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Mr. T is an 80 year old patient with Crohn's disease being seen for speech therapy in the acute care unit.

The speech therapist wants to find some information on treating patients with esophageal dysphagia. She consults Rehabilitation Reference Center, keying in esophageal dysphagia. She consults the clinical review, "Dysphagia: Esophageal."  

She reads about esophageal dysphagia, including presentation, signs/symptoms, and contraindications. Then she reviews the examination of a person with esophageal dysphagia. After completing the physical and subjective examination, she goes on to read about the treatment of people with esophageal dysphagia and the precautions to take.

Note: The above referenced Clinical Review is freely accessible to all readers of the Rehabilitation Reference Center Update. 

Caring for Patients with Adhesive Capsulitis

Adhesive capsulitis (AC) is a condition characterized by capsular stiffness that limits movement of the glenohumeral joint. The unique clinical feature of AC is that mobility is restricted nearly the same in both active and passive range of motion (ROM). It can be idiopathic or be caused by a precipitating factor (e.g. injury, metabolic disorder).

Other characteristics of the condition include:

• Onset of the disorder is typically > 35 years of age
• A strong component of night pain exists in most cases
• Increased pain with rapid or unguarded movement
• Discomfort lying on the affected shoulder
• Pain easily aggravated by movement
• Global loss of active and passive ROM
• Pain at the end range in all directions
• Global loss of passive glenohumeral joint movement
• Restricted mobility in should forward flexion, abduction, internal rotation, external rotation
• Low to high level of chronic pain
• Mild to severe disability (depending on amount of restriction and pain and whether dominant arm is affected)
• Patients who present soon after capsular release will likely have improved ROM but increased acute pain and tenderness

Symptoms include pain, global loss of passive and active ROM, and disability. Physical therapy treatment typically includes joint mobilization, soft tissue mobilization, therapeutic exercise (e.g. passive and active range of motion, strengthening) and modalities (e.g. ultrasound).

You can read the Clinical Review on "Adhesive Capsulitis" by logging into your subscription of Rehabilitation Reference Center. 

Recently, the clinical review Asperger Syndrome: Physical Therapy was revised following review under the systematic literature surveillance program.

Information of value to physical therapy practice regarding Asperger Syndrome (AS) was a recent comparative research study involving adolescents with and without AS.

Conclusions drawn from the results of the research study indicate that adolescents with Asperger Syndrome have lower physical fitness scores and less physical activity than adolescents without Asperger Syndrome. In order to promote more physical activity and improved fitness in adolescents with AS, the authors of the study made the following recommendations: avoid competitive environments, keep the environment stimulation, focus on strengths, promote family activities, allow those with AS to choose the activity, and consider technology-based activities.