TOP 10 EXERCISES FOR MILD STROKE

Depending upon the severity of this condition, stroke can be classified as mild, moderate, and severe. Patients suffering from mild stroke have mild deficiencies in the level of consciousness, impairments in sensory and motor functioning. The purpose of this blog is to provide an exercise program for a mildly affected stroke patient, which can help him to promote strength, balance, and coordination on his own. These exercises may not need assistance but it is necessary to keep a caretaker nearby during the exercise session.

 1: Exercise to strengthen the muscles that stabilize the shoulder.

Lie on the back with your arms resting at your sides. Keep your elbow straight, lift your affected arm to shoulder level with your hand pointing to the ceiling. Raise your hand towards the ceiling, lifting your shoulder blade from the floor. Hold for 3 to 5 seconds, and then relax, allowing your shoulder blade to return to the floor. Slowly repeat the reaching motion several times. Lower your arm to rest by your side.

2. Exercise to strengthen the shoulder muscles as well as those which straighten the elbow.

Lie on your back grasp one end of an elasticized band in each hand with enough tension to provide light resistance to the exercise, but without causing undue strain. Place both hands alongside the unaffected hip, keeping your elbows as straight as possible. Move your affected arm upward in a diagonal direction, reaching out to the side, above your head, keeping your elbow straight. Your unaffected arm should remain at your side throughout the exercise. During the exercise, stretch the band so that it provides resistance. 

3. Exercise to strengthen the muscles which straighten the elbow.

Lie on your back with your arms resting at your sides and a rolled towel under the affected elbow. Bend the affected elbow and move your hand up toward your shoulder. Keep your hand up toward your shoulder. Keep your elbows resting on the towel. Hold for a few seconds. Straighten your elbow and hold. Slowly repeat several times.

4. Exercise to improve hip control preparation for walking activities.

Lie on your back, start with your unaffected leg flat on the floor and your affected leg bent. Lift your affected foot and cross your affected leg over the other leg. Lift your affected foot and un-cross, resuming the position of the previous step. Repeat the crossing and un-crossing motion several times.

5. Exercise to enhance hip and knee control.

Lie on your back, start with your knees bent, feet resting on the floor. Slowly slide the heel of your affected leg down so that the leg straightens. Slowly bring the heel of your affected leg along the floor, returning to the starting position. Keep your heel in contact with the floor throughout the exercise.

6. Exercise to improve control of knee motions for walking.

Lie on your unaffected side with the bottom knee bent for stability and your affected arm placed in front for support. Concentrate on bending and straightening your knee while keeping your hip straight

7. Exercise to improve weight shift and control for proper walking technique.

Lie on your back, start with your knees bent, feet flat on the floor, and knees close together. Lift your hips from the floor and keep them raised in the air. Slowly twist your hips from side to side. Return to center and lower your hips to the floor. Rest, repeat the motion

8. Exercise to improve balance weight shift and control to prepare for walking activities.

The starting position is on your hands and knees. Weight should be evenly distributed on arms and both legs. Rock in the diagonal direction back toward your right heel as far forward towards your left hand as possible. Repeat motion several times, slowly rocking as far as possible in each direction. Return to center. Rock in a diagonal direction to and your right hand. Move as far back as possible in each direction slowly.

9. Exercise to stimulate proper weight shift and knee control necessary for walking.

Stand with your unaffected side next to a waist-height tabletop or other firm surface. Rest your unaffected arm on the surface for support. Lift your unaffected foot from the floor so that you are standing on your affected leg. Slowly bend and straighten the leg on which you are standing through a small range of motion. Try to move smoothly, not allowing your knee to buckle when you bend, or to snap back when you straighten. Repeat the knee bending and straightening several times, slowly.

10. Exercise to stimulate proper weight shift while strengthening the hip and pelvis muscles.

Stand facing a waist-height tabletop or other firm surface for support. Shift your weight onto your right leg and lift your knee straight. Return to center with both feet on the floor. Shift your weight onto your left leg and lift your right leg out to the side keeping your back and knee straight. Repeat several times, alternating lifts.

All these exercises will also help the patient to move more steadily while walking and also improves the motor skills like fastening buttons or tying shoelaces.

Physiotherapy to avoid Hamstring Injuries

 Top 10 Stretches & Exercises To Avoid Hamstring Injuries

Hamstring injuries are common in athletes and often become a troublesome chronic condition. These injured muscles are more prone to re-injury, because of inadequate rehabilitation.  So, to prevent hamstring injury, one should always build up strength, balance, and adequate flexibility of this muscle group. This can be achieved with the help of your physiotherapist who designs a proper regimen to prevent the injury.

Mechanism of injury:

The most common causes of hamstring injury are:

·         Previous injury

·         Lack of muscle strength

·         Lack of flexibility

·         Lack of adequate warm-up

·         Fatigue

·         Imbalance

Hamstring injuries are common in all athletes, especially those who participate in kicking, running, and jumping. Usually, the injury occurs during high-speed exercises. Most hamstring injuries occur when the athlete experiences a sudden onset of pain in the posterior aspect of the thigh during strenuous exercises. The patient may describe an audible pop and pain, which refrains the athlete from participating in sports. In more severe injuries, the patient may describe falling to the ground. Milder injuries are often described as a pull or tightness in the posterior aspect of the thigh during exercise.

Prevention of hamstring injuries:

The emphasis is placed on the prevention of the injury which is achieved by following a proper regimen designed by your physiotherapist. The regimen includes

Hamstring stretching regimen

·         Single-leg hamstring stretch

Lie supine(lying on the back with face upward) with both legs flat on the bed. Loop the towel around the foot and hold the ends of the towel with your hands. Keep the knee straight and the foot pointing towards the ceiling. Pull until you feel a stretch in your back of the leg.

·         Straddle groin and hamstring stretch

Sit on the floor with both the legs straddled. Keep the knees straight with the kneecap facing the ceiling and the feet pointing towards the ceiling.  Reach forward until you feel the stretch in the hamstrings. Be careful to keep your back straight.

·         Sidesaddle and hamstring stretch

Sit on the floor with the injured leg straight, keeping the knee cap facing the ceiling and foot pointing towards the ceiling. The uninvolved leg is relaxed with the knee bent. Reach the injured leg’s ankle until a hamstring stretch is felt.

·         Pelvic tilt stretch

Sit on the edge of the chair with the injured leg resting straight. The uninjured leg is bent at 90⁰. Rest your hands on your thighs for support. With your back straight, bend forward at the hips. Lean forward until you feel the stretch.

·         Standing hamstring stretch

In a standing position bend slightly forward from your hips keeping your one heel on a small brick size block (knee of the same leg should be kept straight) and the other heel on the floor. Now bend forward and feel the stretch.

Hamstring strengthening regimen

·         Isometric hamstring curls

Sit on the floor with the uninjured leg straight. The involved leg is bent with the heel on the floor. Push the heel into the floor and then pull towards the buttocks to tighten the hamstring muscle.

·         Prone hamstring curls

Place an ankle weight on the involved leg. Lie prone, placing a pillow under the involved knee. With the foot in position, bring the heel toward the buttocks in a slow controlled manner.

·         Standing hamstring curls

Place an ankle weight on the involved leg. Stand with the feet shoulder-width apart. Holding onto support, curl the heel towards the buttock in a slow controlled manner.

·         Hamstring curl Theraband

The exercise can be performed on a prone or a standing position against Theraband resistance. The weight will be at the ankle. Curl the leg against resistance put by the Theraband by bringing the heel towards the buttock.

·         Hamstring roll-outs

Lie on your back with heels on a stability ball. Attain a bridge position by raising your hips up by pushing your heels into the ball and squeezing your gluteus muscle. Now straighten your knees and roll the ball away from your body, the shoulders, hips, knees, and ankles should be in a straight line, and then bring the ball back towards your body by bending your knees.

The regimen helps in the restoration of strength and flexibility of the hamstring muscles, which is essential for the prevention of injury.

 

Pathology of Osteoarthritis

How Osteoarthritis affects the body? Pathophysiology of Osteoarthritis

Do you suffer from swollen, painful, and restricted joint movements? Are you diagnosed with Osteoarthritis? If yes, then you should start taking treatment and should also self-educate yourself regarding this condition. After reading this blog you will be certainly able to answer the queries that you might have in your mind regarding osteoarthritis.

What is osteoarthritis?

Osteoarthritis is a chronic progressive degenerative condition of the joints, meaning that the condition will deteriorate over time as it is a continuous process. Osteoarthritis affects mainly the articular cartilage of the big weight-bearing joints of the body mainly in aged individuals. It can be broadly classified into two types.

• Primary Osteoarthritis
• Secondary Osteoarthritis

Primary osteoarthritis is due to the wear and tear changes occurring in old age in which weight-bearing joints like the hips and knees are more commonly affected. It is uncommon in non-weight-bearing joints like the shoulder and the elbow.

Secondary osteoarthritis is due to abnormal wear and tear in a joint, caused by mechanical incongruity (lack of symmetry) of the articular surfaces. This incongruity may be the result of a preceding fracture involving the articular surface or partial destruction or deformity due to a previous disease. It can arise as a consequence of other conditions such as hyperthyroidism, dislocation, hemophilia, infection (tracking into a joint from an open wound) or tuberculosis of a joint, etc.

An osteoarthritic joint might be

• Painful
• Swollen
• Stiff
• Tender on restricted movements
• Crackling or grating sound
• Bowlegs deformity (in later cases)

What changes take place in our joints due to osteoarthritis?

• Articular cartilage of the surface

The place, where 2 bones meet, is normally covered with a rubbery material called cartilage. This material allows the bones to slide over each other without causing pain. When osteoarthritis sets in, the cartilage begins to break down and undergoes degeneration. As it is cyclically loaded during movements of joints, it undergoes fatigue failure leading to the fragmentation of the surface and fibrillation (cracks and fissures). In the later stages, the cartilage gets completely eroded, exposing the sclerosed or eburnated (hard and thick) bone and the subchondral cyst is also formed (Subchondral is the layer of bone just below the cartilage in a joint, chondral refers to cartilage. Subchondral bone is a shock absorber in weight-bearing joints. It has many blood vessels supplying it with nutrients and oxygen and taking away wastes).

• Bone

The bone surfaces become hard and polished as they lose protection from the cartilage. Subchondral cysts and cavities are formed as the eburnated bones are brittle. Blood flow may be reduced by venous occlusion (blockage of a blood vessel) and the development of microemboli (small particle often a blood clot) in the subchondral vessels occurs.

And microfractures occur allowing the passage of synovial fluid into the bone tissue. There can be venous congestion (when arterial inflow is greater than venous outflow) also. The bone undergoes hypertrophy (increase in no and size) forming peripheral osteophytes (bony projections)

• Synovial membrane

The synovial membrane undergoes hyperemia (excess blood in the vessels) dry and reactive inflammatory thickening. Reduction of synovial fluid secretion results in loss of nutrition and lubrication of the articular cartilage.

• Capsule

There is degeneration of the capsule along with chronic inflammation.

• Ligaments

Ligaments become contracted or elongated.

• Muscles

Muscles undergo atrophy meaning muscle wasting due to loss of movement and function, as a result of pain

• Joint space

Joint spaces become narrow and joints become stiff. The stiffness is maximum at the end of a long rest period and loosens for few minutes during activity.

There is no permanent cure for osteoarthritis but with a good diet and exercise, you can stop the condition from progressing further. The management involves the role of Doctors, Dieticians, Pharmacists, Occupational therapists, and Physiotherapists.