World Down Syndrome Day

World Down Syndrome Day: Managing Gross Motor Skills via Physical Therapy

Since the year 2012, March 21 has been officially observed by the United Nations as a global awareness day for Down syndrome. Down Syndrome (DS) is a genetic disorder that causes a global delay in development, including motor function, language, and cognition. It is a medical condition that makes the immune system weak and patients have about a 12-fold increased risk of infectious diseases. For COIVD-19 also, Down syndrome patients are considered to be at higher risk. An early intervention presents the most benefits, as neural plasticity is at its peak in the first months of life. One of the interventions used is Physiotherapy. Physiotherapy is offered from birth to stimulate the acquisition of motor skills. It helps to strengthen the muscles, enabling the children with Down syndrome to keep their body in proper alignment and therefore prevents future health problems. 

The physiotherapist uses the following techniques for giving treatment to the Down syndrome patient:

 Relaxation:

Relaxation decreases muscular tension, improves body control, and co-ordinated movements. The treatment may include breathing control, which focuses on relaxing your upper body and breathing from your tummy. This can be used in conjunction with deep breathing which helps the muscles relax when pain is restricting breathing. Progressive muscle relaxation is another technique, which involves slowly tensing and then releasing each muscle group individually, starting with the muscles in the toes and finishing with those in the head.

 Improve Co-ordination:

Coordination is the ability to execute smooth, accurate, controlled motor responses (optimal interaction of muscle function). It is the ability to select the right muscle at the right time with proper intensity to achieve proper action (which involves the co-ordinated action of various segments, as in cases of hand-eye coordination) and general co-ordination (which involves the entire body). The physiotherapist uses the activities like hitting a balloon, rolling balls, popping bubbles, throwing into a container, throw and catch, juggling, egg and spoon race etc, to improve the coordination of the patient.

 Improve Balance:

It is well known that persons with DS are often considered floppy, clumsy, uncoordinated, and have awkward movement patterns due to balance issues. These balance challenges often follow the child into the teen years and sometimes into adulthood. The physiotherapist may use equipment such as an exercise ball or bobath ball, to improve your child's ability to hold the head erect or to maintain a sitting position. Other skills such as jumping, skipping, and dribbling a ball may be incorporated into a fun physical therapy regimen. The development of balance happens progressively, starting from various postures (control of the head from prone positions, of the trunk in the seated position, etc.), and moving on to the more refined postures found in dynamic and in in-motion balance. 

 Improve Motor function:

The Down syndrome patient has hypotonic or low muscle tone. The physiotherapist teaches the patient to move the body in appropriate ways and improves muscle tone. The therapist works on the muscles and movements which help to reach some of the milestones and prevents the child from developing problems of bad posture. Physiotherapy can play a major role in the management of children with Down syndrome, through exercises, manual therapy, and education, physiotherapists can empower people to take charge of their health and participate in their treatment.

 Improving Strength:

If the muscles are not strengthened the child can end up having a postural, gait, and greater risk of joint problems later in life from using their muscles incorrectly. The physiotherapist can teach exercises to improve and increase muscle strength, this can include crawling, climbing, wheelbarrow, pushing up through their arms in tummy line, bridging, crab walking, roll-ups, planks, games, and fun tasks that are adjusted as the child grows. Also identifies new fitness activities to reduce the risk of obesity and improve and maintain heart health.

 Improve Developmental Skills:

Physical therapists can help your child to learn motor skills such as crawling, sitting to standing, standing to sitting, pulling, and walking. They can also give training for positioning, movement, feeding, and play, and suggest changes at home to encourage movement and communication development.

 The importance of early intervention should be emphasized. Physiotherapy treatment aims to assist people to live as independently as possible.

 

Physiotherapy for moderate stroke patient

Top 10 Rehabilitation Exercises for Moderate Stroke Patient 

Are you or any of your loved ones suffering from a stroke? Do you feel depressed or frustrated, due to lack of independence? Do you miss doing the activities and hobbies you used to love? If yes, then Physical therapy has a solution for you. It can help you regain your strength and mobility. This Blog is to provide an exercise program for a moderate stroke patient in order to promote flexibility, range of motion, balance and coordination, and also decrease pain and stiffness in your body. These exercises can be done by the patient without the assistance of a physiotherapist or an assistant.

1: To enhance shoulder motion and possibly prevent shoulder pain

Lie on your back on a firm bed. Interlace your fingers with your hands resting on your stomach

Slowly raise your arms to shoulder level, keeping your elbows straight. Return your hands to the resting position on your stomach.

2: To maintain shoulder motion

Lie on your back on a firm bed. Interlace your fingers, with your hands resting on your stomach. Slowly raise your hands directly over your chest, straightening your elbows. Slowly move your hands to one side and then the other. Then bend your elbows and return your hands to a resting position on your stomach.

3: To promote motion in the pelvis, hip and knee

Lie on your back on a firm bed. Keep your interlaced fingers resting on your stomach. Bend your knees tightly together; slowly move them as far to the right as possible. Return to center. Slowly move your knees as far as possible to the left, still keeping them together. Return to center.

4: To improve motion at the hip and knee, stimulating the movements needed for walking.

Lie on your unaffected side, with your legs together. Bend and move your affected knee as far as possible towards the chest. You may need your helper’s assistance to support the leg you’re exercising. Return to starting position

5: To strengthen the muscles that straighten the elbow.

Sitting on a firm mattress or sofa, put your affected forearm flat on the surface with your palm facing down if possible. You may want to place a firm pillow under your elbow. Slowly lean your weight onto your bent elbow. Push your hand down against the support surface, straightening your elbow and sitting more upright. Slowly allow your elbow to bend, returning your forearm to the support surface. Work back and forth between the two extremities.

6: To strengthen the muscles of the wrist.

Place your forearm on a table facing upwards. Hold a lightweight water bottle or a can in your hand. Flex your wrist by bringing your palm towards your forearm. You can also do wrist extension by turning your forearm face down and bringing the back of your hand towards the forearm.

7: To reduce stiffness in the trunk and promote the body rotation needed for walking.

Sit on a firm straight chair with both feet on the floor. If necessary, a firm mattress, sofa, or wheelchair may be used. Interlace your fingers. Bend forward and reach with your hands towards the outside of your foot, rotating your trunk. Move your hands upward in a diagonal direction toward your left shoulder, keeping your elbow as straight as possible. Repeat the motions, moving your hands from your left foot to your right shoulder.

8: Movements needed to rise from a sitting position

Sit on a firm chair that has been placed against the wall to prevent slipping. Interlace your fingers. Reach forward with your hands. With your feet slightly apart and your hips at the edge of the seat, lean forward, lifting your hips slightly from the seat. Slowly return to sitting.

9: Supine bridge

Lie on your back with feet flat on the ground and arms relaxed by the side. Straighten your legs and place a bolster under your knees, then lift your hips by pressing against the bolster. Then lift and lower one foot, then the other, while holding the top of the bridge.

10: To maintain the ankle motion needed for walking

Stand at arm’s length from the wall, Knees straight. Feet planted slightly apart and flat on the floor with equal weight on both feet. With your unaffected hand, hold your affected hand in place against the wall at the chest level. Slowly bend your elbows, leaning into the wall. This places a stretch on the back of your lower legs. Keep your heels on the floor. Straighten your elbows, pushing your body away from the wall.

Rehabilitation is a slow process. It can take months or years for the condition to improve.

 

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.