Arogya Physiotherapy Centre

आमालाई के चाहिन्छ ? What a mother wants | Dr. Om Murti Anil

आमा, जसले हामीलाई संसार देखाइन् । गर्भमा राखेर जन्म दिइन् । काखमा राखेर पालिन् । ममता कि खानी अनि बालापनमा कल्प वृक्ष सरी हाम्रा हरेक इच्छा, आकाङ्क्षा अनि चाहना पूरा गरिदिने, यस पृथ्वी लोकका सम्पूर्ण आमाहरूलाई कोटी–कोटी नमन छ ।

मातातीर्थ औंसीको शुभकामना !!

आज जानौँ, शारिरीक कसरतबाट के-के फाइदाहरु हुनसक्छन त ?

Guess?

Take care yourself: मौसम परिवर्तन र गर्मी बढे सँगै पखाला, रुघा, ज्वरो आउने जस्ता समस्याहरू देखिन थालेका छन्। आफ्नो शरीरको ख्याल गर्नुहोला र पानी मज्जाले पिउनुको साथै ताजा फलफूलहरू खानु होला। घाम लागेको बेला अतिआवश्यक परे मात्र बाहिर जानु होला। 🙏

Representative Pic.

Stroke and rehabilitation ...contact 986-5236897 for counseling, consultation and rehabilitation .
We provide day care service, inpatient service,and home physiotherapy.

नसा च्यापिनुको:
कारणहरु-
लक्षणहरु-
पत्ता लगाउने तरीका-

Dr. Ragesh Karn
(MBBS. MD. DM Neurology, IOM)
मस्तिष्क, मेरुदण्ड तथा स्नायु रोग विशेषज्ञ

Neuro Clinic
Contact No: 01-4950129, 9848777910

Find us on Youtube : https://www.youtube.com/channel/UC-OPPHa59XOSzc3JeTKcBJQ

| छारेरोगको कारण |
सामान्यतया छारेरोग दुई फरक कारणले हुन्छ ।

Dr. Ragesh Karn
(MBBS. MD. DM Neurology, IOM)
मस्तिष्क, मेरुदण्ड तथा स्नायु रोग विशेषज्ञ

Neuro Clinic
Contact No: 01-4950129, 9848777910

Find us on Youtube https://www.youtube.com/channel/UC-OPPHa59XOSzc3JeTKcBJQ

Bells palsy...

Guillain-Barré syndrome
(Rehabilitation , Functional goals )

Rehabilitation:

• Except for positioning and passive ROM, physical therapy
should not be initiated until patient reaches nadir and disease
is stabilized.
• Fatigue and muscle overuse may lead to further damage; should be
avoided, especially in early stage of recovery.
• Graduated functional exercise program
○ Early stage: Passive ROM, moving to active-assisted, supportedsitting tolerance, assisted bed mobility.
○ Middle stage: Antigravity ROM, speci c and function-resistive
exercises beginning with patient’s own limb/body weight, sitting
balance, standing tolerance.
○ Late stage: Functional exercises working on muscle control and
endurance, standing balance, balance reactions, progressive
aerobic activity while monitoring for fatigue.
• Proprioceptive neuromuscular facilitation for mobility and stability
within graduated exercise program.10
• Adaptive equipment as needed: Wheelchair with cushion, orthotics,
gait devices, eating utensils.
• Energy conservation, patient self-awareness of fatigue.

Functional Goals of treatment :

• In hospital (after nadir)
○ Patient will
■ Tolerate sitting at the edge of bed for 3 minutes with moderate to
maximal assistance and no evidence of orthostatic hypotension.
■ Maintain head control with minimal assistance for 2 minutes
while seated in a wheelchair.
• In-patient rehabilitation or skilled nursing facility
○ Patient will
■ Consistently transition from supine to sit with minimal
assistance and fewer than two verbal cues for safety.
■ Demonstrate independent unsupported sitting at an edge of a
mat for 3 minutes during upper-extremity activity. without
loss of balance
• Out-patient therapy
○ Patient will
■ Ambulate > 150 feet with a wheeled walker on level surfaces
with supervision and no loss of balance.
■ Transfer between all surfaces via lateral pivot transfer with
supervision for safety.

Concussion

A concussion is a traumatic brain injury that affects your brain function. Effects are usually temporary but can include headaches and problems with concentration, memory, balance and coordination.
Concussions are usually caused by a blow to the head. Violently shaking of the head and upper body also can cause concussions.

Symptoms
The signs and symptoms of a concussion can be subtle and may not show up immediately. Symptoms can last for days, weeks or even longer.
Common symptoms after a concussive traumatic brain injury are headache, loss of memory (amnesia) and confusion. The amnesia usually involves forgetting the event that caused the concussion. Physical signs and symptoms of a concussion may include:
Headache
Ringing in the ears
Nausea
Vomiting
Fatigue or drowsiness
Blurry vision

Other signs and symptoms of a concussion include:
Confusion or feeling as if in a fog
Amnesia surrounding the traumatic event
Dizziness or "seeing stars

You may have some symptoms of concussions immediately, and some can occur for days after the injury, such as:

Concentration and memory complaints
Irritability and other personality changes
Sensitivity to light and noise
Sleep disturbances
Psychological adjustment problems and depression
Disorders of taste and smell

Symptoms in children

Head trauma is very common in young children. But concussions can be difficult to recognize in infants and toddlers because they can't describe how they feel. Concussion clues may include:
Dazed appearance
Listlessness and tiring easily
Irritability and crankiness
Loss of balance and unsteady walking
Excessive crying
Change in eating or sleeping patterns
Lack of interest in favorite toys
Vomiting
Seizures

Winging Scapula
( rehabilitation , Functional Goals)

• Address ( Treatment )muscle imbalances
○ Rotator cuff strength and endurance exercises
○ Muscle length of pectoralis major and minor
• Strengthening of scapular musculature
○ Lower trap
○ Serratus anterior
○ Other scapular stabilizers
○ Shoulder lateral and medial rotation
○ Isometric
○ thera-Band resisted
○ Handheld weight resisted
○ Progression through higher ranges of elevation
○ Scapular strength/stabilization
■ Retraction
■ Prone shoulder extension, HABD, scapular plane elevation
• Functional activities (depending on work/recreational desires)
• Addressing pain and inflammation
○ Ice
○ Rest
○ Activity modification (avoiding impingement positions)
○ Ultrasound
○ E-stimulation

Functional Goals of Treatment :

• Patient will be able to:
○ Reach into overhead cabinets in kitchen without pain or restriction
while maintaining scapular control.
○ Lift a gallon milk carton from refrigerator at shoulder–level,
pain free, while maintaining scapular control.
○ Turn steering wheel, pain free, while maintaining
scapular control
○ Perform all dressing and grooming activities (tuck in shirt
behind back, wash hair, etc.) without pain or compensationwhile maintaining scapular control.

⚠️Hemiplegic Gait.

Hemiplegia is a paralysis found only on one side of the body and is typically categorized as right or left side hemiplegia. Paralysis, weakness and spasticity on one side of the body lead to decreased motor control and altered range of motion at the joints.

A stroke occurs when an area of the brain does not receive adequate oxygen and nutrients due to a lack of blood supply, either by obstruction (ischemic stroke, about 80%) or rupture of a vessel (hemorrhagic stroke, about 20%). Almost two-third of hemiplegic patients have sequelae from stroke.

Stroke leads to the damage of motor cortices and their descending corticospinal tracts and subsequent muscle weakness. On the other hand, brainstem descending pathways and the intraspinal motor network are disinhibited and become hyperexcitable, thus leading to poor body support and walking performance. The wide range and hierarchy of post-stroke hemiplegic gait impairments is a reflection of mechanical consequences of muscle weakness, spasticity, abnormal synergistic activation and their interaction.
Post-stroke hemiplegic gait is proposed its clinical implications for management of hemiplegic gait.

🔵 Effect of hemiplegic stroke to gait.

🔹 During foot contact, proper heel strike is often lost due to decreased strength of control of the anterior tibialis or spasticity of the calf muscles. The lack of ability to dorsiflex properly is often referred to as foot drop.

🔹 Stroke survivors usually have decreased stance phase and prolonged swing phase of the paralytic side. Further, the walking speed is decreased and the stride length is shorter.

🔹 Overall hemiplegic stroke commonly leads to difficulties in foot clearance during swing, stability during stance, and maintaining energy efficient gait patterns.

🔹 Gait abnormalities along with muscle weakness place stroke survivors at a high risk of fall.

🔵 Compensatory pattern of hemiplegic gait.

🔸 Compensatory gait patterns are developed to walk with the paralysis, weakness and spasticity caused by a hemiplegic stroke.

🔸 A common compensatory pattern to gain foot clearance is circumduction. In circumduction, the hip is abducted as the foot is being progressed forwards, moving the foot laterally to create a semi-circle path of the foot in the medial/lateral plane.

🔸 The main compensatory pattern used to minimize the effect of instability during stance is to decrease the unilateral support time on the affected side.

🔵 How to quantify hemiplegic gait?

◻️ While changes in hemiplegic gait can be observed, quantifying these changes is important to gain understanding of the gait deviations caused by the stroke.

◻️ Gait mat technology, such as the Zeno Walkway System is commonly used to quantify temporal spatial metrics such as gait speed, step length and stance time

🔵 Treatment management to improve gait in hemiplegic stroke.

◾ Patients require treatment in order to improve their gait quality towards pre-stroke quality.
improving walking safety and speed is the major goal for stroke survivors to prevent falls and to improve quality of life.

◾ Bracing and assistive devices are often used to manage the loss of strength and range of motion. An ankle-foot orthotic (AFO) can be used to prevent excessive plantar flexion of the foot and promote improved foot contact.

◾ Walkers and canes can be used, allowing the upper body strength to assist with stance stability. In cases of spasticity, Botulinum toxin injections into the spastic muscles can be considered.

◾ Functional electrical stimulation (FES) can be used in attempt to promote appropriate muscle activation.

🔵 Physical therapy is commonly used to improve overall function.

FRACTURE AND FRACTURE HEALING-THE INFLAMMATORY STAGE

A fracture is a break in a structural continuity of a bone. It can also be defined as loss of continuity in the substance of a bone.

When your bone is fractured, it will certainly heal, but the most important thing is how best it is healing. This is why a proper reduction is required post fracture. Fracture healing takes place in three stages or phases. The first stage which is the inflammatory phase would be addressed in this article whilst the remaining; reparative and remodeling stages would be tackled in subsequent posts.

➡️ INFLAMMATORY PHASE

The inflammatory phase commences immediately fracture occurs. At the moment of fracture,the blood vessels through the hervessian are torn at the fracture site.

The fractured bone is deprived of blood supply ( lacks oxygen) and the bone dies back in a millimeter or two. There is local haemorrhage and hematoma fills the fracture gap which grows around it.

This forms a scaffolding for granulation tissue which creates a breeding grounds for microphages. The microphages grow to remove the clot and neo vascularization and initial fibrosis commences preparing the way for osteaoblastic and osteaoblastic cells to take over at the reparative state.

PHYSIOTHERAPY

Pain and Physiotherapy

Pain is an annoyance. It can hinder your overall quality of life. Medication can be used for instant, short-term relief, but that is not your only pain management solution. In fact, medication is not the solution at all if you are suffering from a chronic condition. A more meaningful solution to managing pain is physiotherapy.

The reason why patients turn to medication is because they want immediate pain relief. The problem with this is that the pain is only being masked for a short while. Also, taking pills for a long time can result in dependency on prescription drugs. It can lead to conditions like loss of sleep, anxiety and so on. physiotherapists, on the other hand, is a branch of restoration and rehabilitation that helps patients recover their physical abilities through natural means. Physiotherapists make use of strengthening, stretching, manipulations and mobilisations to help relieve pain in the body.

As pain management specialists, physiotherapists are known to treat patients suffering from athletic injuries, fibromyalgia, sprains and arthritis and many more. In most cases, the pain is stopped and the chance of reoccurrence in the future is reduced. Along with relieving pain, physical therapy can also help patients lead a healthy and wholesome life.

Consult your physiotherapist today.

So what is CUPPING ? Thats looks so fancy !!

CUPPING के हो? त्यो धेरै फेन्सी देखिन्छ !!

Looking at the google search cupping is quotes as an *alternative medicine*!!

गुगल सर्च कपिङमा हेर्दा वैकल्पिक औषधिको रूपमा उद्धरणहरू छन्।

Google definition :
Cupping therapy is a form of alternative medicine in which a local suction is created on the skin with the application of heated cups.

कपिङ थेरापी वैकल्पिक औषधिको एक रूप हो जसमा तातो कपको प्रयोगले छालामा स्थानीय सक्शन बनाइन्छ।

So what is an alternative medicine?
त्यसोभए वैकल्पिक औषधि के हो?

Alternative medicine is any practice that aims to achieve the healing effects of medicine, but which lacks biological plausibility and is untested, untestable or proven ineffective. Complementary medicine (CM), complementary and alternative medicine (CAM), integrated medicine or integrative medicine (IM), and holistic medicine are among many rebrandings that describe various ways alternative medicine is combined with mainstream medicine.

वैकल्पिक औषधि भनेको कुनै पनि अभ्यास हो जसले औषधिको निको पार्ने प्रभावहरू हासिल गर्ने लक्ष्य राख्छ, तर जसमा जैविक प्रशंसनीयताको कमी छ र परीक्षण नगरिएको, अप्रत्याशित वा प्रभावहीन साबित हुन्छ। पूरक औषधि (CM), पूरक र वैकल्पिक चिकित्सा (CAM), एकीकृत चिकित्सा वा एकीकृत चिकित्सा (IM), र समग्र चिकित्सा धेरै रिब्रान्डिङहरू मध्येका छन् जसले वैकल्पिक चिकित्सालाई मुख्यधारा चिकित्सासँग जोड्ने विभिन्न तरिकाहरू वर्णन गर्दछ।

So WHY IS IT USED?

Suction from cupping draws fluid into the treated area. This suction force expands and breaks open tiny blood vessels (capillaries) under the skin. Your body treats the cupping area like an injury. It sends more blood to the area to stimulate the natural healing process. Some people theorize that cupping clears the pores and releases toxins.
Experts are still exploring how cupping eases pain and disease symptoms. There isn’t a lot of research on the therapy.

त्यसोभए यो किन प्रयोग गरिन्छ?

कपिङबाट सक्शनले तरल पदार्थलाई उपचार गरिएको क्षेत्रमा तान्छ। यो सक्शन बलले छालाको मुनि खुल्ला साना रक्तनलीहरू (केशिकाहरू) विस्तार गर्दछ र तोड्छ। तपाईंको शरीरले कपिङ क्षेत्रलाई चोट जस्तै व्यवहार गर्दछ। यसले प्राकृतिक उपचार प्रक्रियालाई उत्तेजित गर्न क्षेत्रमा थप रगत पठाउँछ। कोही-कोहीले कपिङले छिद्रहरू सफा गर्छ र विषाक्त पदार्थहरू छोड्छ भन्ने सिद्धान्त राख्छन्।
विज्ञहरूले अझै पनि कसरी कपिङले दुखाइ र रोगका लक्षणहरूलाई कम गर्छ भनेर अन्वेषण गरिरहेका छन्। उपचारमा धेरै अनुसन्धान छैन।

Conclusion :
You can use how much or whatever you want to, but do not give false claims like it removes toxins , it helps in nerve entrapments , most effective treatment for cervical radiculopathies or gastritis, systemic inflammations. Those are your anectodes and These things are not accepted in medical profession !!

तपाईले जति वा जे चाहानुहुन्छ प्रयोग गर्न सक्नुहुन्छ, तर झूटा दाबी नगर्नुहोस् जस्तै यसले विषाक्त पदार्थहरू हटाउँछ, यसले तंत्रिका इन्ट्रापमेन्टमा मद्दत गर्दछ, ग्रीवा रेडिकुलोपैथी वा ग्यास्ट्राइटिस, प्रणालीगत सूजनहरूको लागि सबैभन्दा प्रभावकारी उपचार।
यी कुराहरु स्विकार्य छैनन् !!

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