This is my prepared ppt Now give me the PT MANAGEMENT OF ULNAR NERVE INJURY ALSO elaborate the PT MANAGEMENT OF GBS and add meralgia parasthetica

Reading File
Reading File
Running Command

python3 << 'EOF' from pptx import Presentation from pptx.util import Emu prs = Presentation("/tmp/workspace/attachments/2d80939b-efe3-4620-83c1-0c995d091949/Physiotherapy Management in the Disorders of Peripheral Nerves-1.pptx") print(f"Total slides: {len(prs.slides)}") print(f"Slide width: {prs.slide_width.inches:.2f} inches") print(f"Slide height: {prs.slide_height.inches:.2f} inches") print() for i, slide in enumerate(prs.slides, 1): print(f"--- Slide {i} (layout: {slide.slide_layout.name}) ---") for shape in slide.shapes: pos = (round(Emu(shape.left).inches, 2), round(Emu(shape.top).inches, 2)) if shape.left is not None else None size = (round(Emu(shape.width).inches, 2), round(Emu(shape.height).inches, 2)) if shape.width is not None else None print(f" Shape: {shape.name}, type: {shape.shape_type}, pos: {pos}, size: {size}") if shape.has_text_frame and shape.text_frame.text.strip(): for para in shape.text_frame.paragraphs: if para.text.strip(): # Get font info from first run font_size = None font_bold = None font_color = None if para.runs: r = para.runs[0] font_size = r.font.size.pt if r.font.size else None font_bold = r.font.bold if r.font.color and r.font.color.type: try: font_color = str(r.font.color.rgb) except: font_color = None print(f" [{font_size}pt bold={font_bold} color={font_color}] {para.text[:100]}") EOF

Running Command

python /tmp/skills/pptx/scripts/office/unpack.py "/tmp/workspace/attachments/2d80939b-efe3-4620-83c1-0c995d091949/Physiotherapy Management in the Disorders of Peripheral Nerves-1.pptx" /tmp/workspace/pn-pptx/unpacked/

Finding Sources
Finding Sources
Finding Sources
Reading File
Finding Sources
Finding Sources
Reading File
Reading File
Running Command

ls /tmp/workspace/pn-pptx/unpacked/ppt/slides/ | head -40

Running Command

python3 << 'PYEOF' # Add new slides to the existing presentation matching the existing style exactly from pptx import Presentation from pptx.util import Inches, Pt, Emu from pptx.dml.color import RGBColor from pptx.enum.text import PP_ALIGN import copy src = "/tmp/workspace/attachments/2d80939b-efe3-4620-83c1-0c995d091949/Physiotherapy Management in the Disorders of Peripheral Nerves-1.pptx" dst = "/tmp/workspace/pn-pptx/Physiotherapy_Management_Updated.pptx" prs = Presentation(src) # ── helper: read layout names ───────────────────────────────────────────────── for i, lay in enumerate(prs.slide_layouts): print(i, lay.name) PYEOF

Running Command

python3 << 'PYEOF' from pptx import Presentation from pptx.util import Inches, Pt, Emu from pptx.dml.color import RGBColor from pptx.enum.text import PP_ALIGN import copy src = "/tmp/workspace/attachments/2d80939b-efe3-4620-83c1-0c995d091949/Physiotherapy Management in the Disorders of Peripheral Nerves-1.pptx" dst = "/tmp/workspace/pn-pptx/Physiotherapy_Management_Updated.pptx" prs = Presentation(src) # Layout indices LAY_TITLE_CONTENT = 1 # "Title and Content" LAY_SECTION = 2 # "Section Header" LAY_TWO_CONTENT = 3 # "Two Content" LAY_TITLE_ONLY = 5 # "Title Only" def add_slide(prs, layout_idx): layout = prs.slide_layouts[layout_idx] slide = prs.slides.add_slide(layout) return slide def set_title(slide, text, bold=True, size=24): tf = slide.shapes.title.text_frame tf.clear() p = tf.paragraphs[0] run = p.add_run() run.text = text run.font.bold = bold run.font.size = Pt(size) def fill_content(slide, bullets, placeholder_idx=1, title_run_size=18, bullet_size=16): """Fill content placeholder. bullets = list of (text, bold, level)""" ph = slide.placeholders[placeholder_idx] tf = ph.text_frame tf.clear() first = True for (text, bold, level) in bullets: if first: p = tf.paragraphs[0] first = False else: p = tf.add_paragraph() p.level = level run = p.add_run() run.text = text run.font.bold = bold run.font.size = Pt(title_run_size if (bold and level == 0) else bullet_size) # ──────────────────────────────────────────────────────────────────────────────── # SECTION DIVIDER — Ulnar Nerve Injury # ──────────────────────────────────────────────────────────────────────────────── s = add_slide(prs, LAY_SECTION) # Section header layout has title and text placeholders for ph in s.placeholders: print(ph.placeholder_format.idx, ph.name) PYEOF

Running Command

python3 << 'PYEOF' from pptx import Presentation from pptx.util import Inches, Pt from pptx.dml.color import RGBColor src = "/tmp/workspace/attachments/2d80939b-efe3-4620-83c1-0c995d091949/Physiotherapy Management in the Disorders of Peripheral Nerves-1.pptx" dst = "/tmp/workspace/pn-pptx/Physiotherapy_Management_Updated.pptx" prs = Presentation(src) def set_ph_text(slide, ph_idx, lines): """lines = list of (text, bold, level, size)""" ph = slide.placeholders[ph_idx] tf = ph.text_frame tf.word_wrap = True tf.clear() first = True for (text, bold, level, size) in lines: if first: p = tf.paragraphs[0]; first = False else: p = tf.add_paragraph() p.level = level run = p.add_run() run.text = text run.font.bold = bold if size: run.font.size = Pt(size) # ── Slide 27: SECTION DIVIDER — Ulnar Nerve Injury ─────────────────────────── s27 = prs.slides.add_slide(prs.slide_layouts[2]) # Section Header set_ph_text(s27, 0, [("Ulnar Nerve Injury", True, 0, 32)]) set_ph_text(s27, 1, [("Physiotherapy Management", False, 0, 18)]) # ── Slide 28: Anatomy & Clinical Features ───────────────────────────────────── s28 = prs.slides.add_slide(prs.slide_layouts[1]) # Title and Content set_ph_text(s28, 0, [("Ulnar Nerve — Anatomy & Clinical Features", True, 0, 24)]) set_ph_text(s28, 1, [ ("Anatomy & Course", True, 0, 18), ("Largest unprotected nerve; C8–T1 roots; medial cord of brachial plexus", False, 1, 16), ("Courses posterior to medial epicondyle through cubital tunnel (elbow)", False, 1, 16), ("Enters hand via Guyon's canal (wrist) — between pisiform & hook of hamate", False, 1, 16), ("Innervates: flexor carpi ulnaris, medial half FDP, all intrinsic hand muscles (except LOAF), hypothenar muscles", False, 1, 15), ("Clinical Deformities", True, 0, 18), ("Claw hand (Ring & Little fingers) — intrinsic minus posture; MCP hyperextension, IP flexion", False, 1, 16), ("Froment's sign — thumb IP flexion on pinch (FPL compensates for adductor pollicis weakness)", False, 1, 16), ("Wartenberg's sign — little finger abduction at rest (palmar interosseous weakness)", False, 1, 16), ("Sensory loss: little finger, ulnar half ring finger, ulnar palm, dorsum of hand", False, 1, 16), ]) # ── Slide 29: Splinting & Protection (Ulnar) ────────────────────────────────── s29 = prs.slides.add_slide(prs.slide_layouts[1]) set_ph_text(s29, 0, [("Ulnar Nerve Injury — Splinting & Protection", True, 0, 24)]) set_ph_text(s29, 1, [ ("Lumbrical Bar Splint (Anti-Claw Splint)", True, 0, 18), ("Blocks MCP hyperextension in ring & little fingers — corrects intrinsic minus posture", False, 1, 16), ("Enables IP extension via extrinsic extensors — improves grip and finger function", False, 1, 16), ("Worn during functional activities; reviewed as reinnervation progresses", False, 1, 16), ("Elbow Splint (Cubital Tunnel)", True, 0, 18), ("Extension splint at night — maintains elbow <30° flexion", False, 1, 16), ("Prevents sustained flexion which increases ulnar nerve tension by up to 55%", False, 1, 16), ("Elbow pad/foam sleeve — protects medial epicondyle from direct pressure during day", False, 1, 16), ("Wrist Splint (Guyon's Canal Entrapment)", True, 0, 18), ("Neutral wrist splint — reduces compression at Guyon's canal for occupational ulnar nerve entrapment", False, 1, 16), ("Avoid: tight gripping tools, prolonged leaning on elbow, cycling (handlebar palsy)", False, 1, 16), ]) # ── Slide 30: Exercise Therapy (Ulnar) ──────────────────────────────────────── s30 = prs.slides.add_slide(prs.slide_layouts[1]) set_ph_text(s30, 0, [("Ulnar Nerve Injury — Exercise & Nerve Mobilization", True, 0, 24)]) set_ph_text(s30, 1, [ ("PROM — Acute/Denervation Phase", True, 0, 18), ("Daily passive ROM: MCP, PIP, DIP of ring & little fingers; wrist flexion/extension", False, 1, 16), ("Web space stretching: prevent 4th–5th web space contracture", False, 1, 16), ("Hypothenar stretch: prevent flexion contracture of little finger", False, 1, 16), ("Ulnar Nerve Gliding Exercises", True, 0, 18), ("Sequential positions: fist → finger extension → wrist extension → supination → elbow extension", False, 1, 16), ("Slider: mobilizes nerve without tension (preferred in acute phase)", False, 1, 16), ("Tensioner: applied once pain/irritability subsides to restore neural mobility", False, 1, 16), ("Progressive Strengthening (Reinnervation Phase)", True, 0, 18), ("Finger abduction/adduction (interossei): paper-grip exercises, rubber band abduction", False, 1, 16), ("Hypothenar strengthening: little finger opposition to ring, middle, index fingers progressively", False, 1, 16), ("Pinch & grip training: lateral pinch, power grip — progressive loading using therapy putty", False, 1, 16), ("Intrinsic strengthening: MCP flexion with IP extension (lumbrical pattern) using resistance", False, 1, 16), ]) # ── Slide 31: Electrotherapy & Sensory (Ulnar) ──────────────────────────────── s31 = prs.slides.add_slide(prs.slide_layouts[1]) set_ph_text(s31, 0, [("Ulnar Nerve Injury — Electrotherapy & Sensory Re-education", True, 0, 24)]) set_ph_text(s31, 1, [ ("Electrotherapy Modalities", True, 0, 18), ("NMES: Applied to hypothenar muscles, interossei, FDP (ulnar half) — retard denervation atrophy", False, 1, 16), ("TENS: Medial epicondyle / Guyon's canal — pain modulation", False, 1, 16), ("Ultrasound (pulsed): Over cubital tunnel / Guyon's canal — reduce perineural fibrosis", False, 1, 16), ("LLLT: May accelerate axonal regeneration — apply over nerve trunk", False, 1, 16), ("Sensory Re-education", True, 0, 18), ("Target areas: little finger, ulnar half of ring finger, ulnar palm, dorsal hand (ulnar)", False, 1, 16), ("Early phase: moving touch discrimination, vibration (256 Hz tuning fork), localization", False, 1, 16), ("Late phase: object identification (stereognosis) — coins, shapes; textured fabrics", False, 1, 16), ("Mirror therapy: helpful in chronic cases for cortical remapping", False, 1, 16), ("Desensitization: if hyperesthesia over medial epicondyle scar post-surgery", False, 1, 16), ]) # ── Slide 32: Functional Training & Post-Surgical (Ulnar) ───────────────────── s32 = prs.slides.add_slide(prs.slide_layouts[1]) set_ph_text(s32, 0, [("Ulnar Nerve — Functional Retraining & Post-Surgical Rehab", True, 0, 24)]) set_ph_text(s32, 1, [ ("Functional Retraining", True, 0, 18), ("Grip & dexterity tasks: jar opening, coin manipulation, pinch-grip activities", False, 1, 16), ("Writing & keyboard use: adaptive pen grips; compensatory strategies during denervation", False, 1, 16), ("ADL retraining: dressing (buttons, zips), grooming, kitchen tasks — occupational therapy integration", False, 1, 16), ("Post-Surgical Rehabilitation (Ulnar Nerve Transposition / Cubital Tunnel Release)", True, 0, 18), ("Immobilization: posterior splint elbow 90° for 1–2 weeks post-op", False, 1, 16), ("Week 2–4: gentle AROM elbow & wrist; wound care, oedema management", False, 1, 16), ("Week 4–8: Progressive strengthening, nerve gliding, scar massage over incision", False, 1, 16), ("Week 8+: Functional retraining, return-to-work program, ergonomic assessment", False, 1, 16), ("Tendon Transfer Rehab (e.g., Brand's transfer for claw correction)", True, 0, 18), ("Immobilization 3–4 weeks; progressive re-education of transferred tendon function", False, 1, 16), ("Graded retraining: motor learning of new muscle function (biofeedback, EMG-assisted)", False, 1, 16), ("Outcome measure: DASH score, grip dynamometry, Semmes-Weinstein monofilaments", False, 1, 16), ]) # ── Slide 33: SECTION DIVIDER — GBS Elaborated ──────────────────────────────── s33 = prs.slides.add_slide(prs.slide_layouts[2]) set_ph_text(s33, 0, [("Guillain-Barré Syndrome (GBS)", True, 0, 30)]) set_ph_text(s33, 1, [("Elaborated Physiotherapy Management — Across All Phases", False, 0, 18)]) # ── Slide 34: GBS Overview & Subtypes ───────────────────────────────────────── s34 = prs.slides.add_slide(prs.slide_layouts[1]) set_ph_text(s34, 0, [("GBS — Overview, Subtypes & Clinical Course", True, 0, 24)]) set_ph_text(s34, 1, [ ("Definition", True, 0, 18), ("Acute immune-mediated polyradiculoneuropathy; most common cause of acute flaccid paralysis", False, 1, 16), ("Typically follows viral/bacterial infection (Campylobacter jejuni, CMV, EBV, COVID-19)", False, 1, 16), ("Subtypes", True, 0, 18), ("AIDP (Acute Inflammatory Demyelinating Polyneuropathy): Most common; demyelination", False, 1, 16), ("AMAN (Acute Motor Axonal Neuropathy): Motor axons attacked; faster motor recovery or worse prognosis", False, 1, 16), ("AMSAN (Acute Motor Sensory Axonal Neuropathy): Both motor and sensory axons", False, 1, 16), ("MFS (Miller Fisher Syndrome): Ophthalmoplegia, ataxia, areflexia; anti-GQ1b antibodies", False, 1, 16), ("Clinical Course", True, 0, 18), ("Phase 1 — Progression (days to 4 wks): ascending weakness, nadir", False, 1, 16), ("Phase 2 — Plateau (days to weeks): stable, requires intensive supportive care", False, 1, 16), ("Phase 3 — Recovery (weeks to months/years): slow improvement; residual deficits in ~20%", False, 1, 16), ("20-30-40 Rule: FVC <20 mL/kg, MIP <30 cmH2O, MEP <40 cmH2O → ICU transfer", False, 1, 16), ]) # ── Slide 35: GBS Acute/ICU Phase ───────────────────────────────────────────── s35 = prs.slides.add_slide(prs.slide_layouts[1]) set_ph_text(s35, 0, [("GBS — Acute / ICU Phase Physiotherapy", True, 0, 24)]) set_ph_text(s35, 1, [ ("Respiratory Physiotherapy (PRIORITY)", True, 0, 18), ("Continuous monitoring: FVC every 4–6 hrs; SpO2 pulse oximetry; inspiratory/expiratory pressures", False, 1, 16), ("Positioning: 30–45° head-up; semi-Fowler's position reduces aspiration risk & aids ventilation", False, 1, 16), ("Breathing exercises: diaphragmatic breathing, incentive spirometry (if tolerated)", False, 1, 16), ("Chest PT: manual or mechanical secretion clearance — percussion, vibration, postural drainage", False, 1, 16), ("Assisted / manually assisted cough — if bulbar weakness impairs cough efficacy", False, 1, 16), ("Suction clearance: cautious — may trigger bradyarrhythmia due to autonomic instability", False, 1, 16), ("Musculoskeletal & Preventive Care", True, 0, 18), ("Passive ROM all joints q 2–4 hrs: prevent contracture during paralysis phase", False, 1, 16), ("Positioning: heel protectors, foot drop prevention (AFO or foam wedge), pillow bridging", False, 1, 16), ("DVT prophylaxis: compression stockings + passive ankle pumps; coordinate with medical team", False, 1, 16), ("Pressure area care: regular turning schedule (q 2 hrs), pressure-relieving mattress", False, 1, 16), ("Shoulder positioning: arm boards to prevent subluxation", False, 1, 16), ("Pain management: positioning, gentle TENS for neuropathic pain, cold packs", False, 1, 16), ("KEY: Monitor for autonomic instability — sudden BP swings, arrhythmias during ALL interventions", True, 0, 15), ]) # ── Slide 36: GBS Subacute Phase ────────────────────────────────────────────── s36 = prs.slides.add_slide(prs.slide_layouts[1]) set_ph_text(s36, 0, [("GBS — Subacute (Plateau/Recovery) Phase", True, 0, 24)]) set_ph_text(s36, 1, [ ("Progressive Verticalization & Mobilization", True, 0, 18), ("Tilt table: gradual upright progression (start 20–30°, advance 10–15° per session) — manage orthostatic hypotension", False, 1, 16), ("Bed mobility training: rolling, sitting up, edge-of-bed sitting with assistance", False, 1, 16), ("Transfer training: bed-to-chair, progressive weight bearing, standing with support", False, 1, 16), ("Hydrotherapy / Aquatic Therapy", True, 0, 18), ("Buoyancy offloads gravity — allows active exercise even at MRC grade 2–3", False, 1, 16), ("Warm water (33–35°C): muscle relaxation, pain relief, improved circulation", False, 1, 16), ("Gentle walking in pool, limb movements, balance training — excellent early mobilization tool", False, 1, 16), ("Strengthening & Gait Rehabilitation", True, 0, 18), ("Progressive resistive exercise as MRC grades improve: start gravity-eliminated, progress to against gravity", False, 1, 16), ("Gait retraining: parallel bars → walker → elbow crutches → walking stick → independent", False, 1, 16), ("Balance retraining: static (standing) → dynamic (weight shifts) → perturbation training", False, 1, 16), ("Cycling ergometer / task-specific training once adequate limb strength achieved", False, 1, 16), ("Fatigue Management", True, 0, 18), ("Energy conservation: activity pacing, prioritization — major long-term problem in 60–80% GBS patients", False, 1, 16), ("Graded return to activity: avoid overexertion (may worsen fatigue and recovery)", False, 1, 16), ]) # ── Slide 37: GBS Rehabilitation Phase ──────────────────────────────────────── s37 = prs.slides.add_slide(prs.slide_layouts[1]) set_ph_text(s37, 0, [("GBS — Rehabilitation & Long-term Management", True, 0, 24)]) set_ph_text(s37, 1, [ ("Sensory & Motor Re-education", True, 0, 18), ("Sensory re-education when protective sensation returns: graded textures, localization, discrimination", False, 1, 16), ("Proprioceptive training: unstable surfaces, eyes-closed balance, reaching tasks", False, 1, 16), ("Coordination & fine motor: pegboard tasks, handwriting, dexterity drills", False, 1, 16), ("Orthoses & Equipment", True, 0, 18), ("AFO (Ankle-Foot Orthosis): if foot drop persists; enables safe ambulation", False, 1, 16), ("Wrist splints / thumb splints: if upper limb weakness persists during daily activities", False, 1, 16), ("Wheelchair/mobility aids: prescribed based on residual deficit and functional need", False, 1, 16), ("ADL & Functional Independence", True, 0, 18), ("Self-care: dressing, grooming, bathing — graded independence restoration", False, 1, 16), ("Return to work/school planning: graduated reintegration; cognitive-fatigue assessment", False, 1, 16), ("Psychosocial support: anxiety, depression common — refer for counselling; group therapy", False, 1, 16), ("Outcome Measures (GBS Specific)", True, 0, 18), ("GBS Disability Scale (0–6); MRC Sumscore; FVC trends; Fatigue Severity Scale (FSS)", False, 1, 16), ("SF-36; 10-MWT; Berg Balance Scale; 6-Minute Walk Test; Functional Independence Measure (FIM)", False, 1, 16), ("Prognosis: 85% independent ambulation at 6 months; ~20% have significant residual deficits at 1 yr", False, 1, 16), ]) # ── Slide 38: SECTION DIVIDER — Meralgia Paresthetica ───────────────────────── s38 = prs.slides.add_slide(prs.slide_layouts[2]) set_ph_text(s38, 0, [("Meralgia Paresthetica", True, 0, 32)]) set_ph_text(s38, 1, [("Lateral Femoral Cutaneous Nerve Entrapment", False, 0, 18)]) # ── Slide 39: Anatomy, Etiology & Diagnosis ─────────────────────────────────── s39 = prs.slides.add_slide(prs.slide_layouts[1]) set_ph_text(s39, 0, [("Meralgia Paresthetica — Anatomy, Etiology & Diagnosis", True, 0, 24)]) set_ph_text(s39, 1, [ ("Anatomy", True, 0, 18), ("Lateral Femoral Cutaneous Nerve (LFCN): purely sensory; L2–L3 nerve roots", False, 1, 16), ("Exits lateral border of psoas → along ilium → passes under/through inguinal ligament medial to ASIS", False, 1, 16), ("Most common entrapment site: inguinal ligament just medial to ASIS", False, 1, 16), ("Supplies sensation to anterolateral thigh (anterior & posterior branches)", False, 1, 16), ("Etiology / Risk Factors", True, 0, 18), ("Obesity, pregnancy, ascites — increased abdominal girth compresses nerve", False, 1, 16), ("Tight belts, tight waistbands, tool belts, body armor — direct external compression", False, 1, 16), ("Diabetes, trauma to thigh/inguinal region, prolonged standing/walking", False, 1, 16), ("Post-surgical: appendectomy, inguinal herniorrhaphy, iliac bone graft, bariatric surgery", False, 1, 16), ("Clinical Features & Diagnosis", True, 0, 18), ("Burning pain, dysesthesia, numbness of anterolateral thigh — NO motor deficit (pure sensory nerve)", False, 1, 16), ("Aggravated by: prolonged standing, walking, leg extension, crossing legs, tight clothing", False, 1, 16), ("Tinel's sign at ASIS; pelvic compression test (lying, lateral pressure relieves symptoms)", False, 1, 16), ("Differential: L2–L3 radiculopathy, lumbar spinal stenosis, hip OA — no motor or reflex change in MP", False, 1, 16), ("EMG/NCS: sensory nerve conduction study of LFCN; ultrasound-guided nerve block confirms diagnosis", False, 1, 16), ]) # ── Slide 40: PT Management — Meralgia Paresthetica ─────────────────────────── s40 = prs.slides.add_slide(prs.slide_layouts[1]) set_ph_text(s40, 0, [("Meralgia Paresthetica — Physiotherapy Management", True, 0, 24)]) set_ph_text(s40, 1, [ ("Conservative Approach (Mainstay — condition is often self-limiting)", True, 0, 18), ("Patient education: explain benign, self-limiting nature; reassurance reduces anxiety", False, 1, 16), ("Activity modification: avoid prolonged standing, hip extension, crossing legs", False, 1, 16), ("Clothing advice: loose waistbands, avoid tool belts, loosen tight corsets/pants", False, 1, 16), ("Weight reduction program: BMI reduction relieves inguinal ligament pressure", False, 1, 16), ("Manual Therapy & Soft Tissue Techniques", True, 0, 18), ("Lumbar & hip joint mobilization: address L2–L3 stiffness contributing to nerve irritation", False, 1, 16), ("Iliopsoas/hip flexor stretching: lengthening tight structures around inguinal ligament", False, 1, 16), ("Soft tissue release: inguinal ligament region, tensor fasciae latae, quadriceps fascia", False, 1, 16), ("Neural mobilization (LFCN slider): careful nerve tensioning from hip extension with knee extension", False, 1, 16), ("Electrotherapy for Symptom Management", True, 0, 18), ("TENS: over anterolateral thigh — gate control; reduce burning pain and dysesthesia", False, 1, 16), ("IFT (Interferential Therapy): deeper modulation of pain in thigh", False, 1, 16), ("LLLT: may reduce perineural inflammation at entrapment site", False, 1, 16), ("Therapeutic Ultrasound (pulsed): over inguinal ligament entrapment site — reduce fibrosis", False, 1, 16), ]) # ── Slide 41: Meralgia — Exercise & Advanced Mx ─────────────────────────────── s41 = prs.slides.add_slide(prs.slide_layouts[1]) set_ph_text(s41, 0, [("Meralgia Paresthetica — Exercise Therapy & Special Considerations", True, 0, 24)]) set_ph_text(s41, 1, [ ("Stretching & Flexibility", True, 0, 18), ("Hip flexor / iliopsoas stretch: standing lunge stretch — relieves inguinal ligament tension", False, 1, 16), ("Sartorius stretch, TFL/IT band stretch: reduces lateral thigh compression forces", False, 1, 16), ("Lumbar extension exercises (McKenzie-based): if lumbar component contributing", False, 1, 16), ("Postural Correction", True, 0, 18), ("Anterior pelvic tilt correction: activate core (TA, multifidus), hip extensors", False, 1, 16), ("Avoid hyperlordosis: strengthening gluteals and abdominals reduces ASIS stress", False, 1, 16), ("Ergonomic modification: sitting posture — avoid deep hip flexion >90° for prolonged periods", False, 1, 16), ("Sensory Re-education & Desensitization", True, 0, 18), ("Graded desensitization if allodynia present: start with light touch (cotton), progress to textures", False, 1, 16), ("Vibration therapy (100 Hz) over anterolateral thigh: reduces neuropathic sensitization", False, 1, 16), ("Mirror therapy: if chronic with central sensitization component", False, 1, 16), ("Advanced & Surgical Considerations (for refractory cases)", True, 0, 18), ("Corticosteroid injection at ASIS: if conservative PT fails at 6–8 weeks", False, 1, 16), ("Surgical decompression (neurolysis) or neurectomy: for chronic unremitting pain", False, 1, 16), ("Post-injection PT: resume nerve mobilization and stretching within 1–2 weeks", False, 1, 16), ("Prognosis: 85–90% improve with conservative management; recurrence with weight gain/tight clothing", False, 1, 16), ]) prs.save(dst) print("Saved:", dst) print(f"Total slides now: {len(prs.slides)}") PYEOF

Running Command

python3 << 'PYEOF' # Verify the new slides from pptx import Presentation prs = Presentation("/tmp/workspace/pn-pptx/Physiotherapy_Management_Updated.pptx") print(f"Total slides: {len(prs.slides)}") for i in range(26, len(prs.slides)): slide = prs.slides[i] print(f"\n--- Slide {i+1} (layout: {slide.slide_layout.name}) ---") for shape in slide.shapes: if shape.has_text_frame and shape.text_frame.text.strip(): print(f" {shape.text_frame.text[:120]}") PYEOF

Running Command

ls -lh /tmp/workspace/pn-pptx/Physiotherapy_Management_Updated.pptx

Your updated presentation is ready with 15 new slides added after the original 26. Download it here:

Physiotherapy Management Updated

Presentation · PPTX


What Was Added (Slides 27–41)

Ulnar Nerve Injury — 6 Slides (27–32)

SlideContent
27Section Divider
28Anatomy & Clinical Features (C8–T1, cubital tunnel, Guyon's canal; claw hand, Froment's, Wartenberg's signs)
29Splinting & Protection (Lumbrical bar/anti-claw splint, elbow extension splint, elbow pad, Guyon's canal wrist splint)
30Exercise & Nerve Mobilization (PROM web space, ulnar nerve gliding slider vs. tensioner, progressive intrinsic strengthening with putty)
31Electrotherapy & Sensory Re-education (NMES hypothenar/interossei, TENS, ultrasound, LLLT; graded texture discrimination, stereognosis)
32Functional Retraining & Post-Surgical Rehab (transposition protocol week-by-week, Brand's tendon transfer re-education, DASH/grip dynamometry outcomes)

GBS — Elaborated — 5 Slides (33–37)

SlideContent
33Section Divider
34Subtypes (AIDP, AMAN, AMSAN, MFS) + Clinical phases + 20-30-40 Rule for ICU transfer
35Acute/ICU Phase (respiratory PT, FVC monitoring, secretion clearance, chest PT, PROM, pressure care, DVT prophylaxis, autonomic instability warning)
36Subacute Phase (tilt table verticalization, aquatic therapy, progressive gait ladder, balance retraining, fatigue management/energy conservation)
37Rehabilitation Phase (sensory re-education, proprioceptive training, AFO, ADL independence, psychosocial support, GBS Disability Scale, FSS, FIM)

Meralgia Paresthetica — 4 Slides (38–41)

SlideContent
38Section Divider (Lateral Femoral Cutaneous Nerve Entrapment)
39Anatomy (LFCN L2–L3, inguinal ligament entrapment medial to ASIS), Etiology (obesity, pregnancy, tight belts, post-surgical), Diagnosis (Tinel's at ASIS, pelvic compression test, differential from L2–L3 radiculopathy)
40PT Management: patient education, activity/clothing modification, manual therapy (iliopsoas stretch, inguinal ligament STR, LFCN neural mobilization), electrotherapy (TENS, IFT, LLLT, ultrasound)
41Exercise therapy (hip flexor/TFL stretching, postural correction, anterior pelvic tilt correction), desensitization/sensory re-education for allodynia, surgical escalation pathway (injection → neurolysis), prognosis 85–90% resolution
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