Casebook of Orthopedic Rehabilitation. including Virtual Reality

About this book

Highlights the uses of the computer in the field of orthopedic surgery
Details the increasing importance of virtual reality in orthopedics
Emphasizes the emerging importance of tele-rehabilitation, especially for patients in rural areas
Covers the new paradigm shift in other fields of orthopedics, like osteoporosis

This book is a companion text to Orthopedic Rehabilitation, Assessment, and Enablement by the same author, but can be used independently.

Section 1 serves to illustrate through real-life examples the rehabilitation ideas and principles taught in the companion text, ranging from conditions seen daily by the orthopedic surgeon or primary care physician like knee and hip osteoarthritis or plantar fasciitis; through more challenging conditions like hamstring injury rehabilitation or heterotrophic ossification; to recent paradigm shifts in the management of osteoporosis and new technologies like vertebral fracture assessment using state-of-the-art DXA machines, hypergravity stimulation therapy, and many more.

In Section 2, the author introduces the reader to the vast number of applications of computers in orthopedic surgery, with special emphasis on the emerging importance of virtual reality in all aspects of orthopedics, ranging from pre-operative planning, pre-operative surgical practice on virtual patients, and virtual wayfinding and navigation; through intra-operative virtual bone structure modeling to enhance accuracy; to, most importantly, post-operative or non-operative rehabilitation of orthopedic conditions using these new computer techniques. The book ends by stressing the importance of telerehabilitation, an increasingly important tool for ensuring that even patients living in remote rural areas can have the chance to participate in rehabilitation guided by a therapist through the use of a virtual environment and teleconferencing.

Written for:

Orthopedic surgeons, orthopedic nurses, physiotherapists, physiatrists

Keywords:

• Injury
• Musculoskeletal
• Physical Therapy
• Rehabilitation outcome

Contents

Section I

Case 1 New Dual-energy X-ray Absorptiometry Machines
(iDXA) and Vertebral Fracture Assessment (VFA) .. . . . . . . 3
Case 2 Hyper-gravity Stimulation Therapy .. . . . . . . . . . . . . . . . . . . . . 11
Case 3 Lady Having Difficulty in Controlling the Computer Mouse .. .. . . . . . . . . . . . 17
Case 4 Whiplash-associated Neck Disabilities .. . . . . . . . . . . . . . . . . . 21
Case 5 Sizable Cartilage Defect in a Professional Footballer .. . . . 31
Case 6 Functional Knee Complaints in a Child with Cerebral Palsy . . . . . . . . . 37
Case 7 Hamstrings Injuries in a Professional Sprinter . . . . . . . . . . . 41
Case 8 Was it Simply Tachycardia or Something More Sinister? 49
Case 9 A Lady with Intractable Heel Pain .. . . . . . . . . . . . . . . . . . . . . . 53
Case 10 Hip Swelling after Combined TBI and SCI .. . . . . . . . . . . . . . 59
Case 11 Consultation for a Third Opinion on Bone Health .. . . . . . . 67
Case 12 Was It Really Another Case of “Tennis Elbow”? .. . . . . . . . . 71
Case 13 A Patient Requesting an “Oxford Uni” for his knee OA .. . 75
Case 14 Bisphosphonates and Peri-prosthetic Osteolysis .. . . . . . . . . 79
Case 15 A Young Engineer with Disabling Sciatic Pain . . . . . . . . . . . 85
Case 16 The “Wonder Drug” Glucosamine .. . . . . . . . . . . . . . . . . . . . . . 93
Case 17 Hyaluronan for Knee OA, Facts Vs. Myths .. . . . . . . . . . . . . . 99
Case 18 High Heels Woes .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Case 19 Silent Bone Loss and Vitamin D Insufficiency .. . . . . . . . . . . 111
Case 20 A Professor Suffering from OA Knee Pain . . . . . . . . . . . . . . . 119
Case 21 New Physical Sign in Carpal Tunnel Syndrome . . . . . . . . . . 129
Case 22 Kinesiophobia .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Case 23 Breakthrough Fracture While on Bisphosphonates .. . . . . . 139
Case 24 Can Back Pain Be Predicted? .. . . . . . . . . . . . . . . . . . . . . . . . . . . 149
Case 25 Enthusiasm for “Non-fusion Technology” for Discogenic Back Pain .. . . . . . . . . 153
Case 26 Extra Busy Banker Troubled by Subacute Back Pain, Yet No Time for Physiotherapy .. . . . . . 163
Case 27 Metal-on-Metal Hip Surface Replacement .. . . . . . . . . . . . . . 171
Case 28 A Young Lady with AVN after SARS .. . . . . . . . . . . . . . . . . . . . 177
Case 29 An Athlete Going for Anterior Cruciate Ligament Reconstruction with Little Time for Rehabilitation .. . . 183
Case 30 The Office Lady with Neck, Shoulder, Arm, and Back Pain 191
Case 31 Bone Health and Space Travel .. . . . . . . . . . . . . . . . . . . . . . . . . . 197
Case 32 Crouch Gait . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201
Case 33 Non-healing Diabetes Mellitus Heel Ulcer .. . . . . . . . . . . . . . 209
Case 34 Cervical Disc Replacement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215
Case 35 Intractable Lateral Epicondylitis . . . . . . . . . . . . . . . . . . . . . . . . 221
Case 36 Chronic LBP in a Laborer Whose Job Requires Repeated Lifting . . . . . . . . . . . . . 229
Case 37 Stiffness after Flexor Tendon Repair .. . . . . . . . . . . . . . . . . . . . 237
Case 38 Postpartum Sacroiliac Joint Pain .. . . . . . . . . . . . . . . . . . . . . . . 243
Case 39 Use of Smart Materials in Orthopedics . . . . . . . . . . . . . . . . . . 249

Section II

General Introduction .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 257
Uses of the Computer in Orthopedics . . . . . . . . . . . . . . . . . . . . . . . . . . . . 258
Emerging Importance of Data Storage and Retrieval . . . . . . . . . . . . . . . 260
Why Develop Virtual Reality? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 260
Summarizing the Four Main Advantages of Virtual Reality .. . . . . . . . 261
Key Components of a Virtual Reality Platform .. . . . . . . . . . . . . . . . . . . . 262
Evolution .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 262
Forms of Virtual Reality .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 262
Modifications to Suit Training in Surgery and Rehabilitation:
Concept of Mixed or Augmented Reality .. . . . . . . . . . . . . . . . . . . . . . 263
Uses of Virtual Reality in Orthopedic Surgery and Rehabilitation .. . 263
Advances in Hardware .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 264
Advances in Software . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265
The Process of Pipeline Synchronization .. . . . . . . . . . . . . . . . . . . . . . . . . . 266
Advances in Input-output Devices .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 266
Improving Visual Effects and Depth Perception . . . . . . . . . . . . . . . . 266
Quick Scanning of 3D Objects Subsequently Used in the Virtual World .. . . . . . . . 267
Virtual 3D Sound Effects Vs. Stereo Sound Effects .. . . . . . . . . . . . . 268
Importance of the Use of Haptic and Force Feedbacks in Orthopedic Rehabilitation ... . . . . 268
Other Modalities Besides Vision, Hearing, and Force Feedbacks 271
Way Finding in Virtual Environments .. . . . . . . . . . . . . . . . . . . . . . . . . . . . 271
Different Types of Trackers .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 271
Real Life Applications .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 275
Preoperative Training of Surgeons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 275
Preoperative Planning .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 275
Intraoperative Virtual Model .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 277
Intra- or Perioperative Stability/Impingement Testing in Other Fields of Orthopedic Surgery .. . . . . . . 277
An Intraoperative Aid to the Surgeon Combined with Robotics .. . . . 279
Use of Virtual Reality in Postoperative Orthopedic Rehabilitation .. . 279
Use of Virtual Reality in Non-operative Orthopedic Rehabilitation 281
Example 1: Pain Management .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 281
Practical Case Illustration (Case 40): Virtual Reality in Burns Care for a Child .. . . . . . . . . . . 283
Example 2: Ankle Rehabilitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 286
Example 3: Training the Patient in the Use of Assistive Technology . . . . . . . . . . . . . . . . . . . . 288
Example 4: Improving Quality of Life Through the Use of Music 290 Tele-rehabilitation .. .. . . . . . . . . . 293
Literature Support of the Use of Tele-rehabilitation with a VR Platform in Hand Rehabilitation .. . . . . . 294
Combined Use of Tele-rehabilitation and Virtual Reality in Postoperative Orthopedic Conditions .. . . . . 295
Practical Case Illustration (Case 43) on Hand Rehabilitation .. . . 295
Other Clinical Applications of Virtual Reality .. . . . . . . . . . . . . . . . . . . . . 299
Cognitive Rehabilitation .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 299
Stress Reduction by the Use of VR Biofeedback .. . . . . . . . . . . . . . . . 299
As an Aid in Biopsychosocial Interventions in the Future .. . . . . . 300
Virtual Tomography .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 301
Cost Concern .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 301
The Future . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 301
Group Therapy in the Future Via a VR Platform .. . . . . . . . . . . . . . . 301
Generating the Ultimate 3D Effects .. . . . . . . . . . . . . . . . . . . . . . . . . . 301
VR and Robotics .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 302
Summary of References for Section II .. . . . . . . . . . . . . . . . . . . . . . . . . . . 303
General References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 303
Journal References .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 303
Subject Index .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 305