bestphysiotherapistingurgaon Archives

10Apr

POSTOPERATIVE KNEE REPLACEMENT EXERCISE

dynafisio 2 Comments Knee Pain Treatment Gurgaon

OVERVIEW

The most common indication for a primary knee replacement, TKA, is Osteoarthritis. Osteoarthritis causes the cartilage of the joint to become damaged and no longer able to absorb shock. Risk factors for knee osteoarthritis include gender, increased body mass index, history of a knee injury. Pain is typically the main complaint of patients with knee osteoarthritis.

A TKA surgery typically lasts 1 to 2 hours. The majority of individuals begin physiotherapy during their inpatient stay, within 24 hours of surgery. Range of motion and strengthening exercises, cryotherapy and gait training are typically initiated, and a home exercise programme is prescribed before discharge from hospital.

PHYSIOTHERAPY GOALS

The goal of physical therapy intervention during the early post-operative phase is to decrease swelling, increase range of motion, enhance muscle control and strength in the involved lower extremity and maximize patients’ mobility with a goal of functional independence. Physical therapy interventions are also directed towards identifying other sensomotor or systemic conditions that may influence a patients’ rehabilitation potential.

EXERCISES

Ankle Pumps

Move your foot up and down rhythmically by contracting your calf and shin muscles.
Perform this exercise for 2 to 3 minutes, 2 or 3 times an hour in the recovery room.

STATIC QUADS

Tighten your thigh muscle.
Try to straighten your knee.
Hold for 5 to 10 seconds.

Towel Roll under the Heel

Place a small rolled towel just above your heel so that your heel is not touching the bed. Tighten your thigh.
Try to fully straighten your knee and to touch the back of your knee to the bed.
Hold fully straightened for 5 to 10 seconds.

Straight Leg Raises

Tighten your thigh muscle with your knee fully straightened on the bed, as with the quadriceps set above. Lift your leg 30-70 degree.
Hold for 5 to 10 seconds.
Slowly lower.

Bed-Supported Knee Bends

Slide your foot toward your buttocks, bending your knee and keeping your heel on the bed
. Hold your knee in a maximally bent position for 5 to 10 seconds and then straighten.

Sitting Supported Knee Bends

While sitting at your bedside or in a chair with your thigh supported, place your foot behind the heel of your operated knee for support.
Slowly bend your knee as far as you can.
Hold your knee in this position for 5 to 10 seconds.

Sitting Unsupported Knee Bends

While sitting at bedside or in a chair with your thigh supported, bend your knee as far as you can until your foot rests on the floor.
With your foot lightly resting on the floor, slide your upper body forward in the chair to increase your knee bend.
Hold for 5 to 10 seconds.
Straighten your knee fully.

Walking

Proper walking is the best way to help your knee recover.
At first, you will walk with a walker or crutches

Stair Climbing and Descending

At first, you will need a handrail for support and will be able to go only one step at a time
Always lead up the stairs with your good knee and down the stairs with your operated knee.
Remember, “Up with the good” and “down with the bad”.

Standing Knee Bends Standing erect with the aid of a walker or crutches, lift your thigh and bend your knee as much as you can. Hold for 5 to 10 seconds. Then straighten your knee, touching the floor with your heel first.

09Mar

CEREBRAL PALSY

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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;

Fast / Quick
Prolonged
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

04Mar

Trapezius Myalgia

dynafisio Neck Pain Gurgaon

Myalgia is generally known as a muscle ache or muscle pain.

Trapezius myalgia (TM) is the complaint of pain, stiffness, and tightness of the upper trapezius muscle. It is characterised by acute or persistent neck-shoulder pain.

Aetiology

Monotonous jobs with highly repetitive work, forceful exertions, high level of static contractions, prolonged static loads, constrained work postures or a combination of these factors are possible causes of neck and shoulder disorders (which include TM) in the working population.

As recent research suggests with most musculoskeletal conditions there is a strong relationship between psychosocial factors and the occurrence of TM

Clinical Presentation

Sudden onset of pain
Muscle stiffness and spasms
Tightness of the neck-shoulder complex
Heaviness of the head and occipital headache
Tenderness of the upper trapezius area

Other symptoms:

Low mood
Anxiety
Paresthesia

Medical Management

Analgesia
Ergonomic advice
Referral to physiotherapy
Injection therapy
Radiofrequency denervation

Physical Therapy Management

Raising awareness for at risk groups of people:

Repetitive movement jobs
Sedentary jobs (computer work)
High work demands
Work posture
Vibration
Stress
Low activity level outside of work
Gender (women)

Exercise Therapy

Different forms of exercise is recommended for acute or persistent neck pain

Physical activity and exercise have been proven to give the most immediate and long-term pain relief in patients with TM^]. Both general fitness training and specific strength training generate significant effects on decreasing pain. However; strength training has been proven to be more effective compared to general fitness training.

High-intensity strength training relying on principles of progressive overload for 20 minutes has been shown to be successful in reductions of neck and shoulder pain.

Following a specific neck strengthening exercise program for up to 1 year can lead to long term reduction and further prevention of recurring pain even after the strength program has ceased.

Shoulder shrugs:
The subject is standing erect and holding the dumbbells to the side, then elevates the shoulders while focusing on contracting the upper trapezius muscle.
One-arm row:
The subject bends their torso forward to approximately 30° from horizontal with one knee on the bench and the other foot on the floor. The subject now pulls the dumbbell towards the ipsilateral lower rib, while the contralateral arm is maintained extended and supports the body on the bench.
Upright row:
The subject is standing erect and holding the dumbbells while the arms are hanging relaxed in front of the body. The dumbbells are lifted towards the chest in a vertical line close to the body while flexing the elbows and abducting the shoulder. The elbows are pointing out- and upwards.
Reverse flies:
The subject is prone on a bench at a 45° angle from horizontal and the arms pointing towards the floor. The dumbbells are raised until the upper arm is horizontal, while the elbows are in a static slightly flexed position (~5°) during the entire range of motion.
Lateral raise:
The subject is standing erect and holding the dumbbells by their side, and then abducts the shoulder joint until the upper arm is horizontal. The elbows are in a static slightly flexed position (5°) during the entire range of motion.

Manual Therapy

Ischaemic compression, stretching of the upper trapezius muscle, and transverse friction massage are manual techniques to help patients with TM. These techniques appear to have instant improvement on pain.

cupping

kinesotaping

dry neeedling

MFR techniques