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Case-Study 2

 

 
 
“A.M.” is a 76 year old, right-handed, female former assistant director of the United Way, who retired 11 years ago.

History:

On August 2007, “A.M.” was involved in a ferry accident. She was thrown on to the car deck of the ferry after it accidentally struck the dock. Within hours of the accident, “A.M.” was complaining of pain in the right buttock. She developed a persistent pain in the right groin and episodic pains in the right buttock that tracked down the back of the right leg. She noticed that the pains were made worse by climbing up stairs or when getting out of a vehicle. The pain last until she had the PST therapy (16 month). She had no history of back pain prior to the accident.


Physical Examination:

  • On August 2007, “A.M.” was involved in a ferry accident. She was thrown on to the car deck of the ferry after it accidentally struck the dock. Within hours of the accident, “A.M.” was complaining of pain in the right buttock. She developed a persistent pain in the right groin and episodic pains in the right buttock that tracked down the back of the right leg. She noticed that the pains were made worse by climbing up stairs or when getting out of a vehicle. The pain last until she had the PST therapy (16 month). She had no history of back pain prior to the accident.
  • An x-ray of the lumbar spine on September 12, 2007 (approximately one month after the ferry incident) revealed a moderate levo-convex scoliosis of the lumbar spine centered at L2 and a wedge compression fracture of L4 (one-third height loss). There was also evidence of moderately advanced facet joint arthropathy (degenerative osteoarthritis) at the L5-S1 junction and, to a lesser extent, at the L4/5 junction. Moderately advanced degenerative disc disease was also noted at L2/3.
  • Direct palpation of the right groin itself was painless and she has good movements of the hip joint itself.


Previous Therapies:

  • “A.M.” has been tried on at least two anti-inflammatories, but has either had a side effect or felt that the medications were of little benefit.
  • Eight physiotherapy treatments (ineffective)


Diagnosis:

Traumatic soft tissue injury to the right sacroiliac joint and the adjacent musculature.


Pulsed Signal Therapy (PST):

Pain Scale:


Before PST

Right after PST

6 weeks after PST

6 months after PST

Date of treatment

Jan 26, 2009

Feb 06, 2009

Mar 16, 2009

Sept 15, 2009

Intensity of pain

2

2

1

0

Frequency of pain

3

1

1

0

Rest. of Mov.

2

0

0

0

Swelling

1

1

0

0

Warming

1

1

0

0

Discolouring

0

0

0

0

Paresthesic

3

0

0

0

Explanation of ratings: 
0 = none or never
1 = slight or seldom
2 = moderate or sometimes
3 = severe or often
4 = extreme or always


Daily Function Scale:


Before PST

Right after PST

6 weeks after PST

6 months after PST

Sleep

0

0

0

0

Sitting

2

2

1

0

Standing

0

0

0

0

Driving

2

1

0

0

Walking

3

NA

2

0

Mood

NA

NA

NA

NA

Explanation of ratings: 
0 = six or more hours before the pain increases and disturbs function. 
1 = around 4 hours before the pain increases and disturbs function. 
2 = around 2 hours before the pain increases and disturbs function. 
3 = 20 min to 1 hour before the pain increases and disturbs function. 
4 = 5 min to 20 min before the pain increases and disturbs function. 
NA = not applicable


Conclusions:

  • Six months after PST, the intensity of the pain, frequency of pain, paresthesiae decreased 100% while the restriction of movement improved 100%.
  • Patient had improvements of 100% sitting, driving and walking.


 

 

 
 
 
 
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