Academy of Orthopaedic Physical Therapy

American Physical Therapy Association (APTA)

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27.4 Frontiers in Orthopaedic Science
Table of Contents

THE SCIENCE OF NEUROMUSCULAR HEALING

Abstract:

The healing process begins immediately after musculoskeletal injury, enabling varying degrees of tissue repair and regeneration. Great strides have been made to support the efficacy of many physical therapy interventions on patient outcomes. However, the precise mechanisms underlying their effects on the human body are often poorly understood. Comprehension of the healing process and the way through which physical therapy interventions influence this chain of events is crucial to maximize therapeutic effects. This will allow clinicians to optimize human movement, while creatively adapting their treatment selection based on a sound understanding of the why behind each exercise, manual therapy technique, or modality. Nerve, tendon, and muscle healing are the emphasis of this monograph. Three case scenarios are included. These will test the reader's ability to apply concepts of neuromuscular healing, and comprehend their importance in optimizing patient care.

Keywords:​

regeneration, manual therapy, exercise, modalities

References:​

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INTERFACING ENGINEERING TECHNOLOGY AND REHABILITATION:
NEW FRONTIER FOR PHYSICAL THERAPY

Abstract:

Orthopaedic physical therapy uses a management approach focused on accelerating recovery after injury or disease. While physical therapists use a repertoire of techniques to manage different musculoskeletal conditions, there is still much to be learned about how physical therapy interventions can be applied to optimally link structure and function of the human movement system. Gaps in our understanding can be partially attributed to the fact that quantifying the impact of physical therapy applications at the molecular, cellular, and systems levels is complex and mostly unknown. In this monograph, we review concepts of sensing technologies and robotic interfaces that hold great promise in addressing our knowledge gaps, as well as expanding the possibilities of how physical therapy can evaluate, treat, and monitor complex interactions within the human movement system following disease or injury. Indeed, physical therapists will be vital in providing critical information for design and development of future generation of sensing technologies and robot interfaces, which will further enhance orthopaedic practice. Rather than the passive consumer of these technologies, physical therapists must evolve into proactive partners, working with engineers, to induce discoveries that will optimize best practice principles for our patients.

Keywords:​

sensors, robots, orthopaedic physical therapy

References:​

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REGENERATIVE REHABILITATION

Abstract:

Recent advancement of science and technology promotes the development of regenerative medicine. Many clinical trials have already begun for patients with diseases such that no appropriate treatment is currently available. The importance of the role of rehabilitation in regenerative medicine is gaining recognition, and developing as a new field called regenerative rehabilitation. Three basic elements, namely cells, scaffolds, and growth factors are essential in regenerative medicine. In order to facilitate comprehension of these elements, this monograph introduces information on stem cell biology and tissue engineering as well as the latest trends in regenerative medicine technologies in orthopaedics. Further, this monograph describes the potential of regenerative rehabilitation with several examples in vitro and in vivo studies. Regenerative rehabilitation is expected to be a promising attribute to maximize the tissue regeneration and functional restoration in regenerative medicine. We hope many physical therapists have an interest in this attractive field and they develop it and deliver the benefits to patients in need.

Keywords:​

regenerative medicine, cell biology, tissue engineering, mechanical stimuli

References:​

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TELEHEALTH AND VIRTUAL REALITY IN MUSCULOSKELETAL PRACTICE

Abstract:

This monograph will address the current evidence, practical considerations, and future directions of innovative approaches for telehealth and virtual reality applications in musculoskeletal practice in physical therapy. The overall purpose of this monograph is to inform musculoskeletal physical therapy practitioners on advances in telehealth and virtual reality innovations that may enhance clinical practice in the digital age. Three cases are presented at the end of this monograph. The first case describes a 65-year-old man who has undergone a knee arthroplasty and desires to travel during his rehabilitation. Specific telehealth practice needs and considerations for this patient are highlighted. The second case involves a 10-year-old female from Mexico previously diagnosed as having infant cerebral paralysis spastic dystrophy. A telehealth consultation visit with a physical therapist pediatric certified specialist from the United States is described. The third case is a 25-year-old woman with status post left grade 2 talofibular ankle sprain who desires to add the Wii Fit and Kinect gaming systems to her plan of care.

Keywords:​

telerehabilitation, biosensing technology, virtual environments, orthopedics

References:​

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Frontiers in Orthopaedic Science

This series introduces the reader to the emerging fields of regenerative medicine and sensor technologies and their role in advancing orthopaedic rehabilitation.

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