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Physio360chennai, 1, Abdul kalam salai, Lakshmi Nagar, Gerugambakkam, Chennai (2025)

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1, Abdul Kalam Salai, Lakshmi Nagar, Gerugambakkam

09/07/2025

Brunnstrom approach was developed by Signe Brunnstrom, a Swedish physical therapist, to describe the predictable progression of motor function recovery after stroke. The stages range from complete flaccidity to normal motor function.

✅ Stage 1 – Flaccidity
No voluntary movement or muscle tone.

Reflexes are absent.

Limb is flaccid and heavy.

Patient cannot initiate movement.

👉Therapy goal: Prevent contractures and maintain joint integrity with positioning and passive range of motion (PROM).

✅ Stage 2 – Spasticity Begins
Appearance of basic limb synergies (primitive reflex patterns).

Spasticity begins to develop.

Some components of the movement synergies may appear as associated reactions or minimal voluntary movement.

👉Therapy goal: Encourage the use of any voluntary movement and prevent increased spasticity.

✅ Stage 3 – Peak Spasticity
Spasticity reaches its maximum.

Voluntary control over synergies increases, but movements are still stereotyped and patterned.

Movements are not yet isolated; they follow flexor/extensor synergy patterns.

👉Therapy goal: Promote movement out of synergy patterns and work on controlled motion.

✅ Stage 4 – Declining Spasticity
Spasticity decreases.

Voluntary movement begins to deviate from synergy patterns.

Patient gains some isolated joint movements.

👉Therapy goal: Promote isolated and functional movement patterns.

✅ Stage 5 – More Complex Movement
Spasticity continues to decline.

More complex movements are possible.

Synergies are less dominant, and voluntary movement becomes smoother and more coordinated.

👉Therapy goal: Improve coordination, balance, and movement precision.

✅ Stage 6 – Disappearance of Spasticity
Spasticity disappears completely.

Individual joint movements become possible.

Movements are well-coordinated and nearly normal.

👉Therapy goal: Encourage normal movement patterns and higher-level functional tasks.

✅ Stage 7 – Normal Function Returns
Normal motor function is restored.

Coordination, strength, and timing are similar to pre-stroke levels.

👉Therapy goal: Enhance endurance, task-specific activities, and community reintegration.

09/07/2025

Brunnstrom approach was developed by Signe Brunnstrom, a Swedish physical therapist, to describe the predictable progression of motor function recovery after stroke. The stages range from complete flaccidity to normal motor function.

✅ Stage 1 – Flaccidity
No voluntary movement or muscle tone.

Reflexes are absent.

Limb is flaccid and heavy.

Patient cannot initiate movement.

👉Therapy goal: Prevent contractures and maintain joint integrity with positioning and passive range of motion (PROM).

✅ Stage 2 – Spasticity Begins
Appearance of basic limb synergies (primitive reflex patterns).

Spasticity begins to develop.

Some components of the movement synergies may appear as associated reactions or minimal voluntary movement.

👉Therapy goal: Encourage the use of any voluntary movement and prevent increased spasticity.

✅ Stage 3 – Peak Spasticity
Spasticity reaches its maximum.

Voluntary control over synergies increases, but movements are still stereotyped and patterned.

Movements are not yet isolated; they follow flexor/extensor synergy patterns.

👉Therapy goal: Promote movement out of synergy patterns and work on controlled motion.

✅ Stage 4 – Declining Spasticity
Spasticity decreases.

Voluntary movement begins to deviate from synergy patterns.

Patient gains some isolated joint movements.

👉Therapy goal: Promote isolated and functional movement patterns.

✅ Stage 5 – More Complex Movement
Spasticity continues to decline.

More complex movements are possible.

Synergies are less dominant, and voluntary movement becomes smoother and more coordinated.

👉Therapy goal: Improve coordination, balance, and movement precision.

✅ Stage 6 – Disappearance of Spasticity
Spasticity disappears completely.

Individual joint movements become possible.

Movements are well-coordinated and nearly normal.

👉Therapy goal: Encourage normal movement patterns and higher-level functional tasks.

✅ Stage 7 – Normal Function Returns
Normal motor function is restored.

Coordination, strength, and timing are similar to pre-stroke levels.

👉Therapy goal: Enhance endurance, task-specific activities, and community reintegration.

08/07/2025

Juvenile Idiopathic Arthritis (JIA) is the most common type of arthritis in children under 16 years of age. It is an autoimmune disorder where the body’s immune system mistakenly attacks its own joints, leading to inflammation, pain, and stiffness.

✅ Symptoms:

🔸Persistent joint pain and swelling

🔸Morning stiffness

🔸Limping (especially after rest)

🔸Fever and rash (in systemic JIA)

🔸Fatigue and reduced physical activity.

✅Protocol-Based Physiotherapy Approach:

✔️ Acute Phase (Inflammatory Stage)
➡ Goals: Pain relief, reduce inflammation, prevent joint stiffness
Do’s:

Rest and joint protection (splinting if needed)

Cold packs for inflamed joints (10–15 min, 3x/day)

Gentle passive ROM exercises (within pain limits)

Positioning to prevent contractures (e.g., extension for knees/elbows)

Breathing and relaxation techniques

✔️ Subacute Phase (Reduced Inflammation)

➡ Goals: Restore mobility, begin strengthening
Interventions:

Active-assisted ROM progressing to active ROM

Isometric exercises for affected joints

Stretching tight muscles

Hydrotherapy (warm water supports movement with less stress)

Postural correction exercises

Low-impact aerobic activity (cycling, walking in pool)

✔️ Chronic/Remission Phase:

➡ Goals: Improve strength, endurance, and function
Exercises:

Progressive resistance training (light weights, Therabands)

Functional training (sit-to-stand, stair climbing)

Gait training (if limping or altered mechanics)

Balance and coordination drills

Aerobic conditioning: swimming, dancing, walking.

08/07/2025

Juvenile Idiopathic Arthritis (JIA) is the most common type of arthritis in children under 16 years of age. It is an autoimmune disorder where the body’s immune system mistakenly attacks its own joints, leading to inflammation, pain, and stiffness.

✅ Types:

🔸Oligoarticular JIA – Affects 4 or fewer joints, often the knees or ankles.

🔸Polyarticular JIA (RF-positive/negative) – Affects 5 or more joints; may resemble adult rheumatoid arthritis.

🔸Systemic JIA (Still’s Disease) – Includes joint inflammation along with fever, rash, and internal organ involvement.

🔸Enthesitis-related JIA – Involves the attachment points of tendons and ligaments (entheses), commonly seen with spine and lower limb involvement.

🔸Psoriatic JIA – Associated with psoriasis (skin condition).

🔸Undifferentiated JIA – Doesn’t fit any one category clearly.

✅ Symptoms:

🔸Persistent joint pain and swelling

🔸Morning stiffness

🔸Limping (especially after rest)

🔸Fever and rash (in systemic JIA)

🔸Fatigue and reduced physical activity.

✅Protocol-Based Physiotherapy Approach:

✔️ Acute Phase (Inflammatory Stage)
➡ Goals: Pain relief, reduce inflammation, prevent joint stiffness
Do’s:

Rest and joint protection (splinting if needed)

Cold packs for inflamed joints (10–15 min, 3x/day)

Gentle passive ROM exercises (within pain limits)

Positioning to prevent contractures (e.g., extension for knees/elbows)

Breathing and relaxation techniques

✔️ Subacute Phase (Reduced Inflammation)

➡ Goals: Restore mobility, begin strengthening
Interventions:

Active-assisted ROM progressing to active ROM

Isometric exercises for affected joints

Stretching tight muscles

Hydrotherapy (warm water supports movement with less stress)

Postural correction exercises

Low-impact aerobic activity (cycling, walking in pool)

✔️ Chronic/Remission Phase:

➡ Goals: Improve strength, endurance, and function
Exercises:

Progressive resistance training (light weights, TheraBands)

Functional training (sit-to-stand, stair climbing)

Gait training (if limping or altered mechanics)

Balance and coordination drills

Aerobic conditioning: swimming, dancing, walking

Play-based therapy to enhance compliance

✔️ Parental & Child Education

🔸Importance of joint care and regular exercise

🔸Energy conservation techniques

🔸Safe school participation strategies

🔸Ergonomics for writing, sitting, and play.

07/07/2025

Dysarthria is a motor speech disorder caused by weakness or poor coordination of the muscles used for speaking. It often results from damage to the brain or nervous system. People with dysarthria may have slurred, slow, or soft speech that can be difficult to understand.

✅ Common Causes:

🔸Stroke

🔸Traumatic Brain Injury (TBI)

🔸Parkinson’s Disease

🔸Multiple Sclerosis (MS)

🔸Cerebral Palsy

🔸ALS (Amyotrophic Lateral Sclerosis)

✅Symptoms of Dysarthria:

🔸Slurred or mumbled speech

🔸Difficulty controlling pitch, volume, or rhythm

🔸Nasal-sounding voice

🔸Strained or breathy speech

🔸Difficulty moving the tongue, lips, or jaw

✅ Management at Physio360:

At Physio360 Chennai, we provide individualized speech and physiotherapy-based rehab programs for dysarthria, focusing on:

✔️ Oro-motor exercises to strengthen speech muscles
✔️ Breathing coordination to improve speech clarity
✔️ Postural corrections for better vocal support
✔️ Facial stimulation & neuromuscular re-education
✔️ Tongue & lip mobility drills
✔️ Speech pacing and articulation therapy

We also combine neuro physiotherapy to support underlying neurological conditions contributing to dysarthria.

07/07/2025

Dysarthria is a motor speech disorder caused by weakness or poor coordination of the muscles used for speaking. It often results from damage to the brain or nervous system. People with dysarthria may have slurred, slow, or soft speech that can be difficult to understand.

✅ Common Causes:

🔸Stroke

🔸Traumatic Brain Injury (TBI)

🔸Parkinson’s Disease

🔸Multiple Sclerosis (MS)

🔸Cerebral Palsy

🔸ALS (Amyotrophic Lateral Sclerosis)

✅Symptoms of Dysarthria:

🔸Slurred or mumbled speech

🔸Difficulty controlling pitch, volume, or rhythm

🔸Nasal-sounding voice

🔸Strained or breathy speech

🔸Difficulty moving the tongue, lips, or jaw

✅ Management at Physio360:

At Physio360 Chennai, we provide individualized speech and physiotherapy-based rehab programs for dysarthria, focusing on:

✔️ Oro-motor exercises to strengthen speech muscles
✔️ Breathing coordination to improve speech clarity
✔️ Postural corrections for better vocal support
✔️ Facial stimulation & neuromuscular re-education
✔️ Tongue & lip mobility drills
✔️ Speech pacing and articulation therapy

We also combine neuro physiotherapy to support underlying neurological conditions contributing to dysarthria.

05/07/2025

Maxillofacial injuries refer to trauma involving the face, including the jaw, cheekbones, nasal bones, orbital (eye) bones, and soft tissues such as muscles, skin, and gums. These injuries are commonly seen after road traffic accidents, sports injuries, falls, assaults, or industrial accidents.

✅Common Types of Maxillofacial Injuries:

🔸Fractures: Nasal bone, mandible (lower jaw), maxilla (upper jaw), zygomatic bone (cheekbone).

🔸Soft tissue injuries: Lacerations, bruises, and swelling.

🔸Dental trauma: Broken or displaced teeth.

🔸Orbital injuries: Affecting vision and eye movement.

✅ Symptoms to Watch For:
Facial pain and swelling

✔️Difficulty opening the mouth or chewing

✔️Bleeding from the mouth or nose

✔️Misaligned bite or missing teeth

✔️Blurred vision or double vision

✔️Numbness in the facial area

✅Physiotherapy Protocol for Maxillofacial Injury (Post-Surgical or Conservative Management)

👉Phase 1: Acute Phase (0–1 week)
Goals:

🔸Pain & swelling control

🔸Prevent joint stiffness

🔸Educate on jaw rest and soft diet

👉 Phase 2: Subacute Phase (1–3 weeks)
Goals:

🔸Improve range of motion

🔸Begin soft tissue mobilization

🔸Prevent TMJ hypomobility

👉 Phase 3: Rehabilitation Phase (3–6 weeks onward)
Goals:

🔸Restore functional jaw movements

🔸Improve strength & coordination

🔸Return to normal activities (eating, speaking, yawning).

04/07/2025

Eagle’s Syndrome is a rare condition caused by the elongation of the styloid process or calcification of the stylohyoid ligament, leading to compression or irritation of nearby neurovascular structures such as the glossopharyngeal nerve, internal carotid artery, or vagus nerve. This can cause a variety of head, neck, and orofacial symptoms.

✅Causes:

🔸Elongated styloid process.

🔸Calcification or ossification of the stylohyoid ligament.

🔸Post-tonsillectomy scar tissue altering tissue planes or increasing sensitivity.

🔸Developmental abnormalities in the styloid-stylohyoid complex.

🔸Trauma to the cervical region or pharyngeal area.

🔸Hormonal changes (especially in postmenopausal women).

✅ Symptoms:

🔸Throat pain, especially during swallowing (odynophagia).

🔸Foreign body sensation in the throat.

🔸Ear pain or fullness.

🔸Neck or facial pain, possibly radiating to the jaw.

🔸Difficulty in swallowing (dysphagia).

🔸Headaches or pain at the base of the skull.

🔸Voice changes or hoarseness.

🔸Pain aggravated by neck rotation or head extension.

✅ Physiotherapy Management:

While Eagle’s Syndrome may require medical or surgical management. conservative physiotherapy can significantly help relieve muscular and postural contributions to symptoms.

1️⃣ Pain Management:

👉Modalities such as TENS, IFT, and ultrasound to reduce pain and local inflammation.

👉Cryotherapy or heat therapy depending on symptom severity and patient comfort.

2️⃣ Manual Therapy:

👉Myofascial release techniques targeting sternocleidomastoid, masseter, and temporalis muscles.

👉Cervical mobilization to relieve associated cervical spine stiffness.

👉Trigger point therapy for cranio-cervical tension.

3️⃣ Postural Correction:

👉Address forward head posture, rounded shoulders, and thoracic kyphosis.

👉Ergonomic advice for desk workers to reduce cervical strain.

4️⃣ Neuromuscular Re-education:

👉Deep cervical flexor strengthening (chin tucks, head nods).

👉Scapular stabilizer training to improve neck and shoulder mechanics.

5️⃣ Breathing and Relaxation Techniques:

👉Diaphragmatic breathing, segmental breathing, and progressive muscle relaxation to reduce stress-related muscular tightness.

6️⃣ Home Exercise Program:

👉Cervical isometrics and stretches.

👉Jaw mobility exercises to reduce TMJ strain.

👉Self-mobilization techniques for neck flexibility.

03/07/2025

Ocular Myasthenia Gravis is a localized form of myasthenia gravis, an autoimmune neuromuscular disorder. In OMG, the body’s immune system produces antibodies that disrupt the communication between nerves and muscles—specifically affecting the extraocular muscles that control eye and eyelid movements.

✅Causes:

Antibodies block or destroy acetylcholine receptors at the neuromuscular junction, leading to muscle weakness. While the condition initially presents in the eyes, it can progress into generalized myasthenia gravis in some cases.

✅ Key Symptoms:

🔸Ptosis (drooping eyelids), often worse at the end of the day

🔸Diplopia (double vision) due to weakness of eye muscles

🔸Variable fatigue—symptoms improve with rest

🔸No sensory deficits or pain

✅ Diagnosis Includes:

🔸Ice pack test (improves ptosis)

🔸Antibody blood tests (AChR or MuSK)

🔸Single-fiber electromyography (EMG)

🔸Tensilon test (edrophonium injection)

🔸MRI/CT scan to rule out thymoma.

At Physio360, we offer comprehensive physiotherapy support for Ocular Myasthenia Gravis patients through:

✔️ Oculomotor Exercises – Improve control of eye movements.

✔️ Visual Tracking Drills – Strengthen eye coordination.

✔️ Saccadic & Pursuit Exercises – Restore smooth and accurate vision shifts.

✔️ Neuro Rehab – Focuses on neuroplasticity and adaptive eye-brain communication.

✔️ Energy Conservation Techniques – Managing fatigue effectively.

✔️ Postural Training – Helps reduce compensatory neck strain due to eye misalignment.

02/07/2025

Sciatic nerve glide is a gentle neurodynamic exercise used to mobilize the sciatic nerve within its surrounding tissues. It helps reduce nerve tension, improve mobility, and relieve symptoms like shooting leg pain, numbness, or tingling along the back of the leg.

✅Purpose & Benefits:

🔸Reduce irritation of the sciatic nerve

🔸Restore normal movement and elasticity of the nerve

🔸Decrease pain, tingling, and numbness in the leg

🔸Improve hamstring flexibility and lower back mobility

🔸Prevent nerve adhesion after disc injury or surgery

✅Basic Sciatic Nerve Glide Exercise (Slump sitting method)

🔸Sit upright at the edge of a chair.

🔸Extend one leg forward with the knee straight and ankle dorsiflexed (toes pointing up).

🔸At the same time, gently look up (neck extension).

🔸Then bend the leg back and look down (neck flexion).

🔸Repeat the glide slowly for 10-15 repetitions, 2-3 sets/day.

01/07/2025

The Royal London Hospital Test is a clinical examination used to assess Achilles tendinopathy, particularly mid-portion Achilles tendinitis. It evaluates changes in pain intensity when the Achilles tendon is moved between relaxed and tensed positions (plantar flexion vs dorsiflexion). The test helps differentiate true tendinopathy from other causes of heel pain.

✅Procedure:

👉The patient lies prone or sits with the foot hanging freely.

👉Place the ankle in neutral or slight plantar flexion.

👉Palpate the Achilles tendon to locate a tender spot.

👉Ask the patient to move the ankle into maximum dorsiflexion.

👉Re-palpate the previously identified tender spot.

👉Then, move the foot into maximum plantarflexion and palpate again at the same spot.

✅Interpretation:

✔️ Positive Test:
If the tenderness decreases or disappears when the tendon is dorsiflexed (tensed), the test is considered positive, indicating Achilles tendinopathy.

✔️Negative Test:
If the tenderness persists regardless of ankle position, the test is negative, and the cause of pain may be from other structures or insertional tendinopathy.

30/06/2025

Optic neuritis refers to the inflammation of the optic nerve, which transmits visual information from the eye to the brain. It is a common early symptom of Multiple Sclerosis (MS)—an autoimmune demyelinating disease that affects the central nervous system.

✅Symptoms:

Patients with optic neuritis, particularly in the context of MS, may experience:

🔸 Sudden vision loss (partial or complete) in one eye

🔸 Pain behind the eye, especially worsened by eye movement

🔸 Reduced color vision (especially red desaturation)

🔸 Flashing lights or photopsia

🔸 Blurred vision or visual field defects.

✅Physiotherapy Management:

While optic neuritis itself is managed primarily by neurologists and ophthalmologists with medications like corticosteroids, physiotherapy plays a crucial role in managing associated MS-related disabilities and enhancing quality of life:

✔️ Visual Retraining Therapy:
Use of eye tracking exercises, visual scanning, and contrast sensitivity training.

Integration of visual-motor coordination tasks to aid adaptation.

✔️Balance & Gait Training:
Optic neuritis can affect depth perception and spatial awareness, contributing to balance issues.

Use of proprioceptive training, balance boards, and treadmill walking with visual cues.

✔️Fatigue Management:
Energy conservation strategies.

Incorporate graded aerobic exercises to boost stamina without overexertion.

✔️ Postural Re-education:
Address compensatory postures due to visual changes.

Strengthening of core and neck muscles.

✔️ Functional Rehabilitation:
Task-specific training to improve confidence in daily living.

Orientation training in familiar and unfamiliar environments.

Physio360chennai

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Monday	8am - 9:30pm
Tuesday	8am - 9:30pm
Wednesday	8am - 9:30pm
Thursday	8am - 9:30pm
Friday	8am - 9:30pm
Saturday	8am - 9:30pm
Sunday	8am - 9:30pm