CIMT involves constraining the unaffected limb, along with intense therapy, in order to force the use of the affected limb with intent to improve motor function.
CIMT involves constraining the unaffected limb, along with intense therapy, in order to force the use of the affected limb with intent to improve motor function.
Concept given by Shacklock (modern concept) and Butler (old concept), a method of assessment as well as treatment of peripheral neurological system by physiotherapists.
Part-I: The current slideshow: theoretical aspect of neurodynamics.
Part-II: Assessment of peripheral nervous system on the basis of neurodynamic concepts: Date: 01/04/2020
Part-III: treatment part: Date: 03/04/2020
Part-IV: Self neurodynamics: 05/04/2020
Spina Bifida: Physiotherapy in the management of meningomyeloceleAyobami Ayodele
Spina bifida is a treatable spinal cord malformation that occurs in varying degrees of severity. Meningomyelocele is associated with abnormal development of the cranial neural tube, which results in several characteristic CNS anomalies. About 90% of babies born with Spina Bifida now live to be adults, about 80% have normal intelligence and about 75% play sports and do other fun activities. Most do well in school, and many play in sports.
myasthenia gravis , a neurological disorder, causes skeletal muscle weakness. There are classification according to american clinical classification of myasthenia gravis.Risk factors and causes of myasthenia gravis with animated gif shown in ppt. Types of muscle weakness and pathophysiology of myasthenia gravis explained. Clinical manifestation explained through animated gif. Important diagnostic test explained through pictures. Medical management, surgical management, nursing management explain in detail of myasthenia gravis. Excercise goals and rehablitation management of myasthenia gravis is explained. Types of rehablitation excercise for myasthenia gravis explained. Complications of myasthenia gravis and research article of myasthenia gravis is included in ppt. Summary and conclusion is also included in ppt.
Concept given by Shacklock (modern concept) and Butler (old concept), a method of assessment as well as treatment of peripheral neurological system by physiotherapists.
Part-I: The current slideshow: theoretical aspect of neurodynamics.
Part-II: Assessment of peripheral nervous system on the basis of neurodynamic concepts: Date: 01/04/2020
Part-III: treatment part: Date: 03/04/2020
Part-IV: Self neurodynamics: 05/04/2020
Spina Bifida: Physiotherapy in the management of meningomyeloceleAyobami Ayodele
Spina bifida is a treatable spinal cord malformation that occurs in varying degrees of severity. Meningomyelocele is associated with abnormal development of the cranial neural tube, which results in several characteristic CNS anomalies. About 90% of babies born with Spina Bifida now live to be adults, about 80% have normal intelligence and about 75% play sports and do other fun activities. Most do well in school, and many play in sports.
myasthenia gravis , a neurological disorder, causes skeletal muscle weakness. There are classification according to american clinical classification of myasthenia gravis.Risk factors and causes of myasthenia gravis with animated gif shown in ppt. Types of muscle weakness and pathophysiology of myasthenia gravis explained. Clinical manifestation explained through animated gif. Important diagnostic test explained through pictures. Medical management, surgical management, nursing management explain in detail of myasthenia gravis. Excercise goals and rehablitation management of myasthenia gravis is explained. Types of rehablitation excercise for myasthenia gravis explained. Complications of myasthenia gravis and research article of myasthenia gravis is included in ppt. Summary and conclusion is also included in ppt.
The term Spinal Cord Injury is used to refer to neurological damage of the spinal cord
Any lesion involving the spinal cord result a syndrome called a “myelopathy”
Spinal cord injuries are defined as complete or incomplete according to the International Standards for the Neurological Classifification of SCI and the American Spinal Injuries Association Impairment Scale (AIS)
Complete lesions are defifined as AIS A, and incomplete lesions are defifined as AIS B, AIS C, AIS D or AIS E (Harvey, 2016)
Physiotherapy in wards
physiotherapy in ICU
physiotherapy in Cardiology
physiotherapy in Gynecology
post operative physiotherapy
physiotherapy in PICU
Palliative patients physiotherapy
Geriatric patients
Benefits of the chest physiotherapy in ward patients
Benefits of Exercise Specific to Breast Cancer
Knee osteoarthritis (OA), also known as degenerative joint disease, is typically the result of wear and tear and progressive loss of articular cartilage. It is most common in the elderly. Knee osteoarthritis can be divided into two types, primary and secondary. Primary osteoarthritis is articular degeneration without any apparent underlying reason. Secondary osteoarthritis is the consequence of either an abnormal concentration of force across the joint as with post-traumatic causes or abnormal articular cartilage, such as rheumatoid arthritis (RA).
Osteoarthritis is typically a progressive disease that may eventually lead to disability. The intensity of the clinical symptoms may vary for each individual. However, they typically become more severe, more frequent, and more debilitating over time. The rate of progression also varies for each individual. Common clinical symptoms include knee pain that is gradual in onset and worse with activity, knee stiffness and swelling, pain after prolonged sitting or resting, and pain that worsens over time. Treatment for knee osteoarthritis begins with conservative methods and progresses to surgical treatment options when conservative treatment fails. While medications can help slow the progression of RA and other inflammatory conditions, no proven disease-modifying agents for the treatment of knee osteoarthritis currently exist.
Patients with spinal cord injury face a number of challenges, with continence being a top priority. For those affected by neurogenic bladder and bowel, there are various management options available. To help understand these options, study notes in this area can be useful. These notes, which are similar to index cards, can highlight key information related to the management of neurogenic bladder and bowel in spinal cord injury patients.
presentation about relation between posture and pain. there is lot of talk and research regarding bad posture and chronic pain. but posture, disease along with physical activity intervention should be done to manage.
Cancer Rehabilitation. integrating rehabilitation with oncology. a model of care. cancer survivorship. rehabilitation care in low resource area. Mrinal Joshi. Rehabilitation Research Center. Jaipur.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
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.
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.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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!
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
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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
Rehabilitation in myopathies - dr venugopal kochiyil
1. Rehabilitation in myopathies
Venugopal Kochiyil
Medical Head of the Unit - Northern Adelaide
Rehabilitation Service
Modbury Hospital
South Australia, Australia
2. Myopathies
• A group of disorders affecting skeletal muscle
producing weakness, fatigue and deformities
• Can be associated with involvement of other systems
• Can be dystrophic, congenital, metabolic,
inflammatory, endocrine, toxic or steroid induced
3. Clinical pearls in diagnosis
• Pattern of weakness, wasting, hypertrophy
• Course of weakness – acute, chronic, episodic
• Progression of weakness
• Onset
• Muscle cramps, stiffness
• Sensations
• Gait abnormalities
• Functional difficulties
• History of recent illness
• Feeding difficulties
• Cardiac symptoms, pulmonary symptoms
• Developmental history
• Family history (AD, AR, X-linked)
Myopathic Disorders in Physical Med and Rehabilitation (Braddom RL, 2011)
4. Rehabilitation in myopathies
• Identify impairments, activity limitations and
participation restrictions
• Goal orientated (maximise functions, maintain
mobility, prevent physical deformities, prevent
medical complications, social life)
• A multidisciplinary/interdisciplinary approach
5. Physical training
• Eccentric contraction v/s concentric contractions
• Muscle groups doing eccentric activity are affected
first in many myopathies
• Resistance exercises are not harmful
• A submaximal resistance exercise program could be
tried
• Assisted exercise training
• Supervised or not supervised
6. Exercises
• Voluntary active exercises like swimming
• Limited by perceived exertion
• Mechanism - preventing disuse, enhance myofiber
repair, decreasing muscle fibrosis and production of
antioxidants
• Fatigue is equally important and need to be
differentiated from muscle weakness
• Aerobic training
7. Evidence
• Moderate-intensity strength training in myotonic
dystrophy and FSHD and aerobic exercise training in
dermatomyositis and polymyositis and myotonic
dystrophy type I appear to do no harm, but there is
insufficient evidence to conclude that they offer benefit.
• In mitochondrial myopathy, aerobic exercise combined
with strength training appears to be safe and may be
effective in increasing submaximal endurance capacity
• Limitations in the design of studies in other muscle
diseases prevent more general conclusions in these
disorders
9 Jul 2013 | DOI: 10.1002/14651858.CD003907.pub4
8. Contractures
• Contractures – myogenic, arthrogenic or soft tissue
• High risk in dystrophinopathies
• To prevent contractures – regular standing and
walking, passive stretching as a home program,
positioning to promote extension and night splinting
• Use of wheelchair accelerate contractures
9. Polymyositis/Dermatomyositis
• Idiopathic inflammatory myositis
• Female to male 2:1
• Evidenced by proximal muscle weakness (subacute) and
inflammation
• Distal muscle groups are also involved
• DM has characteristic skin findings which occurs prior or
along with weakness (in 60%), muscle tenderness in up to
50%.
• Associated with Interstitial pulmonary disease, dysphagia,
polyarthritis, myocarditis, risk of malignancy
• Overlap syndromes
10. Diagnosis
• Elevated muscle enzymes (CK, LDH, ALT, AST)
• Correlation between CK and muscle involvement.
• May be normal in DM
• Elevated CK MB in the absence of myocarditis (Do troponins in
this case)
• ANA
• Myositis specific antibodies (30%) – anti Jo 1, anti SRP, anti M2
• EMG
• MRI
• Biopsy
11. Prognosis
• Delay in the initiation of treatment for more than six
months after symptom onset
• Greater weakness at presentation
• The presence of dysphagia
• Respiratory muscle weakness
• Interstitial lung disease
• Associated malignancy
• Cardiac involvement
• ? Increased CK
www.uptodate.com
12. Management
• Glucocorticoids – start with oral or pulse IV
• Once the disease is under control, taper to lowest
effective dose for atleast one year
• No standard tapering regimen
• Glucocorticoid sparing agents – Azothiaprine, MTX
• IVIg – def role in resistant and recurrent presentation
14. Therapy
• Therapy according to the severity of disease process
• Passive range of motion exercises
• Positioning to prevent contractures and pressure sores
• Easy to moderate resistive exercises in acute group
• Moderate to intensive resistive and aerobic exercises
in chronic group
Alexanderson H, Lundberg IE. Curr Opin Rheumatol 2012;24 www.co-rheumatology.org
15. Inclusion Body myositis
• Rare sporadic disorder
• Affect elderly men
• Insidious onset of weakness/ history of falls
• Proximal and distal muscle weakness (asymmetric
weakness)
• Facial muscle involvement
• Occasional myalgia
• Muscle atrophy
• Dysphagia could be a presenting complaint
16. Diagnosis
• History, examination
• Ask for history of drugs and other substances
• Family history of hereditary myopathies
• Increased muscle enzymes
• Muscle biopsy – rimmed vacuoles, mononuclear
inflammatory cells invading non necrotic muscle
18. Prognosis
• Tend to progress over time
• Faster progression in elderly patients
• Significant disability within 15 years of diagnosis
19. Statin induced myopathy
• Approx 0.1% of population
• Presents with myalgia and weakness
• Within weeks and months after statin initiation
• Possibly related to reduction in the synthesis of Co Q10
• Type of statin is important
• Avoid statin in pre existing neuromuscular weakness
• Higher risk in Hypothyroidism, renal failure and
obstructive liver disease
• CK level
21. Critical illness myopathy
• Critical illness neuropathy, myopathy or both
• Muscle weakness, failure to wean, prolonged
ventilation
• 25-83%
• Proximal weakness and wasting in myopathy
• Higher in trauma, sepsis, steroid use, neuromuscular
blockade drug use in ICU
22. Criteria for myopathy (Latronico 2011)
• Individual is critically ill (multi-organ involvement)
• Limb weakness and or difficulty in weaning off
ventilator
• CMAP less than 80% without conduction block in
atleast two nerves
• Sensory action potential more than 80%
• Myopathic pattern in needle EMG
• Absence of decremental pattern in repetitive
stimulation
• Muscle biopsy shows primary muscle pathology
23. Criteria for CIP
• 1 and 2 criteria are the same
• Electrophysiological evidence of axonal motor and
sensory neuropathy
• Absence of decremental response
24. Prognosis
• 50% near complete recovery
• Residual impairments in severely affected
25. Physical rehab
• Early mobilisation
• Electrical muscle stimulation
• Cycle ergometry
• Ongoing ambulatory rehab
Connally B, O’Neill B et al Thorax 2o16;0:1-10