World Stroke Day: Managing Post Stroke Rehab by physiotherapy

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October 29 celebrated as World Stroke Day, seeks to emphasize the serious nature and high rates of stroke. This day is also observed to raise awareness about the disease prevention and therapy, ensure better survivor support and treatment. Organizations around the world have facilitated activities on this day, emphasizing education, research, and programme globally to prevent the adverse effects of stroke. The annual event was started in 2006 by the World Stroke Organization (WSO) and WSO declared stroke a public health emergency in 2010. The WSO now has an on-going campaign that serves as a year-round interface for advocacy, policy, and outreach to support strides and continue the progress made on World Stroke Day. Over 6 million people die as a result of a stroke. Stroke is the second leading cause of death throughout the world. Medical experts and health advocates across the globe share similar messages on World Stroke Day. The messages range from stressing the importance of quick action during a suspected stroke to simple tips for preventing stroke. Most stroke survivors opt for a rehabilitation program. Physiotherapists recommend the most rigorous therapy program based on age, overall health and degree of disability from stroke.

 

Why Stroke matters, Factors responsible?

A stroke occurs when the blood supply to part of your brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients. A stroke is a medical emergency, and prompt treatment is crucial. Early action can reduce brain damage and other complications. Stroke has two types i.e. ischemic strokes and Hemorrhagic stroke. Ischemic strokes are usually caused by a piece of plaque or a blood clot that blocks blood flow to the brain while sudden bleeding can cause a hemorrhagic stroke. This happens when an artery in or on top of the brain breaks open. The leaked blood causes the brain to swell, putting pressure on it that can damage brain cells. A stroke can cause lasting brain damage, long-term disability, or even death.

FAST is an acronym used as a mnemonic to help detect and enhance responsiveness to the needs of a person having stroke. The acronym stands for:

·   Facial drooping: Facial weakness can indicate a stroke. A person having a stroke, one side of their face may appear droopy.

·   Arm weakness: A stroke can cause muscle weakness, numbness and paralysis on one or both sides of body. A person may be unable to lift one arm or one are may be drifted.

·   Speech difficulties: Strokes can also affect speech and understanding. Difficult speaking or slurred speech indicates a stroke.

·   Time to call emergency services: Seeking immediate  medical help is important if a person experiences any of the above symptoms

Chances of having a stroke increase with certain risk factors associated with it. High blood pressures, Heart diseases, Diabetes, smoking, and cholesterol often increase the chances of having stroke. However adopting a healthy lifestyle, changing in eating habits, and regular exercises are the best steps that can reduce the likelihood of having a stroke.

Physiotherapy For Post Stroke Rehabilitation:

Physical Therapy plays an important role in the process of rehabilitation after stroke. As a part of the interdisciplinary team, physiotherapists work in concert with the managing doctor and other rehabilitation specialists to provide stroke patients with a comprehensive rehabilitation program. The stroke physical therapy rehabilitation program involves a dynamic process of assessment, goal-setting, treatment and evaluation; its coverage spans from the acute stage, through the rehabilitation stage, to the community stage. The whole rehabilitation program is predicated on two general components. The first includes preventive measures targeted at maintaining physical integrity and minimizing complications that will prevent or prolong functional return.

Physiotherapy is an integral component of the road to recovery from a stroke as rehabilitation continues as long as the person is showing measurable benefit from treatment and has achieved their agreed goals. Rehabilitation improves recovery of function and mobility after stroke. Post-stroke, physiotherapists begin rehabilitation in short frequent spells, focused on getting out of bed, standing and walking. This repetitive task training helps people regain movement and relearn everyday activities. Physiotherapists often work with other professionals to help you with the range of problems that stroke can cause. Physiotherapy applied early in the patient journey will improve, function, health, and independence.

Physical therapy enables people to relearn lost abilities, regain independence and reduce the risk of further strokes. Physiotherapists use assistive equipment to enhance stroke rehabilitation. Robot-assisted devices support people to walk independently while treadmill training improves walking speed and endurance. Physiotherapy helps stroke survivors incorporate the physical activity recommendations into their daily routine to reduce the risk of another stroke by up to 35%. Physiotherapists can provide circuit training, involving intensive repetition of everyday activities, to help people walk further, faster, with more independence and confidence. Integrating endurance and strength training into rehabilitation reduces disability. Core stability and exercises incorporating balance, weight-shifting and gaits improve balance after stroke.

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World Osteoporosis Day: Managing Bone Health with Physiotherapy

World Osteoporosis Day is observed on the 20th of October every year. This day is dedicated to raising awareness for early diagnosis, prevention, and treatment of Osteoporosis. World Osteoporosis Day WOD aims to make osteoporosis and fracture prevention a global health priority by reaching out to health-care professionals, patients, and the public at large. Osteoporosis is a skeletal condition, which leads to the thinning of bones, mainly due to a deficiency of minerals such as calcium. Mineral deficiency leads to reduced bone density, which is characterized by brittle bones that are prone to fractures. Individuals with osteoporosis often experience multiple fractures in the long bones of arms and legs, and in the spine. Osteoporosis hinders movement and thus causes Joint Pain and Pain in the bones. Regular exercise and good nutrition, including getting the recommended daily amounts of calcium and vitamin D, are essential for building and maintaining bone strength throughout the lifespan. Various osteoporosis treatments have been proven to reduce fractures by 30 to 50 percent.

 

Factors Responsible for Osteoporosis 

 

Genetic factors play a critical role as a risk determining factor for Osteoporosis, but dietary and lifestyle modifications can help to prevent it. Identifying early signs and symptoms can help people take tangible steps to monitor Osteoporosis. Family history, low bone density, poor levels of vitamins and minerals and some health conditions and medications contribute to osteoporosis risk. Sedentary lifestyles alcoholic consumption, dietary gaps are also associated with the risk factors of osteoporosis. Reduction in bone mineral density is a natural process after the mid-20s, but incorporating an adequate amount of calcium, proteins, and vitamin D in our everyday diet can help to reduce our risk of Osteoporosis. Older adults lose bone mass with natural aging. With age, the ability to create new bone decreases while disuse continues to occur. In women, there is a sharp decline in bone mineral density after menopause, thereby increasing the risk of osteoporosis. Thus, postmenopausal women need necessary measures to prevent osteoporosis during later years in life.

 

 

Role of Physiotherapy in treating Osteoporosis

 

Strategies to improve bone density and reduce the likelihood of falls are important in the prevention of osteoporosis. Physiotherapists have a role to play in this condition through exercise prescription, therapeutic modalities, specific techniques and education. Appropriate treatment goals can be established following a thorough assessment of signs and symptoms, risk factors for osteoporosis and functional status. Since the aim is to maximize peak bone mass in children and adolescents, participation in a variety of high-impact activities should be encouraged.

 

Physiotherapy includes certain bone-strengthening exercises, such as weight-bearing activities (including walking or jogging) or resistance training (such as weight lifting or yoga).To also help prevent further fractures, a physical therapist helps patients suffering from osteoporosis to improve balance and posture. Better control over balance will help people to prevent falls while proper posture takes unnecessary stress off the spine, which will reduce the risk of spinal fractures. A physical therapist may even help people to make changes in-home and/or office to promote a healthy recovery. Often physiotherapy teaches people safe ways to do everyday activities—from how to correctly lie down to how to sneeze properly—that will help people to avoid fractures. Physical therapy is an effective non-surgical treatment for osteoporosis that may help restore healthy movement, function, and bone strength. Physiotherapy will teach patients suffering from weak bones to exercise for bone health and ways to manage daily activities to lessen the chances of having an osteoporosis-related fracture.

https://cbphysiotherapy.in/blog/world-spine-day-managing-spine-health-with-physiotherapy

World Spine Day: Managing Spine Health with Physiotherapy

WORLD SPINE DAY

 

World Spine Day celebrates spine health annually on October 16th. The day aims to increase awareness for the prevention, diagnosis, and treatment of back pain and other spine issues. With an estimated one billion people worldwide suffering from spinal problems, it affects all age groups, from children to the elderly. It is the biggest single cause of disability on the planet. World Spine Day brings together people from all walks of life – patients, health providers, healthcare organizations, associations, and governments – to help ease the global burden of spinal disorders. World Spine day also provides a forum for on-going discussion about the burden of spinal disorders and sharing best practices. Spinal problems can be managed by the promotion of regular physical activity, encouraging good posture throughout all stages of life and teaching responsible lifting and developing healthy working conditions.

 

The Theme for World Spine Day 2020: Back on track

 

The 2020 theme for World Spine Day is ‘Back on Track’. The timely theme was inspired by the challenges of the COVID-19 pandemic, which have inevitably led to a decrease in physical activity, potentially leaving people susceptible to spinal pain. COVID-19 affecting the various people across the world followed by imposing restrictions on people’s movement has been linked to a range of health conditions. Back on Track highlights the importance of exercise, posture, movement, and good self-care to ensure a healthy spine. The activities can be as simple as ensuring to exercise daily, maintain a balanced diet, and get enough sleep. Practicing Straighten Up stretching program is also a great way to help you regain control over your health. The theme celebrates for the cause of people being able to reactivate and revitalize their bodies by getting out and focusing on effective spine care. The theme also highlights the importance of exercise, posture, movement, and good self-care to make the spine healthy.

 

 

 

 

PHYSIOTHERAPY IN MANAGING SPINAL HEALTH

 

Physiotherapists are trained in many different aspects of the spine, which are proved to be effective in managing spinal related health concerns, from rehabilitating patients with spinal cord injuries or systemic spinal conditions (such as Ankylosing Spondylitis) to treat conditions such as lower back and neck pain. Physiotherapy has a special interest in neuro-musculoskeletal conditions and treats patients with nerve irritations referred from the spine, muscle injuries and pain, and pain in all joints including the spine. Physiotherapy aims at helping regain normal movement patterns of the spine to aid in and prevent pain. This is usually carried out through joint mobilizations, soft tissue techniques, as well as teaching, improved movement through mobility, flexibility, and strengthening exercises.

 

The goal of physical therapy is to decrease back pain, increase function, and teach the patient a maintenance program to prevent future spinal problems. The patient may only need the treatment and education that patient receives during the initial assessment or the patient may need months of rehabilitation. Common forms of physical therapy include Passive physical therapy (modalities), which includes things done to the patient, such as heat application, ice packs, and electrical stimulation. While as the Active physical therapy focuses on specific exercises and stretching. For most spinal problems related to back pain treatments, active exercise is the focus of the physical therapy program. 

https://cbphysiotherapy.in/blog/world-arthritis-day-managing-arthritis-causes-prevention-treatment 

World Arthritis Day: Managing Arthritis – Causes, Prevention & Treatment.

Arthritis, the second most common rheumatologic problem is also the most frequent joint ailment affecting the quality of life with a prevalence of around 40% among the population. It is a serious disease with significant financial and socioeconomic implications. World Arthritis Day is celebrated every year on October 12th to raise awareness about one of the prevalent health conditions, as among the commonly found health conditions that come with age is perhaps arthritis (or joint pain). Arthritis describes the conditions of joint pain, where there is an inflammation in the joints that affects one or multiple joints. Most common in adults above the age of 60-65 years, joint pain cases are attributed to weak bones, excessive weight, lack of nutrients, an injury or wrong posture.

 Factors responsible for causing Arthritis 

Attributing to innumerable reasons including lifestyle changes, obesity and increasingly ageing population the prevalence and complications related to arthritis are rising. Joint pains are often neglected until it causes distress or impaired quality of life, but still a greater number of young patients are presenting with this problem. Obesity is a key modifiable factor which should not be overlooked as the joints are burdened with at least three to six times the load bearing capacity. Arthritis is progressive disorder which starts gradually and worsens with time. Though joint related problems have always been an issue related to aging, but for a variety of reasons including poor eating habits, sedentary lifestyle, consumption of body building supplements and steroids in excessive quantities, a number of younger patients have been diagnosed with joint related ailments.

How to Prevent Arthritis?

Despite the high level of public interest in knowing how to prevent arthritis, there is no single strategy for avoiding this disease. In case of autoimmune disorders such as rheumatoid arthritis it is impossible to know how to prevent arthritis because the reason for the inappropriate activity of the immune system is not yet known. However the kind of diet that contributes to a healthy weight may also provide nutritional support for healthy joints.

Naturally occurring substances in garlic, cruciferous vegetables and omega 3 fats present in fishes can reduce the inflammation of joints that is characteristic of osteoarthritis. Supplements such as glucosamine and chondroitin are commonly used to support joint health, but they seem to be most effective in the early stages of osteoarthritis. Excess body weight is one of the major risk factors for arthritis. High-impact exercises may predispose you to osteoarthritis and arthritis pain. Avoiding injuries reduce the risk of developing arthritis later in life. It has been found that regular exercises have been very effective ways to prevent arthritis. Regular exercise strengthens your whole body and helps keep your joints flexible.

How Physiotherapy can help against Arthritis?

Physiotherapy is an ideal treatment for people suffering from arthritis to help relieve pain and regain mobility. Physiotherapists are experts when it comes to assessing movement and can help show how to take proper care of your joints. Physiotherapists examine the joints that are giving trouble to the patient and the assessment helps to design the affective treatment that suits the particular need of a patient.

Treatment usually consists of an exercise program as well as advice on how to gradually increase your mobility and activity as well as how to avoid any injuries related to exercise. The various physiotherapy treatment modalities for a sufferer of arthritis depending on condition include ice and/or heat packs, TENS (transcutaneous electrical nerve stimulation) machines, hydrotherapy pools, manipulation, taping, massage, medications and acupuncture. Some patients are also prescribed splints or walking aids to help keep you independent and mobile.

 https://cbphysiotherapy.in/blog/physiotherapic-rehabilitation-in-times-of-covid-19

PHYSIOTHERAPIC -REHABILITATION IN TIMES OF COVID 19

 As the era of COVID-19 began with the global contagion engulfing the whole world, the healthcare systems across the world faced a daunting range of challenges. Scientific understanding of COVID-19 was considerably evolving since the World Health Organization declared it a “public health emergency of international concern” in late January 2020.  The combination of unpredictable patterns and incomplete knowledge meant that planning for and implementing both an immediate and sustainable long-term pandemic response was difficult—yet absolutely critical for the care of patients, employees, and organizational survival.

 

PANDEMIC CHALLENGING HEALTHWORKERS AND ROLE OF PHYSIOTHERAPY

The covid-19 pandemic landed all healthcare professionals across the world in an unprecedented situation, facing tremendous challenges to make impossible decisions and work under extreme pressures. These challenges ranged as how to allocate scant resources to equally needy patients and how to provide care for all severely unwell patients with constrained or inadequate resources.

Physiotherapists working in primary healthcare facilities played a significant role and faced huge challenges and being an established profession throughout the world had major contributions in assessing and treating the Covid-19 patients with comorbidities. Physiotherapy proved promising and beneficial in the respiratory treatment and physical rehabilitation of patients with COVID-19. Physiotherapists who practise in the ICU environment also provided airway clearance techniques for ventilated patients who show signs of inadequate airway clearance and they can assist in positioning patients with severe respiratory failure associated with COVID-19, including the use of prone position to optimize oxygenation.

 

 ADAPTING TELE-REHABILITATION AT CB PHYSIOTHERAPY IN TIMES OF COVID

Tele-Rehab has emerged as a great tool to help deliver physiotherapy services remotely to patients. Tele- Rehabilitation has significantly contributed toward the sustainable care of patients who were looking for quality care at home in the global contagion. By embracing technology, physios are now able to offer recovery & pain management sessions remotely through online channels (aka Telehealth, Virtual Physiotherapy, online Consultations, and e-Health.

At CB Physiotherapy early adoption of tele-health was of immense help in adapting to the new normal. With our Exercise Prescription software TelePT, Our Physiotherapists were quick to adapt to the new normal and help patients in their recovery while staying at home. Physiotherapists at CB Physiotherapy & across the world were able to continue delivering physio care to patients even during lockdowns & stay at home guidelines. As the experts in the respective fields, physiotherapists at CB Physiotherapy guided patients in how exercise and various home-based treatment modalities can help recovery at home. Exercise Prescription software like TelePT by CB Physiotherapy should be leveraged to provide video instructions & make understanding exercises easy for the patients. At CB Physiotherapy, we also have conducted tele physiotherapy sessions to NRIs stuck in other parts of the world.

 

TAIL PIECE

Therefore, it is very important for us to identify, recognize and appreciate the efforts and importance of physiotherapy practitioners in their contribution to delivery of healthcare. Not only that but for the general health of population, awareness needs to be created to highlight the benefits of physiotherapy and how it can help people in management of pain, maintaining mobility & improving the overall quality of life.

 

 

 

https://cbphysiotherapy.in/blog/neurological-physiotherapy-in-the-wake-of-global-pandemic-covid-19 

NEUROLOGICAL PHYSIOTHERAPY IN THE WAKE OF GLOBAL PANDEMIC (COVID 19)

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This article reviews the basic principles that underlie the subspecialty of neurological rehabilitation. Neurological rehabilitation is in many ways different from the other branches of physical rehabilitation. Neurological Physiotherapy is able to kick-start the message pathways that your brain is struggling to use, to make new pathways through repetitive actions and exercises. Many of the patients who undergo Neurological Physiotherapy can improve symptoms such as, difficulties with loss of balance, loss of hand and arm, or leg and foot function, walking, spasticity and pain. It is a process that centrally involves the disabled person in making plans and setting goals that are important and relevant to their own particular circumstances.

IMPAIRMENT DISABILITY AND HANIDCAP

These are key concepts that form the basic principles of neurological rehabilitation. The concepts were developed by the World Health Organization in 1980 and are concerned that it is worthwhile discussing the older terms in the first instance.

Impairment is just a descriptive term. It implies nothing about consequence. Examples are a right hemiparesis, left sided sensory loss, or a homonymous hemianopia. However, a right hemiparesis can obviously be relatively mild and lead to virtually no functional consequence, or can be severe and lead to a complete inability to walk. The functional consequence of impairment is the disability.  However, neurological rehabilitation goes beyond the impairment and looks at the functional consequence and tries to minimize the impact of the disability on the individual.

Thus, neurological rehabilitation mainly deals with disability. However, the concept of handicap is equally important. Handicap is the description of the social context of the disability. A person with a right hemiparesis, for example, may have a relatively mild weakness but even a limited weakness may have profound social consequences for some people. 

How it works?

By focusing on all aspects of a person's functional independence and well-being, Neuro-rehabilitation offers a series of therapies from the medications, physiotherapy, and speech and swallow therapy, psychological therapies, occupational therapies, teaching or re-training patients on mobility skills, communication processes, and other aspects of that person's daily routine. Neuro-rehabilitation also provides focuses on nutrition, psychological, and creative parts of a person's recovery.

Many neuro-rehabilitation programs, whether offered by hospitals or at private, specialized clinics, have a wide variety of specialists in many different fields to provide the most well rounded treatment of patients. These treatments, over a period of time, and often over the lifetime of a person, allow that individual and that person's family to live the most normal, independent life possible.

Neurological rehabilitation post Covid Era

The coronavirus 2019 (COVID-19) pandemic has potential to disproportionately and severely affect patients with neuromuscular disorders. In a short period of time, it has already caused reorganization of neuromuscular clinical care delivery and education, which will likely have lasting effects on the field. The  potential neuromuscular complications of COVID-19,  assessment and mitigation of COVID-19-related risk for patients with pre-existing neuromuscular disease,  guidance for management of neuro rehabilitation  therapies, practical guidance regarding neuromuscular care delivery, telemedicine, and education, and  effect on neuromuscular research.

In this rapid Review, we consider which neurological manifestations might be expected for COVID-19, given what is known about related coronaviruses and respiratory viruses more broadly.

Neurological physiotherapists are vital to the rehabilitation efforts in the acute phase of Covid 19. Neurological rehabilitation needs may be specific to the consequence of Covid 19 for most of the people suffering from different impairments and disabilities. Neurological physiotherapy in times  played a vital role in maintaining and restoring functional ability for those with disabilities and frail older people and didn’t compromised to the rehabilitation needs of people with pre-existing co-morbidities.  Neuro-rehabilitation services were adopted and evolved with changing practise environment as lock downs and public restrictions were imposed since the outbreak of Covid 19. Some reports are also highlighting some prominent neurological consequences of Covid 19 such as Guillain–Barré syndrome (GBS), stroke encephalitis, motor peripheral neuropathy and demyelinating lesions. It is imperative that a thorough neurological assessment is carried out during the rehabilitation of people post Covid 19.

 How CB Physiotherapy plays a role.

COVID-19 placed significant demands on healthcare resources and on healthcare professionals of CB Physiotherapy as it did on health care system throughout the world.  CB Physiotherapy being one of the prominent physiotherapy chains being operational at the times of Covid adopted to best practices to minimize the morbidity related to Covid 19 for patients with neurological disorders. With enhanced and amplified effort CB Physiotherapy played a vital role in mitigating the risk related to neurological disorders pertaining in the times of Covid.

During the current COVID-19 pandemic, physiotherapists at CB Physiotherapy for Neuro-rehabilitation were vigilant for neuromuscular complications that may be directly or indirectly related to coronavirus infection. CB Physiotherapy also planned to adjust their clinical practices to prevent the spread of COVID-19 and to care for patients with NMDs and the complications they experience during this time. Considering the effects of the pandemic are expected to persist for longer than several weeks, CB Physiotherapy adapted to advanced neuromuscular educational training and tele rehabilitation programs. Neuro- rehabilitation was consulted, and practitioners have to know that this may encounter in the acute setting. Given that there is limited data on neurological symptoms, health care providers at CB physio benefit from accurate and real-life data to better treat their patients.

 Latest Developments

The face of Neurorehabilitation has progressively changed in recent years. Traditional Neurorehabilitation procedures may have limited efficacy in most patients with common neurological diseases, such as stroke, Parkinson's disease, spinal cord injury, severe brain injury, spasticity, and cognitive disorders. New technologies have been reported to enhance the effectiveness of rehabilitation strategies in these conditions. They include robotic-assisted training, virtual reality, functional electro stimulation, non-invasive brain stimulation (NIBS) to enhance the intensity and quality of Neurorehabilitation, and to manipulate brain excitability and plasticity, as well as innovative approaches such as assistive technology and demotics.

The exploration of the effects of Neurorehabilitation technologies and NIBS on plasticity through the use of advanced technologies (i.e., functional MRI, near infrared spectroscopy, high-density EEG, etc.) may represent a surrogate outcome measure in the near future. On the other hand, translational and back-translational models are important to offer robust neurobiological grounds to current rehabilitative approaches to neurological disorders.

 Conclusion

A number of Neuro-Physiotherapy approaches emerged in various places around the world throughout the 20th century, each with their own rationale and strategies that could be used to encourage recovery of movement and function in patients with Central Nervous System (CNS) injury or disease Technology and innovation in the area of neuro-rehabilitation is expanding rapidly. It is difficult to predict the next chapter for Neurological Physiotherapy. Clinical and neuro-scientific research is expanding rapidly, and advances in technology such as tele-rehabilitation, motion analysis, robotics and functional electrical stimulation will no doubt influence our practice in coming years. As such in the times of global contagion like Covid 19 followed by global lockdown , Neurological rehabilitation process have countlessly evolved in its delivery process with advance practice in neuro physiotherapy covering various aspects of this discipline that include motor relearning exercise prescription and treatment approaches.