The document defines proprioceptive neuromuscular facilitation (PNF) as an exercise approach based on functional anatomy and neurophysiology. It was developed in the 1940s to mobilize patients' reserves and help them achieve their highest function. PNF uses techniques like resistance, stretch, traction and timing of contractions/relaxations to facilitate muscle strength, endurance and range of motion. Common PNF techniques include rhythmic initiation, repeated contraction, slow reversal and contract-relax stretching. PNF patterns target specific muscle groups through combinations of flexion/extension, abduction/adduction and rotation.
Basic Introduction about Joint Mobilisation and Manipulation, This article gives clear notes for the students to understand the Mobilisation techniques.
This Presentation is about Mitchell relaxation technique also known a physiological relaxation technique Mitchell’s physiological relaxation technique is based on reciprocal inhibition and involves diaphragmatic breathing and a series of ordered isotonic contractions.
Brian Mulligan described novel concept of the simultaneous application of therapist applied accessory mobilizations and patient generated active movements
Basic Introduction about Joint Mobilisation and Manipulation, This article gives clear notes for the students to understand the Mobilisation techniques.
This Presentation is about Mitchell relaxation technique also known a physiological relaxation technique Mitchell’s physiological relaxation technique is based on reciprocal inhibition and involves diaphragmatic breathing and a series of ordered isotonic contractions.
Brian Mulligan described novel concept of the simultaneous application of therapist applied accessory mobilizations and patient generated active movements
Introduction to muscle energy techniques (METs)Fared Alkordi
The use of Muscle Energy Techniques (METs) to reduce muscle pain and improve muscle length. Types, physiological mechanisms and practical techniques in clinical settings.
Co-ordination Exercise,Definitions,Nervous control,Motor pathway,Cerebral cortex,Kinesthetic sensation,Causes of Incoordination,Flaccidity
Spasticity ,Cerebellar ataxia,Loss of kinesthetic sensation,Types of coordination,Posterior column,Test for Incoordination.
Joint mobilization refers to a technique of manual therapy by which a therapist applies a brief stretch of 30s or less through traction and gliding along a joint surface.
Introduction to muscle energy techniques (METs)Fared Alkordi
The use of Muscle Energy Techniques (METs) to reduce muscle pain and improve muscle length. Types, physiological mechanisms and practical techniques in clinical settings.
Co-ordination Exercise,Definitions,Nervous control,Motor pathway,Cerebral cortex,Kinesthetic sensation,Causes of Incoordination,Flaccidity
Spasticity ,Cerebellar ataxia,Loss of kinesthetic sensation,Types of coordination,Posterior column,Test for Incoordination.
Joint mobilization refers to a technique of manual therapy by which a therapist applies a brief stretch of 30s or less through traction and gliding along a joint surface.
content from
(proprioceptive neuromuscular fascilitation article of Marymount University Fall 2009),
DPT AMIR MEMON (pnf presentation)
DPT AARTI SAREEM (pnf presentation)
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Title: Sense of Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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2. DEFINATION
• PROPRIOCEPTIVE: having to do any of the sensory
receptors that give information concerning movement
and position of the body.
• NEUROMUSCULAR: involving the nerve and muscles.
• FACILITATION: making easier.
3. • Proprioceptive neuromuscular facilitation is a exercise
based on the principles of the functional human
anatomy and neurophysiology.
• PNF is an approach to patient care, which as
orignated in the 1940’s by Harman Kabat, M.D.
Maggie knott joined him in his effort to discover and
define the approach in the late 1940’s
4. Basic principles of PNF
• PNF is an integrated approach : each treatment is directed at a total
human being, not just at a specific problem or body segment.
• Based on the untapped existing potential of all the a patients,the
therapist will focus on mobilizing the patient’s reserve.
• The treatment approach is always positive, reinforcing and uses that,
which the patient can do, on a physical and psychological value.
• The primary goal of all treatment is to help patients achieve their
highest level of function.
• To reach the highest level of function, the therapist integrates
principles of motor control and motor learning. This includes
treatment on the level of the body structures, on the activity level as
well as on the participation level (ICF, International Classification of
functioning, WHO)
5. Neurophysiologic principles
• The work of Sir Charles Sherrington was important in
the development of the procedures and techniques of
PNF. The following useful definitions were abstracted
from his work (Sherrington 1947)
6. • After discharge: The effect of a stimulus continues
after the stimulus stops. If the strength and duration
of the stimulus increases, the after discharge
increases also. The feeling of increased power that
comes after a maintained a static contraction is a
result of after discharge.
• Temporal summation: A succession of weak
stimuli(subliminal) occuring within a certain period
(Short) of time combine(summate) to cause
excitation.
7. • Spatial Summation: Weak stimuli applied
simultaneously to different areas of the body
reinforce each other (summate) to cause excitation.
Temporal and spatial summation can combine for
greater activity.
• Irradiation: this is spreading and increased strength of
a response. It occurs when either the number of
stimuli or the strength of stimuli is increased. The
response may be excitation or inhibition.
8. • Successive Induction: An increased excitation of the
agonist muscles follows stimulation (contraction) of
their antagonist. Technique involving reversal of
antagonist make use of this property(induction,
stimulation, increased excitability).
• Reciprocal innervation: Contraction of muscles is
accompanied by simultaneous inhibition of their
antagonist. Reciprocal innervation is a neccessory part
of coordinated motion. Relaxation techniques make
use of this property.
9. Basic principles of PNF
• Resistance
• Irradiation and reinforcement
• Manual contact
• Stretch
• Verbal command
• Traction and approximation
• Timing
• Body positioning and body mechanics
10. Resistance
Resistance is used in the treatment to:
• Facilitate the ability of the muscle to contract
• Increase the motor control
• Help the patient gain an awareness of motion and its
strength.
• Increase the strength
11. Irradiation
• Is the spread of the response to stimulation.
• This response can be seen as increased
facilitation(contraction) or inhibition (relaxation) in
the synergistic muscles and patterns of movement.
The responses increases as the stimuli increases in
duration and intensity
12. Reinforcement
• The therapist directs the reinforcement of the weaker
muscles by the amount of resistance given to the
strong muscles.
• Increasing the amount of resistance will increase the
amount and extent of muscular response.
13. Manual contact
Effects:
• Stimulates the muscle.
• Stimulates the synergistic muscle to reinforce the
movement.
• Promotes trunk stabilization and indirectly helps the
limb motion.
• Prevents confusion.
14. Stretch
• The stretch stimulus occurs when the muscle is
elongated.
• The lengthened position of the muscle is the starting
position of each pattern and the stretch is maintained
throughout the movement.
• All the components of a pattern must be stretched
simultaneously.
15. Stretch
Effects:
• Stimulates the activity of muscle spindle.
• Any contraction of muscle on stretch will result in
movement and the brain knows not of muscles but of
movement.
16. Traction
• Traction is elongation of trunk or an extremity
• Traction force is applied gradually, maintained
throughout the movement, and combined with
appropriate resistance.
• Joint separation stimulates joint receptors
• Muscle stretch stimulates muscle spindle stretch
receptor
• Facilitates Alpha Motor Neuron
• Facilitates Strength
17. Approximation
Definition:
• Approximation is the compression of the trunk or an
extremity.
• Compression through a joint stimulate joint receptors
• Facilitate alpha motor neuron
• Facilitate stability
18. Uses:
• Promote stabilization
• Facilitate weight bearing and contraction of postural
muscles
• Facilitate upright reactions
• Resist some component of motion. E.g., use
approximation at the end of shoulder flexion to resist
scapula elevation
19. Verbal stimulation
• The volume with which the command is given affects
the strength of resulting muscle contraction.
• Louder command when strong muscle contraction is
required. Softer and calmer tone when the goal is
relaxation and relief of pain.
20. Verbal stimulation (commands)
The command is divided into three parts:
• Preparation: readies the pt for action. “ready”
• Action: tells the pt to start the action. “now pull your
leg up and in”
• Correction: tells the pt how to correct and modify the
action. “keep pulling your toes up”
21. Timings
• Timing is the sequencing of motions
• Normal timing of most coordinated and efficient
motions is from distal to proximal
• Timing for emphasis involves changing the normal
sequencing of motion to emphasis a particular muscle
or desired activity
22. Body positioning and mechanics
• The therapist body should be in line of motion
• Shoulder and pelvis face the direction of motion.
• Therapist stands in walk standing position.
• The resistance comes from the therapist’s body, while
the hands and arms stay comparatively relaxed.
24. RHYTHMIC INITIATION
• Progression from( agonist pattern)
Passive
Active assisted
Active
USED IN
• Limited ROM due to increase tone
• Who are unable to initiate movement
25. REPEATED CONTRACTION
• Patient move isotonically against maximum resistance
repeatedly until fatigue is evidenced
• When fatigue is evident then a stretch at that point in
the range should facilitate the weaker muscles and
results in coordinated movement.
USED
• To develop strength and endurance.
26. SLOW REVERSAL
• Involves isotonic contraction of the agonist followed
immediately by an isotonic contraction of the
antagonist.
USED :
• For development of active ROM and
• Normal reciprocal timing b/w agonist and antagonist
27. SLOW REVERSAL HOLD
• Involves isotonic contraction of the agonist followed
immediately by an isometric contraction, with a hold
command given at the end of each active movement.
USED:
• In developing strength at a specific point in the range
of motion.
28. RHYTHMIC STABILIZATION
• Uses an isometric contraction of the agonist, followed
by an isometric contraction of the antagonist.
USED:
• To increase strength and endurance
29. STRETCHING TECHNIQUES/PNF STRETCHING
• It is often a combination of passive stretching and
isometrics contractions.
• encourage flexibility and coordination throughout the
limb's entire range of motion.
• PNF is used to supplement daily stretching and is
employed to make quick gains in range of motion to
help athletes improve performance.
• Good range of motion makes better biomechanics,
reduces fatigue and helps prevent overuse injuries.
30. CONTRACT-RELAX
• Moves the body part passively into the agonist
pattern.
• Patient is instructed to push by contracting the
antagonist isotonically against the resistance.
USED:
• When ROM is limited by muscle tightness.
31. HOLD RELAX
• Begins with isometric contraction of the antagonist
against resistance, followed by concentric contraction
of the agonist muscle.
32. PNF PATTERNS
Each pattern has three dimension –
1. Flexion or extension
2. Abduction or adduction
3. Rotation
• Movement occurs in a straight line, in diagonal
direction with a rotatory component