Create a patient case where one of these modalities would be beneficial to include in their POC. Modalities are :
2 Deep oscillation Therapy
3 Dry Needling Therapy
Please include impairment, subjective, and objective data to support appropriateness of modality. Then, justify why the modality you have chosen would be an ideal choice to include in the patients POC.
Here is an example
Subjective:
Patient came into physical therapy complaining of lower back pain (LBP) pointing to the R side with a pain level of 7/10 and it gets worst at night. The patient is a 35-year-old female athlete who workout every day since she competes in CrossFit (CF) games. Patient-reported having pain in her LB with certain movements. The patient stated having also radiating pain from the lower back to the buttocks-R hip, and going down to her right quadriceps (anteriorly). The patient stated that she was performing a heavy power snatch when she felt a pull on her lower back. The patient saw her Dr. and according to her MRI patient has inflammation from L1 to L4 due to bulging discs on L3-L4, stenosis, and degenerative disc disease. The patient stated that she hopes she can go back to her CF training and be able to compete soon, “I just want to get better, I miss my training”.
Impairment:
Patient presented with decreased lumbar AROM. Flexed posture with severe spasm on R hip flexors, thoracolumbar spinals, QL, quadriceps, and hamstrings. Impaired bed mobility. Decreased lumbar and abdominal strength. Decrease activation of the multifidus muscles. Oswestry disability index score of 75% indicates severe disability
Objective:
The patient present decreased Lumbar AROM with trunk flexion and lateral bending. Noted pain at end range of motion mostly with lateral bending to the L. Palpable tightness on R hip flexors, thoracolumbar paraspinlas, and R QL with tenderness at touch.
Lumbar ROM: flexion 45 degrees with pain
extension 20 degrees with mild pain
Left lat flex 16 degrees with pain and restriction
Right lat flex 22 degrees mild pain at end range
Justification:
The patient presents severe muscle restriction and lumbar ROM limitations. The patient's radiating pain symptom indicates trigger points mostly on R QL and hip flexors with severe inflammation of the nerves causing severe pain and muscle spasms. For this reason, the patient will benefit from Deep Oscillation Therapy (DOT) since it’s a technique that relaxes the muscles, enables optimal metabolism, and normalize the defective nerve function. The technique has an anti-inflammatory and edema-reduction effect and stimulates self-mobilization relieving pain. In addition, it will help to promote healing and improve the quality of the tissue. After the DOT session patient will have improved ROM of LB and a reduction of muscle spasms.
Reference
Tsaggarelis, N. (n.d.). Deep oscilation. Dr. Nick | Chiropractic, Soft Tissue Therapy, Medical Acupuncture, Sports Injury Management, Rehabilitation. Retrieved June 8, 2022, from http://www.drnick.ca/deep-oscilation
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