This document presents a case study of a 68-year-old male patient admitted to the hospital with symptoms of a right middle cerebral artery infarct. The physiotherapy assessment found left-sided weakness and reduced reflexes. The short-term physiotherapy goals are to educate the patient, improve respiratory and circulatory function, prevent complications like pressure sores, and prevent deconditioning. The long-term goals include improving sensory function, flexibility, strength, spasticity management, motor control, upper extremity function, balance, locomotion, feeding/swallowing, and discharge planning. A variety of interventions are outlined to address each goal.
CASE PRESENTATION - SPINAL CORD INJURY BY HIMANIKAUSHIK - .pptxHimani Kaushik
Spinal cord injury (SCI) is a debilitating neurological condition with tremendous socioeconomic impact on affected individuals and the health care system. Today, the estimated lifetime cost of an SCI patient is $2.35 million per patient. According to the National Spinal Cord Injury Statistical Center, there are 12,500 new cases of SCI each year in North America. More than 90% of SCI cases are traumatic and caused by incidences such as traffic accidents, violence, sports, or falls. The Male-to-female ratio of 2:1 for SCI, which happens more frequently in adults compared to children. Demographically, men are mostly affected during their early and late adulthood (3rd and 8th decades of life) while women are at higher risk during their adolescence (15–19 years) and 7th decade of their lives i.e. age distribution is bimodal, with a first peak involving young adults and a second peak involving adults over the age of 60. Those over 60 years of age who suffer SCI have considerably worse outcomes than younger patients their injuries usually result from falls and age-related bony changes.
Adhesive capsulitis case presentation physiotherapymanisha thakur
Satisfactory presentation on adhesive capsulitis because of satisfactory results in 2 weeks.
Can do these exercises to increase range
Muscle strength and overall well being.
Case of Prolapse intervertebral Disc, lumbar disc prolapse, case, physiotherapy management, Assessment, recent Advance, orthopaedic case presentation, musculoskeletal physiotherapy case presentation, orthopaedic physiotherapy, case of a low back pain patient, lumbar radiculopathy, final year,
This document presents two clinical case presentations of patients with back pain. The first case involves a 28-year-old male with low back pain radiating to his right leg. Diagnostic tests revealed a prolapsed intervertebral disc at L4-L5 with lumbar canal stenosis. He underwent a laminectomy with discectomy and experienced post-operative relief. The second case involves a 34-year-old male with low back pain radiating to his left leg. Diagnostic tests revealed a prolapsed disc at L4-L5 more pronounced on the left side. He underwent a laminotomy with micro-discectomy at L4-L5 and also experienced post-operative relief.
This case presentation describes a 57-year-old female patient experiencing left shoulder pain for 6 months. On examination, she had tenderness over the left AC joint and tight upper trapezius. All shoulder ranges of motion were limited. The physiotherapy diagnosis was adhesive capsulitis. The treatment plan focused on reducing pain and stiffness through ice, stretches, and exercises to improve range of motion and strengthen muscles. The goals were to relieve pain, increase mobility, restore posture and strength, and allow the patient to regain normal activities of daily living. After two sessions, the patient's pain level decreased and all shoulder ranges of motion improved.
The document contains a neurological physiotherapy evaluation form with sections on subjective and objective assessment. The objective assessment includes examination of vital signs, higher mental functions, sensory and motor systems, coordination, balance and gait. The evaluation concludes with functional assessment using the Functional Independence Measure and an ICF format assessment of the patient's health status and factors affecting it.
This document presents a case study of a 68-year-old male patient admitted to the hospital with symptoms of a right middle cerebral artery infarct. The physiotherapy assessment found left-sided weakness and reduced reflexes. The short-term physiotherapy goals are to educate the patient, improve respiratory and circulatory function, prevent complications like pressure sores, and prevent deconditioning. The long-term goals include improving sensory function, flexibility, strength, spasticity management, motor control, upper extremity function, balance, locomotion, feeding/swallowing, and discharge planning. A variety of interventions are outlined to address each goal.
CASE PRESENTATION - SPINAL CORD INJURY BY HIMANIKAUSHIK - .pptxHimani Kaushik
Spinal cord injury (SCI) is a debilitating neurological condition with tremendous socioeconomic impact on affected individuals and the health care system. Today, the estimated lifetime cost of an SCI patient is $2.35 million per patient. According to the National Spinal Cord Injury Statistical Center, there are 12,500 new cases of SCI each year in North America. More than 90% of SCI cases are traumatic and caused by incidences such as traffic accidents, violence, sports, or falls. The Male-to-female ratio of 2:1 for SCI, which happens more frequently in adults compared to children. Demographically, men are mostly affected during their early and late adulthood (3rd and 8th decades of life) while women are at higher risk during their adolescence (15–19 years) and 7th decade of their lives i.e. age distribution is bimodal, with a first peak involving young adults and a second peak involving adults over the age of 60. Those over 60 years of age who suffer SCI have considerably worse outcomes than younger patients their injuries usually result from falls and age-related bony changes.
Adhesive capsulitis case presentation physiotherapymanisha thakur
Satisfactory presentation on adhesive capsulitis because of satisfactory results in 2 weeks.
Can do these exercises to increase range
Muscle strength and overall well being.
Case of Prolapse intervertebral Disc, lumbar disc prolapse, case, physiotherapy management, Assessment, recent Advance, orthopaedic case presentation, musculoskeletal physiotherapy case presentation, orthopaedic physiotherapy, case of a low back pain patient, lumbar radiculopathy, final year,
This document presents two clinical case presentations of patients with back pain. The first case involves a 28-year-old male with low back pain radiating to his right leg. Diagnostic tests revealed a prolapsed intervertebral disc at L4-L5 with lumbar canal stenosis. He underwent a laminectomy with discectomy and experienced post-operative relief. The second case involves a 34-year-old male with low back pain radiating to his left leg. Diagnostic tests revealed a prolapsed disc at L4-L5 more pronounced on the left side. He underwent a laminotomy with micro-discectomy at L4-L5 and also experienced post-operative relief.
This case presentation describes a 57-year-old female patient experiencing left shoulder pain for 6 months. On examination, she had tenderness over the left AC joint and tight upper trapezius. All shoulder ranges of motion were limited. The physiotherapy diagnosis was adhesive capsulitis. The treatment plan focused on reducing pain and stiffness through ice, stretches, and exercises to improve range of motion and strengthen muscles. The goals were to relieve pain, increase mobility, restore posture and strength, and allow the patient to regain normal activities of daily living. After two sessions, the patient's pain level decreased and all shoulder ranges of motion improved.
The document contains a neurological physiotherapy evaluation form with sections on subjective and objective assessment. The objective assessment includes examination of vital signs, higher mental functions, sensory and motor systems, coordination, balance and gait. The evaluation concludes with functional assessment using the Functional Independence Measure and an ICF format assessment of the patient's health status and factors affecting it.
This document presents a case study of a 35-year-old female patient diagnosed with carpal tunnel syndrome. The patient experiences numbness, tingling, and pain in both wrists and hands that has progressively worsened over the past 9-10 months. Physical examination findings include decreased grip strength, sensation, and range of motion bilaterally. Tests confirm carpal tunnel syndrome through abnormal nerve conduction velocities and positive Phalen's and Tinel's signs. The physical therapist will utilize interventions like manual therapy, therapeutic exercise, splinting, and modalities to reduce pain and improve function so the patient can return to normal activities.
A 21-year old female marathon runner has begun experiencing knee pain around the patella after increasing her training from twice to 4-5 times per week on hills. This document provides an overview of patellofemoral pain syndrome (PFPS), including causes, risk factors, diagnosis, and treatment options. PFPS is caused by an imbalance of forces around the patella that leads to pain. Treatment focuses on strengthening the quadriceps and hips to correct biomechanics and management of pain. The prognosis is generally good if treatment addresses contributing factors and allows for gradual return to activity.
This case presentation summarizes a 60-year-old female patient who presented with right hip pain and swelling for 8 days following a fall. Her medical history includes diabetes and hypertension for 17-18 years. On examination, she had grade 3 tenderness over the right hip with warmth, swelling, and limited range of motion due to pain. Differential diagnoses included a fractured femur. MRI showed bulging discs at L2-L3 and L3-L4. The diagnosis was probable lumbar disc prolapse. The treatment plan focused on reducing pain and spasm through heat, ultrasound, and TENS therapy. Back and core strengthening exercises were also prescribed along with patient education on posture and lifting techniques.
A case presentation on lateral epicondylitis by prasanjit shomPRASANJIT SHOM
- The document presents a case study of lateral epicondylitis (tennis elbow) in a 30-year-old female patient.
- Objective assessment found tenderness and swelling over the lateral epicondyle of the right elbow, with reduced range of motion. Cozen's and Mill's tests were positive.
- X-rays were normal. The patient was diagnosed with lateral epicondylitis and a treatment plan included modalities for pain relief, exercises to increase strength and flexibility once pain subsided, and advice to rest the elbow and avoid aggravating activities.
This document discusses Guillain-Barré syndrome (GBS), including its definition, clinical features, assessment scales, and phases. It defines GBS as an acute/subacute symmetrical motor neuropathy involving more than one peripheral nerve. The phases of GBS are described as the acute, plateau, and recovery phases. For each phase, goals of physical therapy and examples of interventions are provided, such as chest physiotherapy, positioning, stretching, and strengthening exercises to address weaknesses and functional limitations during the different stages of GBS.
This document provides information about a case study on multiple sclerosis. It discusses the types and characteristics of multiple sclerosis, including relapsing-remitting, secondary-progressive, primary-progressive, benign, progressive-relapsing and malignant forms. It also outlines the symptoms, treatments including medications, physiotherapy and general examination findings of a patient named M.C. who has been diagnosed with relapsing-remitting multiple sclerosis. The patient experiences weakness, spasticity and impaired mobility. Objective examinations findings are provided relating to the patient's condition and progress over time with physiotherapy treatment.
This document summarizes a case of a 55-year-old female tailor presenting with neck pain for 4 months. Her examination showed decreased range of motion of the neck without neurological deficits. Her comorbidities included diabetes mellitus. Differential diagnoses included cervical spondylosis, mechanical neck pain, and cervical disc herniation. She was managed with analgesics, a cervical collar, and physiotherapy. The discussion covered mechanical neck disorders, cervical spondylosis, and cervical disc herniation as potential causes and their typical presentations, investigations, and management approaches.
The document discusses various types of abnormal gaits seen in different medical conditions. It begins by defining the normal gait cycle and its phases. It then describes common causes of abnormal gaits including pain, joint/muscle limitations, weakness, and neurological involvement. Specific gaits are then outlined, including hemiplegic gait seen in stroke, scissor gait in cerebral palsy, myopathic gait in muscular diseases, steppage gait in foot drop conditions, Parkinsonian gait, and sensory gait related to proprioceptive loss.
A 44-year-old female patient presented with severe headache, vomiting, neck pain radiating to the shoulder, giddiness, insomnia, blurred vision, frequent urination, burning urination, and lower back ache. Examinations and investigations revealed elevated ESR, bilateral sclerosing mastoiditis, septated maxillary sinuses, patent osteomeatal unit, and deviated nasal septum to the right. She was diagnosed with cervical spondylosis, sinus headache, migraine, and follicular tonsillitis. Her treatment plan included analgesics, antibiotics, corticosteroids, antidepressants, anxiolytics, antiemetics, and PPI. Tonsillectomy was also
Introduction, principles of sensory re-education hypersensitivity and hyposensitivity, stages of training after nerve repair, uses and benefits, sensory reeducation in stroke - its principle. Actve and passive Sensory reeducation in stroke, orofacial sensory retraining
- 87 year old female admitted on 6/4/14 for aortic stenosis, regurgitation, mitral and tricuspid regurgitation, coronary artery disease, and atrial fibrillation. She underwent MAZE procedure, transcatheter aortic valve replacement, mitral valve repair, tricuspid valve repair, and coronary artery bypass grafting x3.
- She required reintubation post-op and had a slow recovery, beginning to ambulate on POD #10. The physical therapy goals were for the patient to regain independence in bed mobility, transfers, and household ambulation.
- Over 16 physical therapy sessions, the patient improved from ambulating 2 steps to over 100 feet with a
This document summarizes the case of a 48-year-old man who presented with weakness in all four limbs for 8 months and difficulty with speech and swallowing for 4 months. On examination, he had muscle wasting and increased tone in his limbs as well as dysarthria and slurred speech. Investigations including MRI, NCS, and EMG were consistent with a diagnosis of motor neuron disease (ALS). He was started on supportive treatment for ALS but the prognosis for this progressive disorder is fatal within 3-5 years in most cases.
This document presents a case study of a 70-year-old male patient diagnosed with chronic obstructive airway disease who is undergoing physiotherapy treatment. It includes details of the patient's history, symptoms, examination findings, physiotherapy assessment, treatment plan and progress updates. The treatment plan involves chest physiotherapy techniques like percussion and vibration, breathing exercises, posture correction, and improving exercise tolerance. Over follow-up visits the patient is noted to improve in symptoms and functional ability with continued physiotherapy management.
case presentation on cervical spondylosis by naveennaveen ramavatu
A 70-year-old female was admitted with complaints of giddiness, neck pain, headache, and leg pain. Diagnostic tests showed cervical spondylosis and hypertension. She was treated for 5 days with medications including pantoprazole, clopidogrel, rosuvastatin, betahistine, lorazepam, and lactulose. Her symptoms improved and she was discharged on a regimen including pantoprazole, clopidogrel, rosuvastatin, and betahistine to monitor for recurrence of symptoms.
Spasticity, rigidity, hypotonia, dystonia, decerebrate rigidity, and decorticate rigidity are abnormal tones that can occur. Examination of tone includes initial observation, passive and active motion testing using scales like the Modified Ashworth Scale. Typical patterns of spasticity in upper and lower limbs are described for upper motor neuron lesions.
Parkinson's disease is a chronic, progressive neurological disorder characterized by rigidity, bradykinesia, tremor, and postural instability. It is caused by the loss of dopamine-producing neurons in the substantia nigra. Symptoms worsen over time and can include impaired motor skills and coordination, speech and swallowing difficulties, sensory changes, and cognitive impairment. Physiotherapy aims to improve mobility, balance, and function through exercises targeting flexibility, strength, posture, gait, and functional skills.
Cerebellar dysfunction case presentationKamal Sharma
This document provides clinical information about a 26-year-old male patient named Manjunath who was admitted to the hospital with difficulty walking and speaking for 2 years following a road traffic accident. It summarizes his medical history, examination findings, diagnosis of a cerebellar lesion, and the Ayurvedic treatment he received during his hospital stay including herbs, oil therapies, and physiotherapy. His condition improved with treatment as he gained more mobility and coordination.
The document discusses stroke, including its definition, causes, risk factors, symptoms, assessment, recovery stages, and complications. Key points include:
- Stroke is defined as sudden neurological dysfunction due to abnormal cerebral circulation lasting over 24 hours.
- Common causes include atherosclerosis, cerebral thrombus, embolism from the heart.
- Risk factors include hypertension, diabetes, heart disease, smoking, obesity.
- Symptoms can include weakness, numbness, vision issues, speech problems.
- Recovery is assessed based on severity, duration, and affected brain region. Complications can include contractures, seizures, DVT.
- The patient is a 64-year-old male who presented with fever, chills, cough with sputum, and difficulty breathing for the past 4-20 days.
- On examination, the patient showed signs of respiratory distress and reduced breath sounds and chest expansion on the left lung. Investigations revealed pneumonia in the left lower lobe.
- The provisional diagnosis was left lobar pneumonia. Treatment included breathing exercises, positioning, coughing techniques, and medications to improve lung function and relieve symptoms.
Parkinson's disease is a progressive brain disorder that causes a gradual loss of muscle control. Its symptoms include tremors, stiffness, slowed movements, and poor balance. Early signs may include slight shaking, difficulty walking or writing, and stooped posture. Treatments include medications like dopamine agonists and surgeries like deep brain stimulation. Physical therapy focuses on exercises to improve mobility, balance, posture, and prevent contractures. Symptoms fluctuate between "on" and "off" periods depending on dopamine levels, affecting the appropriate exercises.
This document presents a case study of a 35-year-old female patient diagnosed with carpal tunnel syndrome. The patient experiences numbness, tingling, and pain in both wrists and hands that has progressively worsened over the past 9-10 months. Physical examination findings include decreased grip strength, sensation, and range of motion bilaterally. Tests confirm carpal tunnel syndrome through abnormal nerve conduction velocities and positive Phalen's and Tinel's signs. The physical therapist will utilize interventions like manual therapy, therapeutic exercise, splinting, and modalities to reduce pain and improve function so the patient can return to normal activities.
A 21-year old female marathon runner has begun experiencing knee pain around the patella after increasing her training from twice to 4-5 times per week on hills. This document provides an overview of patellofemoral pain syndrome (PFPS), including causes, risk factors, diagnosis, and treatment options. PFPS is caused by an imbalance of forces around the patella that leads to pain. Treatment focuses on strengthening the quadriceps and hips to correct biomechanics and management of pain. The prognosis is generally good if treatment addresses contributing factors and allows for gradual return to activity.
This case presentation summarizes a 60-year-old female patient who presented with right hip pain and swelling for 8 days following a fall. Her medical history includes diabetes and hypertension for 17-18 years. On examination, she had grade 3 tenderness over the right hip with warmth, swelling, and limited range of motion due to pain. Differential diagnoses included a fractured femur. MRI showed bulging discs at L2-L3 and L3-L4. The diagnosis was probable lumbar disc prolapse. The treatment plan focused on reducing pain and spasm through heat, ultrasound, and TENS therapy. Back and core strengthening exercises were also prescribed along with patient education on posture and lifting techniques.
A case presentation on lateral epicondylitis by prasanjit shomPRASANJIT SHOM
- The document presents a case study of lateral epicondylitis (tennis elbow) in a 30-year-old female patient.
- Objective assessment found tenderness and swelling over the lateral epicondyle of the right elbow, with reduced range of motion. Cozen's and Mill's tests were positive.
- X-rays were normal. The patient was diagnosed with lateral epicondylitis and a treatment plan included modalities for pain relief, exercises to increase strength and flexibility once pain subsided, and advice to rest the elbow and avoid aggravating activities.
This document discusses Guillain-Barré syndrome (GBS), including its definition, clinical features, assessment scales, and phases. It defines GBS as an acute/subacute symmetrical motor neuropathy involving more than one peripheral nerve. The phases of GBS are described as the acute, plateau, and recovery phases. For each phase, goals of physical therapy and examples of interventions are provided, such as chest physiotherapy, positioning, stretching, and strengthening exercises to address weaknesses and functional limitations during the different stages of GBS.
This document provides information about a case study on multiple sclerosis. It discusses the types and characteristics of multiple sclerosis, including relapsing-remitting, secondary-progressive, primary-progressive, benign, progressive-relapsing and malignant forms. It also outlines the symptoms, treatments including medications, physiotherapy and general examination findings of a patient named M.C. who has been diagnosed with relapsing-remitting multiple sclerosis. The patient experiences weakness, spasticity and impaired mobility. Objective examinations findings are provided relating to the patient's condition and progress over time with physiotherapy treatment.
This document summarizes a case of a 55-year-old female tailor presenting with neck pain for 4 months. Her examination showed decreased range of motion of the neck without neurological deficits. Her comorbidities included diabetes mellitus. Differential diagnoses included cervical spondylosis, mechanical neck pain, and cervical disc herniation. She was managed with analgesics, a cervical collar, and physiotherapy. The discussion covered mechanical neck disorders, cervical spondylosis, and cervical disc herniation as potential causes and their typical presentations, investigations, and management approaches.
The document discusses various types of abnormal gaits seen in different medical conditions. It begins by defining the normal gait cycle and its phases. It then describes common causes of abnormal gaits including pain, joint/muscle limitations, weakness, and neurological involvement. Specific gaits are then outlined, including hemiplegic gait seen in stroke, scissor gait in cerebral palsy, myopathic gait in muscular diseases, steppage gait in foot drop conditions, Parkinsonian gait, and sensory gait related to proprioceptive loss.
A 44-year-old female patient presented with severe headache, vomiting, neck pain radiating to the shoulder, giddiness, insomnia, blurred vision, frequent urination, burning urination, and lower back ache. Examinations and investigations revealed elevated ESR, bilateral sclerosing mastoiditis, septated maxillary sinuses, patent osteomeatal unit, and deviated nasal septum to the right. She was diagnosed with cervical spondylosis, sinus headache, migraine, and follicular tonsillitis. Her treatment plan included analgesics, antibiotics, corticosteroids, antidepressants, anxiolytics, antiemetics, and PPI. Tonsillectomy was also
Introduction, principles of sensory re-education hypersensitivity and hyposensitivity, stages of training after nerve repair, uses and benefits, sensory reeducation in stroke - its principle. Actve and passive Sensory reeducation in stroke, orofacial sensory retraining
- 87 year old female admitted on 6/4/14 for aortic stenosis, regurgitation, mitral and tricuspid regurgitation, coronary artery disease, and atrial fibrillation. She underwent MAZE procedure, transcatheter aortic valve replacement, mitral valve repair, tricuspid valve repair, and coronary artery bypass grafting x3.
- She required reintubation post-op and had a slow recovery, beginning to ambulate on POD #10. The physical therapy goals were for the patient to regain independence in bed mobility, transfers, and household ambulation.
- Over 16 physical therapy sessions, the patient improved from ambulating 2 steps to over 100 feet with a
This document summarizes the case of a 48-year-old man who presented with weakness in all four limbs for 8 months and difficulty with speech and swallowing for 4 months. On examination, he had muscle wasting and increased tone in his limbs as well as dysarthria and slurred speech. Investigations including MRI, NCS, and EMG were consistent with a diagnosis of motor neuron disease (ALS). He was started on supportive treatment for ALS but the prognosis for this progressive disorder is fatal within 3-5 years in most cases.
This document presents a case study of a 70-year-old male patient diagnosed with chronic obstructive airway disease who is undergoing physiotherapy treatment. It includes details of the patient's history, symptoms, examination findings, physiotherapy assessment, treatment plan and progress updates. The treatment plan involves chest physiotherapy techniques like percussion and vibration, breathing exercises, posture correction, and improving exercise tolerance. Over follow-up visits the patient is noted to improve in symptoms and functional ability with continued physiotherapy management.
case presentation on cervical spondylosis by naveennaveen ramavatu
A 70-year-old female was admitted with complaints of giddiness, neck pain, headache, and leg pain. Diagnostic tests showed cervical spondylosis and hypertension. She was treated for 5 days with medications including pantoprazole, clopidogrel, rosuvastatin, betahistine, lorazepam, and lactulose. Her symptoms improved and she was discharged on a regimen including pantoprazole, clopidogrel, rosuvastatin, and betahistine to monitor for recurrence of symptoms.
Spasticity, rigidity, hypotonia, dystonia, decerebrate rigidity, and decorticate rigidity are abnormal tones that can occur. Examination of tone includes initial observation, passive and active motion testing using scales like the Modified Ashworth Scale. Typical patterns of spasticity in upper and lower limbs are described for upper motor neuron lesions.
Parkinson's disease is a chronic, progressive neurological disorder characterized by rigidity, bradykinesia, tremor, and postural instability. It is caused by the loss of dopamine-producing neurons in the substantia nigra. Symptoms worsen over time and can include impaired motor skills and coordination, speech and swallowing difficulties, sensory changes, and cognitive impairment. Physiotherapy aims to improve mobility, balance, and function through exercises targeting flexibility, strength, posture, gait, and functional skills.
Cerebellar dysfunction case presentationKamal Sharma
This document provides clinical information about a 26-year-old male patient named Manjunath who was admitted to the hospital with difficulty walking and speaking for 2 years following a road traffic accident. It summarizes his medical history, examination findings, diagnosis of a cerebellar lesion, and the Ayurvedic treatment he received during his hospital stay including herbs, oil therapies, and physiotherapy. His condition improved with treatment as he gained more mobility and coordination.
The document discusses stroke, including its definition, causes, risk factors, symptoms, assessment, recovery stages, and complications. Key points include:
- Stroke is defined as sudden neurological dysfunction due to abnormal cerebral circulation lasting over 24 hours.
- Common causes include atherosclerosis, cerebral thrombus, embolism from the heart.
- Risk factors include hypertension, diabetes, heart disease, smoking, obesity.
- Symptoms can include weakness, numbness, vision issues, speech problems.
- Recovery is assessed based on severity, duration, and affected brain region. Complications can include contractures, seizures, DVT.
- The patient is a 64-year-old male who presented with fever, chills, cough with sputum, and difficulty breathing for the past 4-20 days.
- On examination, the patient showed signs of respiratory distress and reduced breath sounds and chest expansion on the left lung. Investigations revealed pneumonia in the left lower lobe.
- The provisional diagnosis was left lobar pneumonia. Treatment included breathing exercises, positioning, coughing techniques, and medications to improve lung function and relieve symptoms.
Parkinson's disease is a progressive brain disorder that causes a gradual loss of muscle control. Its symptoms include tremors, stiffness, slowed movements, and poor balance. Early signs may include slight shaking, difficulty walking or writing, and stooped posture. Treatments include medications like dopamine agonists and surgeries like deep brain stimulation. Physical therapy focuses on exercises to improve mobility, balance, posture, and prevent contractures. Symptoms fluctuate between "on" and "off" periods depending on dopamine levels, affecting the appropriate exercises.
History taking
Adequate time
Listen carefully
Empathetic
Trust building
Do not intervere
Pschosocioeconomic & spiritual codition
- quantity: VAS
- quality: nociceptive
- mode of onset and location
- duration & chronicity
- provocating & relieving factors
- special character
- timing of pain
- relation with posture
- associated complaints
A 60-year old diabetic male presented with progressive walking difficulty over 1 year and slurred speech for 10 months. Examination found masked face, mild cognitive impairment, spastic dysarthria, vertical gaze palsy, and unstable broad-based gait. MRI showed atrophy of the dorsal midbrain. He was diagnosed with progressive supranuclear palsy and diabetes. Treatment included medications, physiotherapy, and speech therapy, with some improvement in instability and falls over 2 months.
This document presents the case of a 40-year-old female school teacher presenting with ataxia. She has a 2-year history of swaying while standing and walking. On examination, she has signs of cerebellar ataxia including impaired finger-nose and heel-shin coordination. Testing revealed normal thyroid and vitamin B12 levels. The differential diagnosis includes inherited ataxias, hypothyroidism, vitamin B12 deficiency, and paraneoplastic syndrome. The features are most consistent with an autosomal dominant spinocerebellar ataxia given the chronic progressive symmetric ataxia with no other neurological deficits. This is likely spinocerebellar ataxia type 1 or 2 given the
multivalvular heart disease AS, MR WITH PDA.pptxpurraSameer
This patient is a 65-year-old female who presented with a 10-year history of palpitations and 5-year history of dyspnea on exertion. Her functional capacity has declined from NYHA class I to class III over 10 years. Examination revealed signs of right and left heart failure including elevated JVP, peripheral edema, and murmurs suggestive of severe aortic stenosis, mitral regurgitation, tricuspid regurgitation, and patent ductus arteriosus. Laboratory findings included hypoxemia. The patient was diagnosed with severe valvular heart disease, pulmonary arterial hypertension, right ventricular pressure overload, and normal left ventricular function.
This document presents a case study of a 1-year-old male child named Master Ved Rathod who is experiencing developmental delays. He is unable to stand, walk, or talk independently for his age. The child's birth history included meconium aspiration syndrome and hypoxic ischemic encephalopathy requiring ventilator support. On examination, he has hypertonicity in his left upper and lower limbs and a foot deformity. Based on his history and examination findings, provisional diagnoses include acute meningitis, brachial plexus injury, and foot deformity.
I need a response to this assignmentzero plgiarismthree refe.docxflorriezhamphrey3065
I need a response to this assignment
zero plgiarism
three references
Initials: J.S Age: 42 Sex: Male Race: African American
S.
CC:
“I am experiencing lower back pain that radiates to my left leg”
HPI
: Mr. Smith is a 42-year-old African American male who reports to the clinic complaining of lower back pain that periodically radiates to his left leg. The pain started about one month ago. The character of the pain is shooting and stabbing. It appears to get worse when sitting for an extended period of time, bending over and during strenuous physical activity. The severity of the pain is 8/10 without medications but relieves to about 3/10 after taking Tylenol and getting some rest.
Location: Lower back
Onset: 1 month
Character: Shooting and Stabbing
Associated signs and symptoms: nausea, vomiting, photophobia.
Timing: Sitting for extended periods, bending over and strenuous physical activity.
Exacerbating/ relieving factors: Tylenol and rest makes the pain tolerable, but not completely better.
Severity: 8/10 pain scale
Current Medications
:
Metoprolol 100 mg tablet, PO once daily.
Acetaminophen 500 mg tabs, 1-2 PO q 6 hrs, PRN for pain. (not to exceed 3 g in 24 hr).
PMHx:
Diagnosis: Hypertension
Surgical Hx:
Laparotomy, 02/2000
Immunizations:
Childhood immunizations completed. Tetanus and Flu shots are up-to-date.
Soc Hx:
Unemployed. Lives alone and never married. Has one brother and both parents are alive. Performs physical exercise regularly at the gym, and uses seat belts all the time when driving. Denies tobacco and alcohol use.
Fam Hx
: Father has a stroke and heart disease, Mother has hypertension, Brother has diabetes. Maternal and Paternal grandparents died of a stroke 2 years ago.
ROS
: BP - 140/90 L arm, P - 86, T - 98.1 oral, RR - 18, Ht. - 5’10”, Wt. - 200 lbs. BMI 28.7
GENERAL: No weight loss, fever, chills, weakness or fatigue.
HEENT: Eyes: No visual loss, blurred vision, doubles vision or yellow sclerae.
Ears, Nose, Throat: No hearing loss, sneezing, congestion, runny nose or sore throat.
Skin: No rash or itching. No skin lesions or moles that are new or suspicious.
CARDIOVASCULAR: No chest pain, chest pressure or chest discomfort. No palpitations or edema. No pleurisy pain, no hx of a heart murmur. No EKG on record. No peripheral edema or claudication. BP controlled with medication.
RESPIRATORY: No cough, sputum or SOB. No DOE, hemoptysis. Chest X-rays - 3 years ago.
GASTROINTESTINAL: No anorexia, nausea, vomiting or diarrhea. No abdominal pain or blood. No unintentional weight loss or gain. No change in bowel habits.
GENITOURINARY: No penile discharge or erectile dysfunction. No nocturia, dribbling, or incontinence.
NEUROLOGICAL: No headache, dizziness, syncope, paralysis, ataxia, numbness or tingling in the extremities. No change in bowel or bladder control. No reports of numbness or tingling to the left leg since the onset of lower back pain.
MUSCULOSK.
In this slideshow, we covered most of neuromuscular disorders which might face you in medicine in general and in pediatrics in particular.
We hope if you find this slideshow helpful for your seeking of this subject.
Cheers,
Mr. Vembuli, a 56-year-old male, presented with recurrent falls, slowness in activities, and uncontrollable crying. He was diagnosed with progressive supranuclear palsy (PSP) based on MRI findings of midbrain atrophy, the hummingbird sign, and features including vertical gaze palsy, pseudobulbar palsy, parkinsonism, and poor response to levodopa. PSP is a rare neurodegenerative disorder characterized by tau protein abnormalities in the brainstem, basal ganglia and cerebellum. It differs from Parkinson's disease in its early gait impairment, symmetrical onset, and lack of tremor. Treatment options are limited but may
This document provides information about stroke including its causes, symptoms, diagnosis, and treatment. It begins with an introduction defining stroke as the interruption of blood flow to the brain. It then discusses the two main types of stroke: ischemic (caused by blockage) and hemorrhagic (caused by bleeding). Symptoms vary depending on the area of brain affected but can include paralysis, weakness, sensory loss, and speech problems. Stroke is diagnosed using CT scans or MRI. Treatment involves medications to prevent clots like aspirin, and sometimes surgery to repair blood vessels. Physiotherapy focuses on improving mobility, balance, and function.
This document provides an overview of low back pain assessment. It discusses the epidemiology of low back pain, including prevalence and impact. It covers the anatomy and etiology of low back pain, including spinal and non-spinal causes. The document describes approaches to history taking, physical examination, classification of low back pain, diagnostic studies, and red flags. Examination techniques like range of motion, neurological tests, and special tests are outlined. The goal of assessment is discussed as ruling out serious pathology while determining the nature and location of pain.
This document presents a case of a 37-year-old female patient experiencing lower back pain radiating to her lower limbs that has prevented walking for 2 months. Examinations revealed diminished sensation below the D3 level. MRI showed a PLID at L4-L5 with a migratory disc. The planned treatment is a left-sided fenestration and microdiscectomy at L4-L5 to remove the migratory disc fragments.
This document summarizes the case of a 72-year-old lady who presented with intermittent fever, weight loss, and joint pains for 3-4 months. On examination, she had pallor, enlarged lymph nodes, mild hepatomegaly, and joint tenderness. Investigations showed anemia, elevated inflammatory markers, hyperferritinemia, and normochromic bone marrow. She did not improve with extensive testing and therapies. The working diagnosis is adult-onset Still's disease given her clinical presentation and elevated ferritin level. She was started on steroids and scheduled for follow up.
The current presentation is regarding history taking skill of a physician and general physical examination of a patient, intended for improving the clinical approach of 1st year BAMS students from a Physiology and Pathological point of view.
A 10-month-old baby, Aasha, presented with delayed developmental milestones, cleft palate, heart disease, and malnutrition. She has global developmental delay, cerebral palsy, quadriplegia, a history of congenital heart disease requiring intervention, cleft palate, cataract, defective vision and hearing, and acute and chronic malnutrition. She likely has multiple congenital anomalies due to a probable etiology like rubella infection. Investigations and management include physiotherapy, correction of defects, stimulation programs, and lab tests.
This document presents a case study of a 42-year-old male patient admitted to SDM Hospital in Hassan, Karnataka, India with neck pain radiating to his right arm along with numbness and weakness. The patient's history, examination findings, investigations and differential diagnosis are documented. Based on the signs and symptoms of pain and stiffness with limited range of motion, the patient was diagnosed with Apabahuka (Frozen Shoulder). The patient underwent Panchakarma treatments including snehana, swedana, nasya and Lepa. His range of motion improved and he was discharged with relief of symptoms on medication.
n-172301.physiotherapy and clinical part of cerebellar ataxiapptAdyataDave
Acute cerebellar ataxia is sudden inability to coordinate muscle movement due to disease or injury to the cerebellum. This is the area in the brain that controls muscle movement. Ataxia means loss of muscle coordination, especially of the hands and legs.
Causes
Acute cerebellar ataxia in children, particularly younger than age 3, may occur several days or weeks after an illness caused by a virus.
Viral infections that may cause this include chickenpox, Coxsackie disease, Epstein-Barr, echovirus, among others.
Other causes of acute cerebellar ataxia include:
Abscess of the cerebellum
Alcohol, medicines, insecticides, and illicit drugs
Bleeding into the cerebellum
Multiple sclerosis
Strokes of the cerebellum
Vaccination
Trauma to head and neck
Certain diseases associated with some cancers (paraneoplastic disorders)
Symptoms
Ataxia may affect movement of the middle part of the body from the neck to the hip area (the trunk) or the arms and legs (limbs).
When the person is sitting, the body may move side-to-side, back-to-front, or both. Then the body quickly moves back to a sitting upright position.
When a person with ataxia of the arms reaches for an object, the hand may sway back and forth.
Common symptoms of ataxia include:
Clumsy speech pattern (dysarthria)
Repetitive eye movements (nystagmus)
Uncoordinated eye movements
Walking problems (unsteady gait) that can lead to falls
Difficulty controlling arm movements
Exams and Tests
The health care provider will ask if the person has recently been sick and will try to rule out any other causes of the problem. Brain and nervous system examination will be done to identify the most affected areas of the nervous system.
The following tests may be ordered:
CT scan of the head
MRI scan of the head
Spinal tap
Blood tests to detect infections caused by viruses or bacteria
Treatment
Treatment depends on the cause:
If the acute cerebellar ataxia is due to bleeding, surgery may be needed.
For an ischemic stroke, medicine to thin the blood can be given. Removing a blood clot from within the blood vessels may also be needed.
Infections may need to be treated with antibiotics or antivirals.
Corticosteroids may be needed for swelling (inflammation) of the cerebellum (such as from multiple sclerosis).
Cerebellar ataxia caused by a recent viral infection may not need treatment.
Physical therapy may be needed to reduce risk of falling.Outlook (Prognosis)
People whose condition was caused by a recent viral infection should make a full recovery without treatment in a few months. Strokes, bleeding, or infections may cause permanent symptoms.
Possible Complications
Falls may result in injury.
In rare cases, movement or behavioral disorders may persist.
When to Contact a Medical Professional
Contact your provider if any symptoms of ataxia appear.
Alternative Names
Cerebellar ataxia; Ataxia - acute cerebellar; Cerebellitis; Post-varicella acute cerebellar ataxia; PVACA
References
Kuo SH, Lin CC, Ashizawa T.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler Community Health Nursing A Canadian Perspective, 5th Edition TEST BANK by Stamler Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Study Guide Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Studocu Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Course Hero Community Health Nursing A Canadian Perspective, 5th Edition Answers Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Course hero Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Studocu Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Study Guide Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Ebook Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Questions Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Studocu Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Stuvia
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
5. HISTORY OF PRESENT ILLNESS
She experienced a minor fall (~3 months ago) after tripping over her
dog and landed on an outstretched right hand, leading to wrist pain.
She saw her family doctor regarding her wrist and also complained
about the balance issues and tremor in her hand.
She was referred to neurologist and was diagnosed with early stage
Idiopathic Parkinson's disease 1 month ago.
She was then referred to a physiotherapist to address her concerns
regarding the condition.
S
I
M
R
A
N
S
H
A
W
6. She has balance issues since 1 year.
She has left-hand tremor since 5 months (right hand dominant).
She has decreased handwriting size since 5 months.
HISTORY OF PRESENT ILLNESS
S
I
M
R
A
N
S
H
A
W
7. P A G E 0 8
PAST MEDICAL HISTORY
Suffering from Depression
Right wrist injury - Resolved.
S
I
M
R
A
N
S
H
A
W
8. Currently None.
Received prescription and education for
Levadopa - doesn’t feel she needs it yet.
Advil (Ibuprofen)- for headaches when
needed.
DRUG HISTORY
S
I
M
R
A
N
S
H
A
W
9. Non Smoker
No longer drinks alcohol since
3 years.
PERSONAL HISTORY
S
I
M
R
A
N
S
H
A
W
10. PSYCHOSOCIAL STATUS
She describes feeling lonely, isolated and frustrated
with the diagnosis.
Showing signs of depression.
She has avoided going to see her friend due to feeling
unsteady and fear of falling(~3 months).
The daughter lives ~2 hours away, and visits 1-2
times/month.
Mrs. GB's husband passed away 5 years ago.
S
I
M
R
A
N
S
H
A
W
11. ENVIRONMENTAL HISTORY
She lives in a bunglow alone with her dog.
There are 4 stairs into the house with railing.
10 stairs to the basement with railing (laundry).
The bathroom has a large shower/bathtub with a non-
slip mat but no railing.
S
I
M
R
A
N
S
H
A
W
12. FUNCTIONAL STATUS
PREVIOUS FUNCTIONAL STATUS
Prior to the onset of PD symptoms (decreased balance and tremor): able to walk
about ~200m to her friend's house, gardening, performed activities of daily
living(ADLs) independently, driving often (grocery store, recreation center)
CURRENT FUNCTIONAL STATUS
Since the onset of PD symptoms: Drives when necessary but less confident with
reaction time, less confident walking outside, no issues with dressing/bathing, no
problems with stairs, no problems with bed mobility
S
I
M
R
A
N
S
H
A
W
14. Slight masked face
Slight muscular deconditioning
Mild dysarthria
Mild left resting hand tremor
which increased while discussing
history of diagnosis
OBSERVATION
S
I
M
R
A
N
S
H
A
W
15. SENSORY EXAMINATION
U/E and L/E intact
REFLEXES
Normal
ORIENTATION, MEMORY, BEHAVIOUR
Depressed
S
I
M
R
A
N
S
H
A
W
16. TONE
Normal
U/E: Limited bilateral shoulder flexion and abduction L>R
Trunk: Limited in bilateral rotation
L/E: Limited in bilateral hip extension, bilateral dorsiflexion (non-
Weight Bearing(WB)) L>R
All other ROM within normal limit (WNL)
ACTIVE RANGE OF MOTION
S
I
M
R
A
N
S
H
A
W
17. U/E: Limited bilateral shoulder flexion and abduction
L>R
L/E: limited in bilateral dorsiflexion (non-WB) L>R
All other ROM is WNL
**Some limits due to mild rigidity (cogwheel)
PASSIVE RANGE OF MOTION
S
I
M
R
A
N
S
H
A
W
18. MANUAL MUSCLE TESTING
20 kg
18 kg
Overall strength: L 4/5, R 4+/5
Apparent weakness in antigravity muscles (back and
neck extensors, hip extensors, quads, hip flexors)
GRIP STRENGTH TESTING
LEFT HAND
RIGHT HAND
S
I
M
R
A
N
S
H
A
W
19. POSTURE & GAIT ASSESSMENT
POSTURE
Moderate kyphosis
Forward head posture
GAIT
Mild Bradykinesia
S
I
M
R
A
N
S
H
A
W
20. BALANCE ASSESSMENT
Activities-Specific Balance Confidence Scale(ABC Scale): 65%
Timed Up and Go (TUG) : 13.2 seconds
Berg Balance Scale (BBS): 40/56
With cognitive task (counting backward from 100 by 3): 13.7 seconds
With dual-motor task (carrying a glass of water in R hand): 15 seconds
Most affected areas: tandem stance, turning 360 degrees, standing with
feet together, standing with eyes closed.
S
I
M
R
A
N
S
H
A
W
21.
22. SELF REPORTED OUTCOME MEASURES
Patient Health Questionnaire (PHQ-9): 12
Parkinson's Disease Questionnaire (PDQ-39): 38/156 = 24%
Most affected areas: mobility, emotional well-being, social
support
S
I
M
R
A
N
S
H
A
W
27. PROBLEM LIST
S
I
M
R
A
N
S
H
A
W
Balance - increased fall risk
Gait
Tremor
Depression
Micrographia
Dysarthria
Bradykinesia
Kyphotic forward head posture
Limited ROM in shoulder, hip, trunk , ankle
Mild rigidity
29. FOR RIGIDITY
Generalised relaxation techniques - Jacobson's technique of
progressive relaxation
Gentle Rocking with the use of adult vestibular ball, rocking chair,
and cradle.
PNF - Rhythmic initiation for upper limb and lower limb
Deep breathing exercise
Meditation technique or cognitive imaging
Home Program(H.P) - Relaxation audiotapes
30.
31.
32. FOR MUSCULOSKELETAL FLEXIBILITY
Active ROM exercises or external heating modality
Passive Stretching of shoulder flexors, abductors, hip
extensors, hip abductors & ankle dorsiflexors.
PNF diagonal patterns of upper limb and lower limb
AROM + PROM + PNF :- 5-7 days/week ( min 2-3 days/week)
Pnf technique - Hold relax, Contract Relax
Prolonged stretching for shortened muscles - 4 reps per stretch
held for 50 to 60 seconds
H.P - Encourage self stretching
33. FOR POSTURE
Postural awareness
Extension Exercises
Positional stretching - 20 to 30
minutes
Postural mirror
Patient should try and stretch out his
whole body.
patient should be instructed to lie
supine with a pillow under the upper
thorax.
34. FOR TREMOR
Reducing anxiety helps in
decreasing the tremor.
Relaxation techniques helps.
Yoga
Meditation
For severe tremor - use gloves in
hands or tie any weight in hand.
35. FOR BALANCE
Appropriate verbal, tactile or
proprioceptive cues
By wobble board
By swiss ball
Perturbations while sitting on edge of cot
weight shifts, alternate unilateral
weight-bearing
Reaching out, axial rotation of head and
trunk
Sit to stand
36. FOR BALANCE
Sitting on therapy ball, bosu ball
Challenges in quadripod, half kneeling ,
kneeling
Kitchen sink exercises - heel rises, toe
offs, partial wall squats, chair risers,
single limb stance and marching in
place.
37. FOR GAIT TRAINING
GO SLOW
Visual cues like stationary floor markings (improve stride length and
velocity)
Auditory cues
Rhythmic auditory stimulation -steady beat or metronomes (improve
gait speed cadence $ stride length
Multisensory cueing
Reciprocal arm movement
39. FOR PSYCHOLOGICAL WELL BEING & MICROGRAPHIA
Educate to lead a relatively active
functional life
no false assurance
Counselling
Encourage to take dog for a walk
or play with the dog
Lead a active lifestyle
Writting in 4 line copy or square
box copy may help in writting size
41. FOR THORACIC EXPANSION
P A G E 1 4
Diaphragmatic Breathing
Segmental Breathing
Balloon blowing
Incentive Spirometry
During extension exercises patient
should be asked breathe in - helps in
increasing thoracic expansion
42. FOR FUNCTIONAL TRAINING
Bed Mobility Skills - Rolling, Bridging, Supine to sit transitions
Anterior posterior tilts, side to side pelvic tilts, pelvic clock exercises.
LSVT Big program
43. FOR STRENGTHENING
For anti gravity muscles.
Using of thera band, free weights
2 days/week on nonconsecutive days
44. IMPROVING THE PHYSICAL FITNESS
Aerobic exercises.
Rejoining her dance
class.
walking to her friends
house.