LOWER BODY CROSS SYNDROME

Lower body cross syndrome is characterised by the weakness in abdominal
muscles and pelvic floor muscles along with the tightness of hip flexor muscles
and thoracolumbar extensors. Typically, this condition creates an imbalance
between the strength and flexibility of synergic muscles of lower limb.


Generally, the group muscles work with counter pressure of equal and
opposite forces exerted by them. When the forces become unequal it leads to
lower cross syndrome.

There are two types of lower body cross syndrome:

  • Anterior pelvic cross syndrome: pelvis is tilted posteriorly because
    weakened abdominal muscles
  • Posterior pelvic cross syndrome: pelvic is tilted anteriorly because of
    shortened or tight hip flexors

Lower body cross syndrome can be caused by:

  • Poor sitting/standing posture
  • Sedentary lifestyle
  • Previous injury


Symptoms include:

  1. Low back pain (most common)
  2. Fatigue
  3. Restlessness
  4. Reduced range of motion at joint

Treatment of lower boy cross syndrome includes: stretching and strengthening
exercises of lower limb.

Visit our physiotherapy clinic in Gurgaon Dynafisio if you go through any
of these symptoms and if your activities of daily living are getting affected. We
make sure to provide you the quality treatment for best and quick results. Our
team of physiotherapists set a standard protocol which is suitable for a certain
treatment and educate you about the procedure properly and along with the
exercises we also use best quality electrical modalities to reduce pain,
inflammation, relaxing the tissues, improves contractions etc. that contribute
in the whole treatment of a particular condition. You can also reach out to us
at our other branches in sec42 and 83.

CEREBRAL PALSY – All you need to know

‘Cerebral’ means ‘Brain’ and ‘Palsy’ means ‘Muscle weakness’. It is a group of disorder that leads to poor postural tone, movements and balance. It affects the child during its underdeveloped immature brain either during his/her growing stage or during pregnancy itself due to any trauma or fall. It may be of various types among which Spastic Hemiplegic side is the commonest form affecting the child.

What may be the risk factors to develop CP?

Some of the risk factors that make the child vulnerable to CP may be during the pregnancy, labour or even after the birth.

Maternal causes:

  • Infection – It could be any viral infection like CMV, Rubella, or herpes that may travel through placenta and infect the child as well but these can be prevented by vaccination.
  • Intra-uterine Causes – Any infection to placenta or ‘torques tangles’ of placenta that may lead to deficient nutrition supply to the infant resulting in malnourished brain with lack of oxygen may develop CP.
  • Others – Mother suffering from thyroid problem or gestational diabetes.

Infant related causes:

  • Jaundice – Severe or untreated jaundice when is unable to filter by-products from blood stream leads to jaundice.
  • Infection or Inflammation – Bacterial meningitis or viral encephalitis that may result in inflammation around brain or spinal cord of child

Labour causes:

  • Breech delivery – When the delivery of child happens from legs out first instead of head may lead to trauma or bleeding into the brain.
  • Premature Birth – Delivery before 37 weeks, low birth weight, or weak immune system of a child makes him more prone to develop the infection and CP.

When to see a doctor?

Whenever a mother or any of the family member notices any of the following symptom in a child then you should immediately visit to a doctor:-

  • Most common symptom is the stiff muscles or un-coordinated musclura movements.
  • Exaggerated Reflexes or spasticity
  • Muscle movement either too tight or flappy
  • Difficulty walking or loss of balance
  • Difficulty in speech or swallowing
  • Excessive drooling or salivation formation
  • Un-coordinated eye response
  • Lack of fine movement like grasping or holding

If any of the family member notices any of these symptoms then you must take your child immediately to the doctor and confirm the diagnosis.

Ways to investigate CP?

  • MRI/CT Scan – These scans may the show the inactivity in the brain through imaging.
  • Blood Test – these test can be done to rule out other underlying causes like infections.
  • Physical findings – Doctor will examinethe child through the delayed milestones and other measures like lack of balance, muscle tone and normal ranges.

Management

  • Medical management – Muscle relaxant and sedatives works best to reduce and control the spasticity of the child. Baclofenac and Diazepam being the commonest form of muscle relaxant which your doctor may prescribe to relax the muscles.
  • Surgical management – Orthopaedic may use some surgical approach the compression or stiffness to increase the range of joints.
  • Therapy – Physiotherapy, occupational therapy and speech therapy plays the most important role in maintain the child functional.

Physiotherapy Management

  • Mobility – Mobilisation of the child is very essential to make him/her activate in daily activities or fulfilling his special needs with minimal support.
  • ADL – Activities of daily living like feeding, grooming, bathing and toileting can be taught with some special modifications can be taught with the help of physical therapist and occupational therapist.
  • Communication – Special signs and ways to communicate must be taught both to the child and to the family members in order to express their feeling, thoughts and needs.
  • Range of motion – Specific group of muscle stretching and strengthening exercises are to be taught to keep the child in motion and functional as much as possible.

For further help reach the best Neuro Physiotherapist in Gurgaon located in different sectors 45, 42, 28 & 83. We here look for the betterment of the child keeping in note to make the child most functional and independent as much as possible. We here look for educational training also for both the child and family members to help the child and make him learn at the home also. For further details contact us at 8929294515 or www.dynafisio.com

PERIPHERAL ARTERIAL DISEASE

Peripheral arterial disease (PAD) is known as a condition where by the blood flow in the limb arteries are obstructed . Commonly, the legs are the most affected. These arteries are obstructed due to plaque deposits that restrict blood flow through the peripheries. Although blood flow may be also restricted by deep vein thrombosis, which may be a blood clot that occurs in the periphery of the limbs 

Aetiology

The most common cause of PAD is atherosclerosis, similarly, they share the same risk factors: smoking, diabetes, age, hypertension, and hyperlipidemia. Uncommon vascular symptoms, such as vasculitis, thromboangiitis obliterans, popliteal entrapment syndrome, and fibromuscular dysplasis, account for less than 10% of cases.  It is estimated that up to 60% of patients with PAD will have ischaemic heart disease, and 30% have cerebrovascular disease.

Risk Factors

Cigarette Smoking-Cigarette smoking increases the chance of having PAD by seven-fold

Diabetes-  Diabetes Mellitus leads to a two-to fourfold increase in risk of cardiovascular events

Age-The risk of PAD increases as the population approaches the age of 50. It has been reported that PAD affects 0.9% of 40-49 year olds and increases to 14.5% of 70 year olds and above .Studies also have shown that men are the target population of PAD 

Gender- TASC II guidelines conclude that men are affected at a younger age than women. However, overall there is no clear distinction in risk.

Hypertension-Hypertension can be a risk for developing PAD.

Symptoms

-claudication

– burning and aching sensation in legs

-Occlusion or stenosis of the aorta commonly causes bilateral buttock, thigh, and calf claudication. 

Clinical Manifestations

  • Non-healing wounds on legs or feet
  • Unexplained leg pain
  • Pain on walking that resolves when stopped
  • Pain in foot at rest made which worsens with elevation
  • Ulcers
  • Gangrene
  • Dry skin
  • Cramping
  • Aching

Physiotherapy Management

  • Supervised treadmill exercise improves treadmill walking performance in patients with PAD.
  • Supervised treadmill exercise has greater benefit on treadmill walking performance than home-based walking exercise.
  • Home-based walking exercise interventions that involve behavioral techniques are effective for functional impairment in people with PAD and improve the 6-min walk distance more than supervised treadmill exercise.
  • Upper and lower extremity ergometry improve walking performance in patients with PAD and improve peak oxygen uptake.
  • Lower extremity resistance training can improve treadmill walking performance in PAD, but is not as effective as supervised treadmill exercise.
  •  

AT our Physiotherapy centre in Gurgaon we have got the best team of physios who are specialised in advance techniques.

For more info contact our best team of physiotherapists on www.dynafisio.com or call us at 8929294515

CEREBRAL PALSY

Cerebral Palsy (CP) is a disorder of movement and posture that appears during infancy or early childhood resulting from damage to the brain. The damage to the brain is permanent and cannot be cured but the earlier we start with intervention the more improvement can be made.Any non-progressive central nervous system (CNS) injury occurring during the first 2 (some say 5) years of life is considered to be CP. There are several definitions of Cerebral Palsy within the literature, although these may all vary slightly in the way they are worded they are all similar and can be summarised to:

Cerebral Palsy is a group of permanent, but not unchanging, disorders of movement and/or posture and of motor function, which are due to a non-progressive interference, lesion, or abnormality of the developing/immature brain

The type of cerebral palsy has also changed:

  • In the 60’s Athetoid / Dyskinetic Cerebral Palsy accounted for approximately 20% of children with Cerebral Palsy.
  • Today only 5 to 10% have this type, with Spastic Cerebral Palsy now accounting for 80-90% of children with Cerebral Palsy.
  • This decrease is mainly due to advances in the treatment of hyperbilirubinemia (Bilirubin is toxic to cells of the brain. If a baby has severe jaundice, there’s a risk of bilirubin passing into the brain ie. acute bilirubin encephalopathy. Prompt treatment may prevent significant lasting damage)[2].
  • The increase of Spastic Cerebral Palsy is predominantly a result of higher survival rates for (very small premature) babies.
  • The most common cause of Cerebral Palsy is idiopathic which means that the cause of damage to the brain during pregnancy is not known.

Risk Factors

There are different risk factors for each stage at which a child might develop Cerebral Palsy. These can be broken down into Prenatal, Perinatal and Postnatal.

Prenatal

  • Prematurity (Gestational age less than 36 weeks)
  • Low Birth Weight (less than 2500 g), which could be due to poor nutritional status of the mother
  • Maternal epilepsy
  • Hyperthyroidism
    Infections (TORCH = Toxoplasmosis, Other (Syphilis, Varicella-Zoster, Parvovirus B19,) Rubella, Cytomegalovirus (CMV), Herpes Simplex Virus)
  • Severe Toxemia, Eclampsia
  • Drug Abuse
  • Trauma
  • Multiple Pregnancies
  • Placental Insufficiency

Perinatal

  • Premature Rupture of Membranes
  • Prolonged and Difficult Labour
  • Vaginal Bleeding at the time of admission for labour
  • Bradycardia

Postnatal (0-2 years)

  • Central Nervous System infection (encephalitis,meningitis)
  • Hypoxia
  • Seizures
  • Coagulopathies
  • Neonatal Hyperbilirubinemia
  • Head Trauma

Anatomical classification are as follows:

  • Unilateral: One side of the body is affected
  • Bilateral: Both sides of the body are affected

Spastic Cerebral Palsy: are used to distinguish between quadriplegia, diplegia and hemiplegia. Spastic Cerebral Palsy is either bilateral or unilateral.

Dyskinetic Cerebral Palsy and Ataxic Cerebral Palsy: always involve the whole body (bilateral).

PHYSIOTHERAPY APPROACH

Neurodevelopmental Treatment (NDT)

One of the more popular approaches utilised in the management of cerebral palsy, the NDT Approach also know as Bobath Approach

Passive Stretching

It is a manual application for spastic muscles to relieve soft tissue tightness. Manual stretching may increase range of movements, reduce spasticity, or improve walking efficiency in children with spasticity. [5]  Stretch may be applied in a number of ways during neurological rehabilitation to achieve different effects. The types of stretching used include;

  1. Fast / Quick
  2. Prolonged
  3. Maintained

Splinting

Static Weight-bearing Exercises

Stimulation of antigravity muscle strength, prevention of hip dislocation, reduction in spasticity and improvements in bone mineral density, self-confidence and motor function have all been achieved through the use of Static Weight-Bearing exercises such as Tilt-Table and Standing Frame.

Muscle Strengthening Exercises

AT our Physiotherapy centre in Gurgaon we have got the best team of physios who are specialised in advance techniques.

For more info contact our best team of physiotherapists on www.dynafisio.com or call us at 8929294515

 

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