Rehman physio Clinic

Floppy Baby Syndrome: Causes, Symptoms And Treatments
Floppy baby syndrome is a condition seen in babies where the body and joints have a reduced amount of resistance towards passive movement due to decreased muscle tone. This condition is also known as the ‘Floppy Infant Syndrome’ (FIS) and could be a symptom of serious underlying disorders, which could lead to developmental problems in the future. The reason why the floppy baby syndrome is referred to as such is due to the ‘floppy’ appearance of the arms, elbows, head position, knees, etc. in a child suffering from it. For instance, when a baby’s arm is flexed, it returns to its normal position quite easily, which signifies normal muscle tone, however, if the baby has the floppy baby syndrome, then the straightening of the arm could take some time as a result of the decreased muscle tone.

Following are some other symptoms associated with this condition:

Baby has trouble keeping head straight; head keeps tilting on one side.
Milestones such as being able to sit up, stand, walk, and crawl are significantly delayed.
Frequent joint dislocation in the jaw, hips, etc.
Soft and underdeveloped muscles.
Baby can’t be picked up by placing hands under his or her shoulders.
Baby experiences difficulty coughing and swallowing.
These symptoms can manifest themselves in a baby suffering from the condition between 6-12 months. An accurately conclusive diagnosis, however, requires a doctor to go through a series of physical checks, diagnostic tests, and a cursory study of the child and family’s medical history.There are several tests that a doctor can typically take to diagnose the condition and to determine the underlying causes, some of them include blood tests, CT Scans, CK (creatine kinase) test, spinal tap analysis, muscle biopsy, MRI test, etc.

The floppy baby syndrome can be caused due to a wide variety of congenital as well as acquired (peripheral) medical conditions. Some of the most common causes are as follows:

Down syndrome.

Cerebral palsy.

Myasthenia gravis syndrome.

Prader-Willi syndrome.

Cerebellar ataxia.

Muscular dystrophy.

Brain injury.

There is no single cure for the floppy baby syndrome, as the treatment for it generally depends on the underlying condition, which it is the symptom of. It is important to ensure that the doctors establish a complete clinical profile of the condition before attempting a treatment, considering the wide range of causes that could be behind it.

Physical therapy is sometimes sought in infants with the floppy baby syndrome to stimulate the development of muscle tone. The syndrome in itself is a symptom of a host of possible diseases, and the treatment thus largely depends on the diagnosis.
If you suspect that your child has the floppy baby syndrome, it is important to rush to the doctor as early as possible for a complete diagnosis. Even though the syndrome could be a reflection of some very serious medical conditions, early diagnosis and intervention have been proven to be the most effective ways to assist in a complete recovery.

If you’re still pregnant and would like to avoid the incidence of floppy baby syndrome in your child, please make sure that any medication that you might be taking is approved by your doctor, keeping the condition in mind. Drugs that affect the central nervous system (CNS), such as benzodiazepines, are said to be correlated with the incidence of floppy baby syndrome.

The floppy baby syndrome is often said to be a life-long condition. However, with timely intervention, diagnosis, and treatment, it’s possible that babies can eventually recover enough to live fairly normal lives with minimal difficulties.
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CORRECTING CERVICOGENIC DIZZINESS

To successfully treat dizziness arising from structures in the neck, a thorough evaluation of the cervical spine must be completed. Some of the tests we perform to help determine the cause of cervicogenic dizziness are:

¶ neck range of motion
¶ objective spinal postural assessment
thermographic nerve scan
¶ digital x-rays (upper cervical) if necessary
neurological and cranial nerve testing
¶ orthopedic testing
¶ cervical alignment testing
¶ motion palpation (feeling how bones move through different ranges)
¶ soft tissue (muscle) testing
Specialized testing allows us to be successful in helping our patients manage, control, and correct their dizziness and vertigo. Treatment is aimed at increasing mobility (motion) in the upper neck and decreasing tenderness and inflammation. This helps restore defective proprioception. As well, re-training the cervical-ocular motor system is necessary.

VESTIBULAR-OCULAR REHABILITATION

The central nervous system is responsible for postural control and uses information from our visual system, inner ear, and upper neck to coordinate posture and balance. One thing that most dizziness/vertigo patients can benefit from is vestibular-ocular rehabilitation (VOR). A simple gaze stabilization exercise uses all 3 systems together (visual, inner ear, and upper neck) to retrain the nervous system.

Inner Ear Problems

Benign Paroxysmal Positional Vertigo (BPPV) is a problem in the inner ear. The crystals in the inner ear (otoliths) become dislodged and move to a place they should not be (semi-circular canal). If symptoms of vertigo or dizziness occur when you ‘look up’ or ‘roll over’ in bed, there is a good chance you have BPPV. But, there is hope. The Epley Maneuver is an effective treatment that has up to an 80% success rate. Try this it home but be prepared to temporarily aggravate the vertigo.

Practical Ways to Incorporate Sensory Input

Role of physiotherapy in musician’s life.

Musicians are a unique population that rarely receive recognition for their ‘athleticism’. Musicians exercise their muscles much like a sporting athlete.They work through hours of practice (6 to 8 hours a day is not an uncommon day) then perform at events in some cases under enormous stress/pressures or unfavorable environments.
The muscles that musicians use most are fine motor muscles. The fibers of these muscles are slightly different from the larger muscles, though still have the capacity to fatigue and strain with overuse.

When there is an injury came up with a musician we have to get back to their highest level of function not the back to normal life. A novel exercise program was specifically designed for professional orchestral musicians to target the performance-related musculoskeletal disorders reported in this occupational group.

Most of the program was based on fundamental sports rehabilitation principles resulting in a program that consisted of

✴️activating the muscles concerned with stability and satisfactory postural control of the region in the early stages.
✴️ added external perturbations or resistive loads in the middle stages, and the late stages

Exercises were used that both increased muscle endurance demands and were applied in a specific functional position relating to common patterns of movement during instrumental performance.

🔵Common injuries

Performance-related musculoskeletal disorders(PRMDs) are globally recognized as commonphenomena amongst professional orchestral musicians.

Other common musician injuries,
🔸Overuse injuries.
🔸Neck and back pain.
🔸Muscle imbalance problems and movement dysfunction.
🔸 Nerve entrapment syndromes.
🔸 musician’s cramp
🔸 Conditions related to Playing posture & ergonomics of playing instruments.

🔵Physical risk factors for injuries

⭕sustained high levels of playing or sudden increases in playing load (overload)
⭕ Lack of rest breaks in rehearsals and private practice
⭕Poor posture and biomechanics
⭕Incorrect instrumental technique
⭕Musicians’ poor health education

🔵ROLE OF PHYSIOTHERAPY

1️⃣ Assessment of the injury
based on careful, thorough physical and musical instrument-specific assessments as well as specialist clinical examination.

2️⃣ Identify the cause of the injury

3️⃣ Treat through an individualized treatment plan
▪️Correct the playing posture
▪️ Demonstrate the correct technique of using the instrument
▪️ Relieve stress on joints and muscles
▪️Improve control of pelvic floor muscles will improve vocal control too.

4️⃣ Prevent further and re-injuries
Identify the modifiable risk factors and develop a plan to prevent them.

5️⃣ Enhance performance
Physiotherapist goal is to get the musician back to their highest level of function with improving muscular endurance, strength.

6️⃣ Provide health education and advice for Musicians
Educate them about the posture, techniques, taking breaks, risk factors for the injuries, and how to avoid them.

Musicians suffer a high incidence and severity of performance-related musculoskeletal disorders. Neck, shoulder, and back injuries are not uncommon.

🔺Neck injuries

Progressions of cervical spine exercise therapy strengthening the deep neck flexors and extensors were adapted for musicians. In the final stages, varying degrees of resistance was applied to the neck from a variety of angles to load the deep neck muscle system in an attempt to replicate the challenges of maintaining a healthy neck position while sustaining the weight of
instruments. Neck problems needs Cervical spine rehabilitation, Improving muscle efficiency by reducing hypertonic muscles (sternocleidomastoid, levator scapulae, upper part of the trapezius) Shoulder rehabilitation - Scapula stabilization and rotator cuff endurance exercise.

🔺Shoulder injuries

A progressive series of scapular stability and rotator cuff exercises were included focusing on restoring shoulder muscle balance and movement control. This progressed to stages that added resistance and increased the functional context of the exercises into instrumental performance biomechanical patterning.

🔺Spinal injuries

The early stages of the spinal series consisted of low load activation of the lumbar multifidus. Later stages progressively integrated the lumbar multifidus into a range of more functional activities with appropriate use of load and a variety of external perturbations to mimic the movements used during a performance.

🔺Abdominal injuries

A focus on activation of the abdominal muscles during commonly prescribed Clinical Pilates exercises was included, progressing into more difficult stages using an unstable base of support. Finally, these exercises were adapted into more functional activation patterns in both sitting and standing.

🔺Hip injuries

A focus was placed on the endurance and strength of the gluteal muscle group, including hip abduction and external rotation exercises. The intermediate stages combined these exercises with upper body movement. The final stage incorporated the elements in the previous exercises in all three planes of movement. Low Back Pain is reduced by, Optimising functions of the lumbar multifidus, Re-training of proper transverse abdominis and internal oblique activation (wind and brass players)
Lumbo-pelvic control is important to support dynamic upper body movements, such as those involved in instrumental playing.
Hip – strengthen the gluteal muscles to improve proprioception and control of lower limb alignment.

🔵Advises from physiotherapist's point of view

✅Throughout the playing, a musician should follow the correct posture.

✅Musicians should carefully plan their private practice schedules as well as monitor their overall playing load to minimize the potential.

✅For musicians’ frequent breaks assist in reducing the constant strain and load bearing on the joints. As well as allowing recovery of supporting musculature and fine control muscles of the fingers and the lips.

✅Before the long practice sessions, it is important to consider nutrition and hydration.

✅Early identification of injury will lead to preventing secondary problems focusing on immediate treatment.

Do you suffer from any of the following pain??

Temporomandibular joint and muscle disorder, commonly called TMJ disorder, affects the jaw joint and the muscles controlling the jaw movement.

🚩If you think you may have a TMJ problem, ask yourself:

❓Is there a popping, grating, or clicking noise when you open or close your mouth?

❓Do you suffer from headaches, or pain in the neck or ear area?

❓Is your jaw muscle stiff, have limited movement or does it lock?

❓Does your jaw feel sore or tender, especially in the morning or late afternoon?

❓Does your jaw hurt when you are yawning, chewing or biting?

❓Do your upper and lower teeth fit together differently now?