Recovering from Omicron | How Physiotherapy helps to regain Strength after COVID-19?

Omicron is a variant of global concern as it has high transmissibility, though the variant causes less damage to the lungs and less severe disease when compared to other variants. In most cases, it causes severe myalgia, body pain, and lethargy, even after recovery. This is because people exercise less and become more sedentary during the pandemic, which worsens the condition. Therefore to prevent this weakness, exercising should be continued. Your physiotherapist will recommend some kind of exercises or activities that can prevent the after-effects of omicron. In this blog, we have discussed how you can manage omicron while staying at your home.

 

What causes this Post-recovery pain?

As data on Omicron is limited and gene sequencing is costly. The reason for pain might be due to inflammatory mediators that this variant is causing after recovery. And the other reason may be that this variant is affecting the musculoskeletal system more than any other variant.

 

What's the Course of Treatment?

Once recovered from the virus, the patient should take all the precautionary measures, like wearing masks and maintaining social distancing. After recovery, your physiotherapist will recommend you to take complete rest and not to exert yourself too much in daily activities, pay heed to the recovery process, not to start with heavy workouts, take one step at a time and also increase the intake of water as the body needs a lot of water during the recovery phase. If myalgia and back pain is severe in the post-recovery period, then regular stretching exercises at home can be done.

 

 

 

Breathing Exercises:

The virus affects the brain function and mind, so the best way to relax is by taking good sleep and doing breathing exercises.

 

Correct sleeping posture:

Long periods spent on the couch or in bed can exacerbate the pain, making it worse while dealing with lower back pain associated with the Omicron variant.  While sleeping and taking rest maintains the spine's natural alignment. The spine has several curves that need to be supported. Use a suitable mattress to support these curves, avoid any mattress that adds extra pressure during sleep. Place the pillow under the knees to remove tension from your back and allow for more natural alignment during sleep. 

 

Heat and cold therapy:

Your physiotherapist will also recommend heat and ice therapy. The patient can try both and use whichever makes him/her feel better. Sometimes heat therapy can have a soothing effect on sore muscles. It should be used for 20 minutes at a time. Whereas ice therapy can be used for lower back pain as it provides great relief.

 

Simple range of motion exercises and stretching exercises:

Rest is essential when you don't feel well. But staying in the same position can cause tightness of the body. To prevent tightness, while taking rest take breaks, get up and move whenever possible during the day. While in isolation or quarantine, start doing simple exercises for 10-minutes like bending and straightening the leg,  bending and straightening the elbow, or doing ankle-toe movements. As the individual is sedentary during the recovery period or isolation or work from home, muscle tightness can develop like tight hamstrings, tight back muscles, tight neck muscles, even tightness may develop in arms and legs. Stretching the foot helps relieve pain in calves while alleviating lower back pain.

Stretching exercises to prevent tightness like raising the arms into the air, slowly twisting the back. Stretching the back bringing it backward, arching the back, bending forward, touching the toes, slowly twisting the back, etc.

 

Tools to support back health:

Your physiotherapist recommends a few tools to support your back health while dealing with back pain. The foam roller is a good example. They come in all shapes, sizes, and designs, and are easy to use and adapt to wherever you have sore muscles. The person can lean on it, lie on it, or can be used by someone to roll it over the sore muscles or knots. These foam rollers increase blood flow and reduce pain and soreness by penetrating the soft tissue. These rollers can be used in the back, legs, arms, and feet, to provide relief to strained muscles.

Back massager: Back massager can be used for dealing with sore muscles, these devices loosen the muscles and can be used in multiple directions to relieve pain.

 

Omicron can be deadly, therefore prevention is essential to keep yourself healthy. Avoid becoming infected with omicron by taking the right precautions.

 

Parkinson’s Disease | How to manage it by Physiotherapy?

Parkinson's disease is a complex neurodegenerative disorder that causes motor and non-motor symptoms, including cognitive impairments. Though there is no permanent cure for Parkinson's disease, drug treatments, surgery, and other therapies are employed to relieve these symptoms. However, for most Parkinson's patients, an additional treatment method like physiotherapy is required to aid mobility and boost independence. Exercise of all types is beneficial for patients with Parkinson's disease. The physiotherapist can guide the patient through the right moves to increase mobility, strength, and balance, and help him/her remain independent. In this blog, we have discussed the physiotherapy management of patients suffering from Parkinson's disease. Given below are the benefits and exercise techniques used by a well-trained physiotherapist to manage the symptoms of Parkinson’s disease.

 

What is Parkinson's disease?

Parkinson's disease is linked to disorders of the basal ganglia, basal ganglia are a group of neurons located deep within cerebral hemispheres. The disorders include rigidity, characterized by an increase in resistance and tremors at rest. Parkinson's disease occurs due to dopaminergic cell loss within the substantia nigra, it occurs due to genetic and environmental factors.

 

Benefits of physiotherapy

The main role of the physiotherapist is to maximize the functional ability strength, endurance, flexibility, functional practice, and balance through movement rehabilitation using support and education. Physiotherapy interventions include exercises and movement strategy training.

• Maintains a good breathing pattern,
• Increases muscle strength and joint flexibility,
• Corrects and improves abnormal movement patterns and posture,
• Maintains and improves function and independence, which helps to improve a person's quality of life.

 

Physiotherapy management

The physiotherapist conducts a comprehensive evaluation of the posture, strength, flexibility, walking, endurance, balance, coordination, and attention with movement. Based on these test results physiotherapist develops an exercise program to help stay as active and as independent as possible.

Depending on the nature and severity of the condition, the treatment program is designed that focuses on activities and patient education. It consists of exercises that help to:

 

• Improve fitness level, strength, and flexibility,
• Turnover in bed more easily,
• To get in and out of bed, chairs, and cars,
• Turnover in bed more easily,
• Stand, turn, and change directions more efficiently,
• Improve the smoothness and coordination while walking.
• Improve ability to perform hand movements,
• Improve ability to climb and descend stairs and curbs,
• Perform dual tasks at a time more efficiently,
• Participate in important activities.

Exercise has been proven to maintain health and well-being in Parkinson's patients. Neuroprotection exercises focus on endurance and use of motor learning principles approaches, such as mental imagery and dual-task training. It involves complex, powerful and intensive exercises. Neuroprotection training is effective and should be introduced in the early stages, though it helps at all stages.

 

Aerobic exercises

Physical activity like aerobic exercise helps slow down motor skill degeneration and depression. And also increases the quality of life of patients with Parkinson's. Exercises aimed to improve cardio-pulmonary functioning and improvement in biomechanics, posture, trunk and overall symmetric movement have been found of great advantage in neurodegenerative disorders.

 

Breathing exercises

Breathing exercises like inspiratory muscle training on lung functions in patients with mild-to-moderate Parkinson's are found to be effective. Respiratory complications are found to develop in many patients as their Parkinson's progresses, so attention should be given to managing the progressive weakness of respiratory muscles and rigidity of the thoracic cage. The individual is encouraged to continue being active and participate in physical exercise for as long as possible.

 

Range of motion exercises

To target both motor and non-motor symptoms, correct and proper movement is achieved by improving range of movement and physical capacity in daily activities by walking, incorporating manual activities like holding, grasping, etc.

 

Strengthening exercises

Strengthening exercises are given against an external resistance like weight machines, weight cuffs, therapeutic putty, cycle ergometer, elastic, etc. This also improves balance, overall physical performance. As muscle weakness is a major problem for patients with Parkinson's disease, depending on the stage of the disease, the physiotherapist recommends resistance exercises with light dumbbells or resistance bands. Hydrotherapy, water resistance can also be used to strengthen muscles.

 

Stretching and Flexibility

Parkinson's disease patients tend to develop tightness in the hip flexor, hamstring, calf muscles, etc. To decrease this stiffness, stretching exercises are given at frequent intervals throughout the day.

 

Executing a dual-task

Motor-Cognitive dual-Task training improves dual-task ability and can also improve gait, balance, and cognition. Dual-task like talking while walking is difficult in patients with Parkinson's.

 

Progressive resistance training (PRT)         

Progressive resistance training (PRT) is used to be effective in decreasing bradykinesia and improving functional performance in patients with mild-to-moderate Parkinson's disease.

 

Reciprocal Patterns

Reciprocal movements include left-to-right or side-to-side patterns, such as swinging the arms while taking steps while walking. Parkinson's disease may affect these patterns. The physiotherapist may help reinforce reciprocal patterns by the use of a stationary bike or an elliptical machine, also incorporate walking by keeping in mind the swinging of the arms.

 

Balance Work

Normal balance is an interplay among the visual feedback, the inner ear which helps orient, and how the feet sense the ground beneath them. Parkinson's disease can affect this balance system, making the gait unstable. Gait training can help to improve balance. Physiotherapy combines cognitive movement strategies, cueing techniques, balance exercises, and physical activities. Immediate effects of external cueing and attention can be seen on improving step length, freezing, and turning during walking tasks, and in activities of daily living.

To deliver a patient-centered treatment, it's important to provide patient education, discuss the options, and have an interactive session. Good communication and educating the patient are important as delivering an intervention.

 

Cardiac Rehabilitation | Best Exercises after Heart Surgery

After the cardiac surgery, patients usually experience pain in the chest area, fatigue, and decreased exercise tolerance till recovery. So to enhance the process of recovery and promote independence, Physiotherapy plays a very crucial role. In this blog, we will be discussing the benefits of physiotherapy in patients who have undergone cardiac surgery.

 

Cardiac Surgery

Cardiac surgery is done if a person has coronary artery, ventricular aneurysms, rhythm disorders, or valve disease. Symptoms of the cardiac problem include shortness of breath, chest pain, sleep apnoea, palpitation, Types of cardiac surgeries include angioplasty, CABG, valve replacement, and pacemaker.

 

1: Angioplasty:

A thin flexible tube with a balloon at the tip is inflated at the narrowed section of the artery to widen the narrowed vessel. A stent is then left in place to keep the artery widened.

2: CABG:

Coronary artery bypass graft (CABG) is done by using a blood vessel graft taken from the chest, leg, or arm to bypass the blocked or narrowed coronary artery.

3: Valve Replacement:

Valve replacement involves removing the damaged valve and replacing it with an artificial valve made of human tissue or carbon fiber.

4: Pacemaker:

The pacemaker is an electrical device that helps to regulate the heartbeat.

 

Benefits of Physiotherapy

Physiotherapy helps to promote cardiovascular fitness and independence by designing a graduated exercise program to enhance functionality.

• Reduces pain.
• Reduces fatigue.
• Increases joint range of motion.
• Increases cardiovascular fitness and endurance.
• Increases muscle strength.
• Trains for transfers, like getting out and into the wheelchair, bed, and toilet.
• Promotes activities of daily life like climbing stairs, walking.
• Promotes independence.

Cardiac Rehabilitation Exercises Consist of 3 Parts

• Warm-up or stretching exercises
• Cardio exercises
• Strengthening exercises
• Cool-down exercises

Before starting blood pressure and heart rate are checked, warm-up is done for 15 minutes, then start the main exercise end with the cooldown exercise for 10 minutes and again check the blood pressure and heart rate.

 

Warm-up:

Always warm-up for 15 minutes with light exercise e.g. walking, marching on the spot, or low-level cycling, followed by stretching of the muscles, that reduces the risk of injuries.

 

Stretching Exercises Include:

 

1: Upper back stretch

Lock the fingers together with the arms stretched in front. Lower the head forward to look at the floor with feet moving. Hold the stretch for 10-15 seconds.

2: Chest stretch

Place the hands on the lower back. Gently move the elbows towards each other by keeping the back straight and feet moving. Hold the stretch for 10-15 seconds

3: Calf stretch

Press the heel of the back leg into the floor till a gentle stretch is felt in the back of the lower leg. Adjust the position by moving the back foot further back and the hips forward in case the stretch is not felt. Hold the stretch for 10-15 secs for each leg.

4: Hamstring stretch

Stand and lean forward slightly with one leg in front of the other and hands-on the hips. Slightly bend the back leg, straighten the front leg. Lean until a stretch is felt in the back of the leg placed. Hold for 10-15 seconds. Repeat on the other leg.

5: Front of thigh stretch

Put the left hand on the wall for support. Lift the right knee in front and hold the right ankle. Keeping the back straight, push the hip forward until a gentle stretch is felt. Hold the stretch for 10-15 secs and repeat with the other leg.

5: Pulse raising activities

During the last 5 minutes of warm-up, pulse-raising activities at a slightly higher intensity like walking, marching, cycling, etc are done. This helps to increase the heart rate and prepares the person for the main exercise session.

 

Cardiovascular Exercises:

After a warm-up and stretching exercises, cardio exercises are started. These exercises strengthen the heart muscles and help them to pump harder and faster. These aerobic exercises include:

• Stationery biking
• Elliptical machine exercising
• Jumping rope
• Walking
• Jogging
• Running
• Swimming
• Dancing
• Playing sports like soccer, tennis, basketball, etc.

 

Strengthening Exercises

Strengthening exercises keep the body in shape and increase the strength for daily activities like opening a jar or carrying groceries.

 

1: Monitoring the exercise level

One should ensure that the body is not pushed too hard during the rehabilitation program, there are various ways by which this can be checked, so that the exercises are done safely and effectively, under the supervision of a trained physiotherapist.

2: Measuring your heart rate (pulse)

Heart rate is the no, of times the heart beats per minute. It is an indicator of how hard the patient is working. During exercise the heart rate increases to fulfill the demand of working muscles to supply blood and oxygen.

The heart rate can be palpated between the tendons in the middle of the wrist and the bone on the outside of the up-turned arm, about 1 inch from the base of the thumb.

• Gently place the index and middle fingers over the area, feeling a slight pulse in the heart pushes blood around the body.
• Count the number of beats that are felt for 15 secs.
• Multiply this by 4 and this will give, how many times per minute the heartbeats, this gives the heart rate.
• The heart rate should be measured soon after each exercise before it starts to slow down

There is a recommended heart rate range when the exercise is started. The target heart rate is just a guide. Certain medications, like beta-blockers, affect the way the heart rate responds to exercise. It might not increase much. In case the top end of this range is reached there is no need to worry just reduce the level.

3: Effort score

Another way of measuring how hard the exercise is, measure the level of effort and give it a score of between 1 and 10.

During the stage of recovery moderate, somewhat strong exercise is recommended, if the effort level is strong, then the exercise is too hard and needs to slow down. The exercise level should be checked and kept within comfortable limits.

4: Talk test

This is another simple way of assessing how hard the exercise is. This test can be done by asking the person to talk, if the person is able to speak in complete sentences, then the exercise level is correct. Shortness of breath or gasp indicates that exercise is too hard and needs to slow down.

 

COOLDOWN:

Cooldown exercises are done for 10 minutes to bring the body back to its resting state, this reduces the risk of dizziness or fainting that can occur due to a sudden drop in blood pressure as a result of suddenly stopping exercise. Stretching during the cool down also helps to reduce muscle soreness that may be caused by the activity. The cool-down exercise should be performed at a slower speed.

 

Wear soft-soled shoes, tracksuits and keep a bottle of water by the side.