Osteomyelitis Chronic, Bone Defects
Conditions
Keywords
Pre-operative rehabilitation, Humeral head deformity, Upper limb deformity, Pre-operative rehabilitation (prehabilitation)
Brief summary
The goal of this observational study (single-patient case report) is to learn whether a structured pre-operative physical therapy rehabilitation program can improve shoulder function, reduce pain, and improve quality of life in an 11-year-old girl with humeral head and shaft deformity (post-inflammatory changes). The main questions it aims to answer are: Does shoulder range of motion and muscle strength improve after the program? Does pain and functional ability (including posture) improve after the program? Participants will: Attend 12 sessions over October-November 2025 (2 sessions/week) at the Faculty of Physical Therapy, Cairo University Receive a standardized session program that may include: TENS, low-level laser therapy, manual therapy (Spencer technique), phonophoresis PNF stretching and progressive exercises, plus scapular taping Complete evaluations at baseline, mid-program, and after the program, including goniometry (ROM), manual muscle testing, pain scale (VAS), postural assessment, and a functional ability checklist
Detailed description
This study is a single-patient case report describing the design, delivery, and observed response to a pre-operative rehabilitation program for a pediatric patient with deformity involving the humeral head and shaft. The report will document the patient's baseline presentation, the clinical reasoning used to select pre-operative rehabilitation goals, and the step-by-step rehabilitation approach used to optimize the shoulder and upper-limb condition before planned surgical management. The rehabilitation program is intended to maximize safe functional capacity pre-operatively by addressing modifiable impairments commonly associated with this condition, such as pain, limited range of motion, weakness, altered scapulohumeral mechanics, and compensatory movement patterns. The case report will describe treatment components (e.g., education, therapeutic exercise, flexibility and strengthening strategies, neuromuscular re-education, and other noninvasive physical therapy modalities as clinically indicated), how the program is progressed over time, and any precautions used to ensure age-appropriate and condition-appropriate care. To evaluate response to the program, the study will collect structured pre- and post-program measurements relevant to shoulder/upper-limb status, such as: * Pain and symptom severity * Shoulder range of motion * Muscle strength and/or functional performance * Activity limitations and functional use of the affected arm * Observed posture and movement quality (as clinically applicable) The report will also capture treatment adherence, any adverse events, and notable barriers/facilitators to participation (e.g., tolerance, fatigue, caregiver involvement). Findings will be presented descriptively to help clinicians and families understand what a pre-operative rehabilitation plan may include for a child with humeral deformity, and what types of short-term changes may be observed during the pre-surgical period.
Interventions
DEVICETranscutaneous Electrical Nerve Stimulation
a method of pain relief that uses a device to send low-voltage electrical impulses through electrodes placed on the skin
DEVICELow-Level Laser Therapy
a non-invasive medical treatment that uses low-level lasers or light-emitting diodes (LEDs) to stimulate cell function and accelerate the body's natural healing process
OTHERManual Therapy
a hands-on treatment approach
OTHERPhonophoresis
a medical procedure that uses therapeutic ultrasound to deliver topical medications through the skin and into deeper tissues
OTHERPNF stretching
is an advanced technique that combines muscle contraction and relaxation to increase flexibility and range of motion
OTHERkinesio taping
Kinesio tape will be applied to the shoulder and scapular region to support improved alignment and scapular control during movement.
Sponsors
Cairo University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Healthy volunteers
No
Inclusion criteria
\- Not applicable (case report; single patient case).
Exclusion criteria
\- Not applicable (case report; single patient case).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Range of Motion | 4 weeks | Shoulder range of motion will be assessed using a standard universal goniometer to quantify the motion of the affected upper limb. |
| Manual Muscle Testing | 4 weeks | Upper-limb and shoulder muscle strength will be assessed using standardized Manual Muscle Testing procedures. Key muscle groups around the shoulder and scapula (e.g., shoulder flexors, abductors, internal/external rotators, and scapular stabilizers) |
| Functional Ability | 4 weeks | Functional status of the affected upper limb will be assessed using the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire. The patient (with caregiver assistance as needed) will rate the difficulty of performing common daily activities and the impact of symptoms such as pain on function. Responses are summed and converted to a 0-100 score, where higher scores indicate greater disability. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pain intensity | 4 weeks | Pain intensity will be measured using a Visual Analog Scale (VAS). The patient will be asked to rate her pain by marking on a 10-cm line anchored by no pain (0) and worst pain imaginable (10). |
Countries
Egypt
Outcome results
None listed