Fortune Physiotherapy And Wellness Clinic

02/06/2023

01/06/2023

Happy new month everyone.

01/12/2022

Happy new month of December to you All

26/11/2022

Cerebral Palsy
Cerebral palsy (CP) is a disorder of movement and posture that appears during infancy or early childhood resulting from permanent and non-progressive damage to the developing brain. It is characterized by deficits in muscle movement, coordination, and balance. In many cases, hearing, vision, and sensation are also affected. This condition is the most common motor disability in childhood and the prevalence is about 1-5/1000 babies.

Signs and symptoms
The symptoms vary among individuals and range from mild to severe. Some of the signs and symptoms include
• Lack of coordination or ataxia
• Muscle stiffness or spasticity
• Delays in motor milestone
• Abnormal muscle tone
• Difficulty speaking
• Difficulty walking
• Involuntary movements
• Excessive drooling and difficulty swallowing
• Intellectual disabilities and so on

Classification of cerebral palsy
Cerebral palsy can be classified into 3 major categories, namely:
• Spastic CP
• Dyskinetic CP
• Ataxic CP

Risk Factors
There are different risk factors for developing cerebral palsy. These include
• Prematurity
• Maternal infection
• Trauma
• Placenta insufficiency
• Neonatal hyperbilirubinemia
• Birth asphyxia
• Central nervous system infection

Diagnosis
The diagnosis is carried out by taking a complete medical history, performing a physical exam that includes a detailed neurological exam, and evaluating the symptoms. The classification of gross motor, fine motor, and communication will help medical professionals to better understand the abilities of the child and what to focus on for interventions.

Treatment
The goal of treatment is to improve limitations and prevent complications. The treatment includes assistive aids, medications, physical therapy, and surgery.
Physiotherapy management
The goal of physiotherapy is to improve mobility, prevent deformity, teach daily living skills, and educate the parent.
Methods of physiotherapy
• Active and passive ROM exercises, weight-bearing exercises, and positioning to maintain soft tissue length and joint integrity
• Cryotherapy is used as an adjunct to reduce spasticity. Ice is also used with static stretch to overcome hyperactive stretch reflexes
• Bobath Neurodevelopmental Therapy is an approach to normalize muscle tone, inhibit abnormal primitive reflexes, and stimulate normal muscle movement.
• Bracing can be used to stabilize the trunk and extremities, improve function, keep joints in a functional position, and facilitate selective motor control.
• Mobility aids such as standers and walkers are used to train standing and walking, as well as improve posture.

12/09/2021

Injection palsy

Injection palsy is a gait abnormality due to weakness, irritation, or damage to the common peroneal nerve including the sciatic nerve. It is characterized by paralysis of the muscles in the anterior portion of the lower leg, leading to the inability to raise the toes (dorsiflexion) when walking.

Causes
Injection palsy can begin suddenly or hours following damage to the Sciatic Nerve. A misplaced intramuscular injection at the gluteal region is the most common cause, and it is attributed to either frequent injections or poor techniques by unqualified medical personnel.

The Sciatic Nerve is the longest in the human body (with nerve roots L4, L5, S1, S2, S3), and it emerges laterally through the greater sciatic foramen inferior to the piriformis. It divides into its terminal branches, namely the Tibial and Common Peroneal nerves, usually just below the mid-thigh.

Clinical presentation
The persistent and most reported symptoms are pain and abnormal gait pattern. However, pain intensity is difficult to quantify especially in the Paediatric population but facial expression is quite helpful.

Other presentations include;
• Foot drop
• External rotation and abduction contracture of the hip
• Equinovarus or Equinus deformity
• Muscular weakness/atrophy
• Motor and sensory deficit such as paraesthesia and numbness.

Complication
Injection palsy may be temporary or permanent, depending on the extent of muscle weakness or paralysis. Furthermore, it can occur in one or both feet. In walking, the raised leg is slightly bent at the knee to prevent the foot from dragging along the ground (high steppage gait).

Treatment
Medical Treatment
In most cases, the symptoms of injection palsy do not respond to the use of nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, and myorelaxants. However, the use of methyl prednisolone via transcaral block is effective to manage neuropathic pain.

Physiotherapy
Conservative means is the first line of approach for the management of patients with sciatic nerve injury.
• Joint or Soft Tissue mobilization helps to retain muscle flexibility and prevent deformity.
• For pain management, the use of TENS, massage, gentle stretching, and desensitization techniques are employed.
• Bracing, such as Ankle Foot Orthosis (AFO) may be used to prevent falls, foot drop, and associated deformity.
• Balance and Co-ordination training because.

23/08/2021

Stroke

Stroke is a medical emergency that occurs when the blood supply to your brain is interrupted or reduced, thereby preventing brain tissue from getting oxygen and nutrients. Without blood, your brain cells begin to die. This can cause serious symptoms, paralysis, disability, and even death.
There are 2 main types of stroke;
• Ischemic stroke: An ischemic stroke occurs when a blood clot keeps blood from flowing to your brain. The blood clot is often due to atherosclerosis, which is a buildup of fatty deposits on the inner lining of a blood vessel
• Hemorrhagic stroke: A hemorrhagic stroke results when a blood vessel in your brain ruptures or breaks, spilling blood into the surrounding tissues.
There is also Transient ischaemic attack, also called mini-stroke. In this case, the blood clot and symptoms last for a short period of time.

Signs and Symptoms

• Trouble speaking and understanding what others are saying
• Paralysis or numbness of the face, arm or leg
• Headache: A sudden, severe headache, which may be accompanied by vomiting, dizziness or altered consciousness, may indicate that you're having a stroke.
• Problems seeing in one or both eyes
• Trouble walking
The National Stroke Association recommends the FAST method to help identify the warning signs of a stroke:
Face: When you smile, does one side of your face droop?
Arms: When you raise both arms, does one arm drift down?
Speech: Is your speech slurred? Are you having trouble talking?
Time: If you experience any of these symptoms, call for help immediately.

Risk factors

Many factors can increase your stroke risk. Potentially treatable stroke risk factors include:

Lifestyle risk factors

• Being overweight or obese
• Physical inactivity
• Heavy or binge drinking
• Use of illegal drugs such as co***ne and methamphetamine

Medical risk factors

• High blood pressure
• Cigarette smoking or second-hand smoke exposure
• High cholesterol
• Diabetes

Complications

• Paralysis or loss of muscle movement
• Difficulty talking or swallowing
• Memory loss or thinking difficulties
• Emotional problems
• Pain

Diagnosis

Things will move quickly once you get to the hospital, as your emergency team tries to determine what type of stroke you're having. That means you'll have a CT scan, MRI, or other imaging tests soon after your arrival. The team also need to rule out other possible causes of your symptoms, such as a brain tumor or a drug reaction.

Treatment

Emergency treatment for stroke depends on whether you're having an ischaemic stroke or a stroke that involves bleeding into your brain. A wide range of treatment techniques and approaches from different philosophical backgrounds are utilized in Stroke Rehabilitation.

Physiotherapy management

Evidence has shown that task-oriented exercise training program is effective to restore patient's function including mobility, balance, gait, and for strengthening the affected lower limb to improve functional independence. Furthermore, physiotherapy facilitates upper limb training through constraint-induced movement therapy to improve the ability to perform functional upper limb activities. In addition, physiotherapy helps reduce the associated pain and spasticity, and may recommend a walking aid to prevent falls.

01/06/2021

Bell's Palsy

Bell’s palsy is a condition that causes a temporary paralysis or weakness of muscles in the face (Facial muscles). It can occur when the nerve that controls your facial muscles becomes inflamed, swollen, or compressed. This condition causes one side of your face to droop or become stiff. Furthermore, you may have difficulty smiling or closing your eye on the affected side. In many cases, it is temporary and symptoms usually go away after a few weeks.

Although Bell’s palsy can occur at any age, it is more common among people between ages of 16 and 60. This condition is named after the Scottish anatomist Charles Bell, who was the first to describe it.

Causes
Although the exact cause of Bell's palsy is not known, it is often related to a viral infection. Viruses that have been linked to Bell's palsy include those that cause:
• Chickenpox and shingles (herpes zoster)
• Infectious mononucleosis (Epstein-Barr)
• Cold sores and ge***al herpes (herpes simplex)
• Respiratory illnesses (adenovirus)
• Cytomegalovirus infections
• German measles (rubella)
• Mumps (mumps virus)
• Flu (influenza B)
• Hand-foot-and-mouth disease (coxsackievirus)
The nerve that controls your facial muscles passes through a narrow corridor of bone on its way to your face. In Bell's palsy, that nerve becomes inflamed and swollen — usually related to a viral infection. Besides facial muscles, the nerve affects tears, saliva, taste and a small bone in the middle of your ear.

Risk factors
Bell's palsy occurs more often in people who:
• Are pregnant, especially during the third trimester, or who are in the first week after giving birth
• Have an upper respiratory infection, such as the flu or a cold
• Have diabetes
Complications
The complications may include:
• Irreversible damage to your facial nerve.
• Abnormal regrowth of nerve fibers. This may result in involuntary contraction of certain muscles when you're trying to move others (synkinesis) — for example, when you smile, the eye on the affected side may close.
• Partial or complete blindness of the eye that won't close due to excessive dryness and scratching of the cornea (the clear protective covering of the eye).

Treatment
In most cases, Bell’s palsy symptoms improve without treatment. However, it can take several weeks or months for the muscles in your face to regain their normal strength.
The following treatments may help in your recovery.

Medication
• corticosteroid drugs, which reduce inflammation
• antiviral or antibacterial medication, which may be prescribed if a virus or bacteria caused your Bell’s palsy
• over-the-counter pain medications, such as ibuprofen or acetaminophen, which can help relieve mild pain
• eye drops.

Physiotherapy
According to clinical practice guidelines, physiotherapy is recommended in Bell's palsy, and Neuromuscular Retraining techniques are effective in increasing facial range of movement and symmetry, as well as reducing/minimizing synkinesis.
Facial massage such as kneading or picking are used to strengthen weakened facial muscles and reduce stiffness.
Furthermore, the physiotherapist may use external electrical stimulation to restore muscle tone. Patients should not try this treatment without supervision as there are some indications that it may cause harm when used incorrectly.