Case Description: The patient was a 42-year-old woman referred for physical therapy with a diagnosis of fibromyalgia. The physical therapist recognized that the patient's symptoms did not resemble those of fibromyalgia and recommended referral to a neurologist for further diagnostic testing.

Outcomes: The patient was referred to a neurologist, who diagnosed serotonin syndrome related to the use of citalopram. The patient was weaned off citalopram and made a successful recovery, with scores on the Oswestry Disability Index decreasing from 70% to 28% at discharge from the physical therapy treatment and to 0% at the 6-month follow-up. The patient has since returned to her prior activity level, which includes skiing, motorcycle riding, and working at her consulting firm.

Discussion: This case report demonstrates how careful evaluation by the physical therapist indicated that signs and symptoms were not consistent with fibromyalgia, and further medical evaluation revealed the actual diagnosis of serotonin syndrome.

Case Description: A 24-year-old woman was non–weight bearing for 6 weeks after right talocrural arthroscopy. Tarsal and metatarsal BMD were measured with QCT 9 weeks (before reloading) and 32 weeks (after reloading) after surgery. A 26-week progressive reloading program was completed. Change scores were calculated for BMD before reloading and BMD after reloading for the total foot (average of all tarsals and metatarsals), tarsals, metatarsals, bones of the medial column (calcaneus, navicular, cuneiforms 1 and 2, and metatarsal 1), and bones of the lateral column (calcaneus, cuboid, cuneiform 3, and metatarsals 2–5). The percent differences in BMD between the involved side and the uninvolved side were calculated.

Outcomes: Before reloading, BMD of the involved total foot was 9% lower than that on the uninvolved side. After reloading, BMD increased 22% and 21% for the total foot, 16% and 14% for the tarsals, 29% and 30% for the metatarsals, 14% and 15% for the medial column bones, and 28% and 26% for the lateral column bones on the involved and uninvolved sides, respectively. After reloading, BMD of the involved total foot remained 8% lower than that on the uninvolved side.

Discussion: The increase in BMD with reloading was not uniform across all pedal bones; the metatarsals showed a greater increase than the tarsals, and the lateral column bones showed a greater increase than the medial column bones.

Objective: Using the experience in treating a 17-year-old high school football player with a posterior dislocation, complicated by involvement of the sciatic nerve, this case report provides background information on hip dislocations and provides a description of the immediate treatment by the physician, followed by 6 weeks of immobilization, and a detailed account of the 5-month intervention.

Case Description: The patient was injured while making a tackle during a high school football game when another player fell on him from behind. The case report describes his plan of care after immediate hip reduction surgery and 6 weeks on crutches. Generally, the program utilized a progression of non–weight-bearing resistance training and stretching in the initial stages of intervention and progressed to weight-bearing activities (on land and in the pool) as the patient was able to tolerate more stress. In addition, the treatment of the sciatic nerve using electrical stimulation during treadmill walking is described.

Outcomes: The patient was seen in an outpatient physical therapy clinic an average of 2 times per week for 5 months. At the end of 5 months, results of the Lower Extremity Functional Scale (LEFS) indicated that recreational and sporting activities were within normal limits, and the patient was able to return to playing on his high school football team the next year.

Case Descriptions: Four patients (55–71 years of age) with CHF (New York Heart Association class III) participated in the rehabilitation program twice per week for 16 weeks. Outcome measures included a 6-minute walk test (6MWT), a cycle ergometer test (aerobic capacity), and a quality-of-life questionnaire.

Outcomes: Patients 1, 2, and 3 increased their aerobic capacity (17%, 25%, and 52%, respectively). Patient 4 did not complete the cycle ergometer test because of limitations associated with his pacemaker. All patients increased their 6MWT distance (117, 66, 135, and 143 m for patients 1, 2, 3, and 4, respectively). No adverse events were reported.

Discussion: The Norwegian Ullevaal Model of cardiac rehabilitation is a novel high-intensity, interval-training program. The 4 patients with CHF in this case series who participated in this program experienced improvements in physical capacity and quality of life and had no adverse events. These results are consistent with recent evidence supporting the efficacy of high-intensity interval training in people with CHF. Randomized clinical trials are needed to evaluate the clinical efficacy of this group-based, high-intensity, aerobic interval-training program for patients with CHF.