveness was found between massage and string wrapping when used singularly.

Adult↗
PubMedDate not supplied

This little light.

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Hand↗
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Getting started.

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Hand↗
PubMedDate not supplied

Reliability.

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Clinical Competence↗
PubMedDate not supplied

Intrarater reliability of a new method and instrumentation for measuring passive supination and pronation: a preliminary study.

Because of the clinical impression that traditional forearm goniometry has several potential sources of error and is therefore inherently unreliable, a new method using a newly designed goniometer was compared with traditional forearm passive range-of-motion goniometry. The new method utilized an offset face with a plumbline design and a patient-held tubular handle. Thirty orthopedic patients (31 wrists) were measured by three experienced hand therapists in a test-retest protocol to determine the reliability of both the traditional and new methods. Both the intraclass correlation coefficients and standard error of the measure showed improved scores with the new goniometric technique, compared with the traditional one. The differences between methods may not be clinically significant.

Adult↗
PubMedDate not supplied

Trustworthy?

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Communication↗
PubMedDate not supplied

Effect of total end range time on improving passive range of motion.

The objective of this study was to test the validity of the so-called total end range time (TERT) theory. This theory claims that the amount of increase in passive range of motion (PROM) of a stiff joint is proportional to the amount of time the joint is held at its end range, or total end range time. Proximal interphalangeal joint (PIP) flexion contractures were chosen as a model upon which to test the theory. Digital extension casts were used to hold the PIPs at the end range of extension. Fifteen patients with 20 PIP flexion contractures between 15 degrees and 60 degrees volunteered for this study. All contractures resulted from primary orthopedic conditions; none arose from a central nervous system lesion. Each joint was treated by two periods of continuous casting in extension: a 6-day period and a 3-day period. Patients were randomly assigned to one of two groups. Group A subjects wore the initial casts for 6 days and the subsequent casts for 3 days. Group B subjects wore the initial casts for 3 days and the subsequent casts for 6 days. Passive range of motion changes were measured under a controlled torque PROM technique before and after each casting period. The sum of the gains in PROM for all subjects during their 6 days of casting totaled 106 degrees (chi = 5.3 degrees). The total gain during the 3 days of casting was 60 degrees (chi = 3.0 degrees). This finding was significant at the p < 0.005 level of confidence.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗