This document discusses geriatric management at both the individual and community level. At the individual level, management includes acute care, functional restoration, and prevention. Acute care focuses on education, pain relief, and healing. Functional restoration maintains and improves range of motion, strength, flexibility, and balance. Prevention maintains previous exercises and identifies risk factors. At the community level, a multidisciplinary team provides primary, secondary, and tertiary prevention. This includes health promotion, early diagnosis and treatment, and rehabilitation. The document also outlines exercise recommendations for older adults, including aerobic, strength, flexibility, endurance, and neuromotor exercises.
A highly structured, goal-oriented, individualized intervention program designed to return the employee to work. Our Work Hardening programs are multidisciplinary in nature and utilize real or simulated work activities designed to restore physical, behavioral and vocational functions.
Retraining of motor control basing on understanding of normal movement & analysis of motor dysfunction.
Emphasis of MRP is on practice of specific activities, the training of cognitive control over muscles & movt. Components of activities & conscious elimination of unnecessary muscle activity.
In rehabilitation programme involve – real life activities included.
This presentation give an upto date insightful information on balance/postural assessment and key domains of Occupational Therapy during assessment of balance using different scales.
A highly structured, goal-oriented, individualized intervention program designed to return the employee to work. Our Work Hardening programs are multidisciplinary in nature and utilize real or simulated work activities designed to restore physical, behavioral and vocational functions.
Retraining of motor control basing on understanding of normal movement & analysis of motor dysfunction.
Emphasis of MRP is on practice of specific activities, the training of cognitive control over muscles & movt. Components of activities & conscious elimination of unnecessary muscle activity.
In rehabilitation programme involve – real life activities included.
This presentation give an upto date insightful information on balance/postural assessment and key domains of Occupational Therapy during assessment of balance using different scales.
Hierachical theory- says that higher centers control on lower center; but when higher center damage then this inhibitory control from the higher center is loss which leads to exageration of the movt.
In normal individual, these occur a smooth, rhythmic movt. Because there is a presence of control from higher center on lower center.
Controlled use of sensory stimulus.
Specific Motor response
Normalization of muscle tone
Use of Developmental sequences.
Sensorimotor development = from lower to higher level.
Use of activity to demand a purposeful response.
Practice of sensory motor response is necessary for motor learning.
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
NDT, BOBATH TECHNIQUE, BASIC IDEA OF BOBATH, CONCEPT OF BOBATH, NEUROPHYSIOLOGY OF NDT, ICF MODEL, PRINCIPLES OF TREATMENT OF NDT IN STROKE AND CP, AUTOMATIC AND EQUILIBRIUM REACTIONS, KEY POINTS OF CONTROL, FACILITATION, INHIBITION AND HANDLING IN NDT
At the end of the lecture, the students should be able to:
Discuss the theoretical basis of the neurodevelopmental approaches
Discuss the concepts and principles underlying the Bobath approach
Discuss the concepts and principles underlying the Brunnstrom approach
This PPT describes neurological gait deviations.
It describes Hemiplegic/circumductory gait, Spastic Diplegic gait, Parkinson gait, Myopathic & Ataxic gait in detail along with its causes and management in with Physiotherapy treatment. detail
Hierachical theory- says that higher centers control on lower center; but when higher center damage then this inhibitory control from the higher center is loss which leads to exageration of the movt.
In normal individual, these occur a smooth, rhythmic movt. Because there is a presence of control from higher center on lower center.
Controlled use of sensory stimulus.
Specific Motor response
Normalization of muscle tone
Use of Developmental sequences.
Sensorimotor development = from lower to higher level.
Use of activity to demand a purposeful response.
Practice of sensory motor response is necessary for motor learning.
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
NDT, BOBATH TECHNIQUE, BASIC IDEA OF BOBATH, CONCEPT OF BOBATH, NEUROPHYSIOLOGY OF NDT, ICF MODEL, PRINCIPLES OF TREATMENT OF NDT IN STROKE AND CP, AUTOMATIC AND EQUILIBRIUM REACTIONS, KEY POINTS OF CONTROL, FACILITATION, INHIBITION AND HANDLING IN NDT
At the end of the lecture, the students should be able to:
Discuss the theoretical basis of the neurodevelopmental approaches
Discuss the concepts and principles underlying the Bobath approach
Discuss the concepts and principles underlying the Brunnstrom approach
This PPT describes neurological gait deviations.
It describes Hemiplegic/circumductory gait, Spastic Diplegic gait, Parkinson gait, Myopathic & Ataxic gait in detail along with its causes and management in with Physiotherapy treatment. detail
Physical activity in people with disabilities and elderly peopleKarel Van Isacker
As presented at the International Workshop on “Qualitative Personal Caring in a European Perspective”, 07 May 2015, Antalya, Turkey
http://mcare-project.eu/
This project (M-Care - 539913-LLP-1-2013-1-TR-LEONARDO-LMP) has been funded with support from the European Commission. This website reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information contained therein.
Physiotherapy Approaches and various therapies for Ankylosing Spondylitis where fusion of the spine causes restriction in movement. This presentation focuses on aqua therapy for this particular condition.
In-service presentation to the rehabilitation therapy department about Denver Health's ACUTE service for severe eating disorders and the role of therapy in treatment.
Arthritis is the swelling and tenderness of one or more joints. The main symptoms of arthritis are joint pain and stiffness, which typically worsen with age. The most common types of arthritis are osteoarthritis and rheumatoid arthritis.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
These lecture slides, by Dr Sidra Arshad, offer a quick overview of 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 leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
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. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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3. INDIVIDUAL MANAGEMENT
• PROBLEM LIST
• AIMS OF MANAGEMENT
ACUTE CARE MANAGEMENT
FUNCTIONAL RESTORATIVE MANAGEMENT
PREVENTIVE MANAGEMENT
4. ACUTE CARE MANAGEMENT
• Patient Education
• Relief of Pain
• Enhance healing (Reduce inflammation and swelling)
5. FUNCTIONAL RESTORATIVE
MANAGEMENT
• Maintenance of existing ROM and efforts to gently begin increasing
ROM
• Maintain joint mobility and soft tissue integrity
• Restore muscle strength & endurance
• Restore extensibility and flexibility of soft tissues
• Postural corrections
• Balance Training & Gait training
6. PREVENTIVE MANAGEMENT
• Maintenance and progression of previous exercise.
• Identify risk factors and comorbidity and frame the exercise protocol accordingly –
diabetes, hypertension, obesity, osteoporosis etc including life style modifications.
• Ergonomic advise & environmental modification.
• Prevention of Sarcopenia.
• Nutritional advise.
• Cardio respiratory endurance.
• Home programs
7. COMMUNITY MANAGEMENT
• TEAM MEMBERS
• STRATEGIES
• PROBLEM LIST
• AIMS OF MANAGEMENT
PRIMARY PREVENTION
SECONDARY PREVENTION
TERTIARY PREVENTION
8. TEAM MEMBERS
Multidisciplinary team approach
• PWD with family members
• Medical team – Physician, General surgeon, Orthopaedic surgeon,
Obstetrician & Gynaecologist, Psychiatrist, Ophthalmologist etc
• Paramedical Team – Physiotherapist, Occupational therapist, Orthotist and
Prosthetist, Speech therapist, Rehabilitation nurse, Clinical Psychologist,
Nutritionist
• Socio-vocational team – Social worker, Health educator, Rehabilitation &
Vocational counsellor, NGO’s, Bank, Special schools and teachers.
9. STRATEGIES
• Geographical mapping of the area
• Permission from local leaders
• Meeting the person with disability
• Support and assistance of professionals / organisations / institutions
• Available resources + transfer of resources
• Date/time/venue
• Awareness through various media
12. SECONDARY PREVENTION
Early diagnosis and treatment
OBJECTIVES:
• Prevent progression of disease process
• Prevent complications and sequelae of disease
• To shorten the period of disability (disease process)
SERVICE PROVIDED BY PHYSIOTHERAPIST
• Complete Examination
• Prompt treatment (STG & LTG)
13. TERTIARY PREVENTION
Late Pathogenesis Phase
MODE OF INTERVENTION
• Disability Limitation
• Rehabilitation: combined and co-ordinated use of medical, social,
educational, vocational measures of training the individuals to the highest
possible level of functional ability.
DISEASE IMPAIRMENT DISABILITY HANDICAP
14. ACSM RECOMMENDATION
An exercise regime for elderly should always include:
AEROBIC EXERCISE
FLEXIBILITY EXERCISE
STRENGTHENING EXERCISE
ENDURANCE EXERCISE
NEUROMOTOR EXERCISE
15. AEROBIC EXERCISE
• Frequency – ≥ 5 days / week (moderate intensity physical activity)
≥ 3 days / week (vigorous intensity physical activity)
3 – 5 days/ week (combination of both)
• Intensity – On scale 0-10 for level of physical exertion, 5 – 6 for moderate intensity and 7 –
8 for vigorous intensity.
• Type – Any modality that does not impose excessive orthopaedic stress
Walking, aquatic exercise, and stationary cycle exercise.
• Time – Moderate intensity : 30 – 60 minutes / day in bouts of 10 minutes each to total of
150 – 300 min / week
Vigorous intensity: 20 – 30 minutes / day to total 75 -100 minutes / week
16. ENDURANCE EXERCISE
• Frequency – ≥ 2 days / week
• Intensity – moderate intensity (5-6) Borg scale
• Type – Walking, stair climbing at self-selected comfortable pace.
• Time – It will be progressively increased according to the participant’s
performance.
• Instructions while starting an endurance training program: Start
out slowly and progress by increasing the time by 5 min or increasing
the speed. Monitor intensity with a Rating of Perceived Exertion Scale
(Modified Borg Scale). Wear shoes that offer support and are
appropriate for the type of activity.
17. FLEXIBILITY EXERCISE
• Frequency – ≥ 2 days / week with a goal of 5 days / week.
• Intensity – Stretch to the point of feeling tightness or slight
discomfort.
• Type - Any activities that maintain or increase flexibility using
sustained stretches for each major muscle group.
• Time – 10 - 15 second hold and 5 repetitions – progressively
increased till 30 – 60 seconds hold.
18. STRENGTHENING EXERCISE
• Frequency – ≥ 2 days / week
• Intensity – Light Intensity (40-50% of 1RM), Moderate Intensity (60-
70% of 1RM)
• Type – Progressive strengthening activities for major muscle group
(delorme/oxford/ Macqueen)
19. NEUROMOTOR EXERCISE
• Frequency – 2 – 3 days / week
• The ACSM exercise Prescription guidelines recommend following activities –
• Progressively difficult postures that gradually reduce the BOS (Two-legged
stand, semi tandem stand, tandem stand, one legged stand.)
• Dynamic movements that perturb the COG (tandem walk, circle turns)
• Stressing postural muscle groups (Heel stands, Toe Stands)
• Reducing sensory inputs (Standing with eyes closed)
20. NEUROMOTOR EXERCISE
Activity Level 1 Level 2 Level 3 Challenges
Static
Balance
Activities
Upright stance with
variations - wide, narrow,
semi tandem, tandem and
single leg stand.
For each variation add -
Forward, backward and
Lateral sway
Add arm movements to sway -
Raise one arm at a time to
front and then to sides, raise
both arms to front and sides
Close one eye, Close
both eyes, turn head
to right and then to
left, Hold an item
such as a book
Dynamic
Balance
Activities
Sit-to-stand-to-sit, walk
forward and Backward
Perform wide-stance walk,
perform narrow stance walk,
walk on heels, walk on toes
Tandem walking, walk while
carrying an item, walk with
head turns
Barefoot, One eye
closed, Surface
change, Obstacles
Walk side to side Side step on heels, Side step
on toes, Turn in a circle
Sidestep while carrying an
item, sidestep with head turns,
perform crossover walk
21.
22. REFERENCES
• Geriatric Physical Therapy – Andrew Guccione (2nd and 3rd ed)
• ACSM’s Guidelines for Exercise Testing & Prescription (9th ed)
• Textbook of Community Medicine and Rehabilitation – T Bhaskararao (3rd ed)
• Preventive and Social Medicine – K Park (23rd ed)
• Essentials of Community Based Rehabilitation – Satyabhushan Nagar (1st ed)
• Community Based Rehabilitation of Persons with Disabilities – S Pruthvish (1st ed)
• Therapeutic Exercise – Kisner Colby (6th ed)
• Physical Rehabilitation – O’Sullivan (6th ed)
• Management of Common Musculoskeletal disorders – Hertling & Kessler (4th ed)
• Rehabilitation Medicine for Elderly – Stefano Masierio (Springer Pub.) – (1st ed)
• Exercise for Aging Adults – Gail M Sullivan (Springer Pub.) – (1st ed)