KatLexy Physiotherapy Services - KPS

Provides Home based quality physiotherapy and nursing services by qualified Health professionals. Care in the comfort of your home.

Mission: Provide information Non-communicable Diseases NCDs in order to play a preventive role. To provide Quality and evidence based physiotherapy to combat the increasing cases of Non-communicable diseases NCDs.

Doctor ASKY

What is destroying your body ?

Unicort

A high spirit is very vital for your recovery.

Do you have triggers?

I heard this song play while I was getting my hair done and I was instantly reminded of the weeks, months, and years I’ve spent paralyzed.

Every time I hear these words I see these images flash before my eyes.

Bang Productions

Big up to all nurses out there.

NURSES #NURSES

Dr Physio

One day at a time.

Recovering from a stroke (cerebral vascular accident CVA). Taking few steps on his own.

Dr. Mujajati Aaron

SO YOU WANT TO LOSE WEIGHT? Here is my opinion.

Physical Therapist Fanatics

Quite insightful.

Tell us your Tshirt ideas, we will design it FREE for you

Defeated stroke: Left Hemiplegia;After 5 weeks of functional rehabilitation: Able to walk and now slowly getting back to his occupation.

Somewhere in Lusaka west.

We care with a healing touch.

Ever Wonder About Muscle Knots?
I have a knot in the muscle between the base of my neck and my left shoulder. My Mom calls this katakori, the Japanese term for a muscle knot in your neck and shoulders. I don't know the term or terms for knots when they occur in other parts of the body. The medical term for a muscle knot, in general, is a myofascial trigger point. Unlike the normal state that your muscle is in, a knot is harder to the touch and can hurt. I tried to untangle what is known about muscle knots, but don't take this as medical advice.

Latent trigger points don't hurt, but restrict movement. They can become active trigger points, which do hurt. Trigger points seem to be a problem of the skeletal muscles, rather than the cardiac muscle of your heart or the smooth muscle in your gut.

Muscles are made of many muscle fibres, which are made of many myofibrils, which are made of cylinders of proteins called sarcomeres. But they might as well be a riddle wrapped in mystery inside an enigma, for all that is known about muscle knots. Still, the basic physiology of muscles is that they only contract. The molecules responsible for the contractions are mainly actin and myosin, which pull past each other to shorten the muscle.

Skeletal muscles come in two categories: slow twitch, which work with oxygen more slowly for longer periods of time; and fast twitch, which are further divided into two categories, depending on how long they work without oxygen. I couldn't figure out if knots are more likely to occur in one kind of muscle over another, but muscle groups tend to have a combination of the two.

As muscles get used, waste products like lactic acid and lactates accumulate. The lactic acid makes the environment more acidic, so the muscles do not contract as well. The lactates result in a burning sensation in the muscles, which is a signal to stop. Lactate levels right after exercise, however, are not related to the muscle soreness that people feel in the coming days. But this is separate topic from trigger points.

The causes of trigger points are not clear, but are probably related to the overworking muscles through an acute trauma or chronic microtrauma—maybe from working so hard on this blog post. A muscle fibre with a trigger point is contracted into a small thickened area and the rest of the muscle fibre is stretched thin. Several contracted fibres in one area feels like a knot. These fibres cannot be used because they are already contracted, so these muscles will be weaker.

They may also cause other muscles to contract. Muscles with trigger points get tired more easily and don't return to a relaxed state as quickly when the muscle stops working. This possibly leads to a release of sensitizing chemicals related to pain. Blood flow is restricted, so nutrients and oxygen have harder time getting into the belly of the muscle and waste has a hard time getting out. This may be why trigger points can last a long time unless something is done. People who exercise regularly are less likely to get trigger points. Physical therapies such as stretching, massage and acupuncture seem to be the main ways to deal with trigger points, but these take time to work.


For further exploration of muscles check out the BodyWorks online game Muscle Hustle and visit the BodyWorks gallery at TELUS World of Science.
Credit: article by Science World.

[01/16/18]   Did you know that you can have one on one physiotherapy right in the comfort of your home?

Our happy client doing gait training.

Proudly and happily.

Gait training.

LIVER CIRRHOSIS

This is a medically chronic condition or state of the liver where it's tissues are hardened and fibrosed, rendering it useless, often caused by unmanaged hepatitis and usually associated with enlarged liver, bloated abdomen (ascites), anorexia, and general body itching.

CAUSES

1. Chronic alcoholism
2. Unmanaged hepatitis
3. Excessive intake of fat
4. Toxins of drugs, eg paracetamol
5. Auto Immune disease
6. Hepatitis viruses; A, B, C, etc

PATHOPHYSIOLOGY

1. When a causative organism such as Hepatitis virus gets into the liver, the liver cells (hepatocytes) sees it as a foreign material.
2. There is therefore a tissue reaction to the virus, resulting in inflammation (hepatitis). Depending on the type of virus implicated it could be hepatitis A, B, C, among others.
3. The virus continues to harm the hepatocytes as they get inflamed, if nothing is done at this stage.
4. There is infiltration of the hepatocytes, rendering them useless.
5. These liver tissues get hardened and fibrosed making the liver to lose all its functions.
6. Plasma proteins would therefore be lost, causing oedema (ascites). Jaundice would also ensue as a result of large amounts of unconjugated bilirubin.

CLINICAL MANIFESTATIONS (signs/symptoms)
1. Bloated abdomen
2. Enlarged liver
3. General body itching
4. Yellowish discolouration of the sclera
5. Weight loss
6. Anorexia (loss of appetite)
7. Abdominal pains (upper right corner)
8. Fatigue
9. Respiratory distress
10. Confusion

DIAGNOSTIC INVESTIGATIONS
1. Liver function test
2. Liver biopsy
3. Abdominal ultrasound
4. Laparoscopy
5. C. T scan

MEDICAL MANAGEMENT
There is no specific medical cure for this condition, however treatment can be offered so as to manage the signs/symptoms presented. Hence :
1. Abdominal paracenthesis can be done to manage ascites
2. Anti histamines for itching
3. Analgesics for general body pains.
4. In severe cases parenteral nutrition could be offered.

NURSING MANAGEMENT
1. Provide Oral hygiene for patient, so as to help boost appetite.
2. Encourage and help patient to eat in bits, to prevent vomiting and ensure adequate digestion and absorption.
3. Encourage bed rest for patient and make bedside commode available for patient.
4. Advice and monitor the diet of patient, so as to ensure low fat and low sodium diet. This would reduce the ascites and load on the malfunctioning liver.
5. Restrict fluids intake in order to prevent fluid overload.
6. Weigh patient daily to establish whether patient losses or increase in weight.
7. Monitor and Record patient's vital signs including Temperature, Pulse, Respiration and Blood Pressure, every four hours.
8. Monitor and Record patient's intake and output chart and report appropriately.
9. Monitor for signs of respiratory distress and probe the head side of patient a bit as in cardiac bed, so as to ensure adequate ventilation of the lungs.
10. Prevent bed sores in bed ridden patients by frequently turning and lubricating pressure areas of patient.
11. Prevent Deep Vein Thrombosis, by offering range of motion exercise to bed ridden patients.

HOW TO PREVENT LIVER CIRRHOSIS
1. Avoid alcoholism!
2. Buy and take only prescribed dosages of medications!
3. Screen and Vaccinate against the Hepatitis B virus!
4. Avoid excessive fat intake!
5. Avoid smoking!

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Sometimes they just need you to be there with them. They took care of you when you were young, weak and very vulnerable: now that they are weak and vulnerable, take care of them. Show them Love.

Speaking baby with my Little friend. In case you don't understand, we were talking about motorcycles lol

Yes I know my job description but why not cut her nails if I can. Going an extra mile.

You to speak the language of kids, you may need to leave your level and get to theirs.

When the calf muscle is limiting dorsiflexion: you can use 'hold relax technique"

Motor skill training: It works better for kids when it's fun.

We love to serve you.

She has tight right hamstring: weight bearing stretching and distracting her from the discomfort with a song.

Happy little friend.

Lower limb exercises with my little friend. Mild CP (right hemiparesis). Exercises for kids ought to be exciting: they easily get bored.

At the age of 9 she has finally started walking. She has learning difficulties but through a lot of repetition she gets to learn. Therapy within your own environment is the best: she's mastering her own environment. #KPS #PhysioInTheComfortOfYourHome

Getting the best out of therapy after she survived a stroke.

[03/19/16]   Arthrogryposis is congenital condition that is characterized by joint contractures of more than one joint. Physiotherapy is one of the major interventions.

[03/19/16]   Did you know that an attemp to abort a pregnancy that fails may lead to a child born with conditions like cerebral palsy, arthrogryposis and other physical deformities.

Angela happily at your service.

Perception

At your service

At your service.

www.clinicaltrials.gov

Home - ClinicalTrials.gov

Arthrogryposis Multiplex Congenita
NORD gratefully acknowledges Judith G. Hall, OC, MD, FCAHS, FRSC, Professor Emerita of Pediatrics and Medical Genetics, University of British Columbia & Children's and Women's Health Centre of British Columbia, Department of Pediatrics, BC's Children's Hospital, for assistance in the preparation of this report.
Synonyms of Arthrogryposis Multiplex Congenita
AMC
arthrogryposis
Subdivisions of Arthrogryposis Multiplex Congenita
amyoplasia
distal arthrogryposis
General Discussion
Arthrogryposis is a general or descriptive term for the development of nonprogressive contractures affecting one or more areas of the body prior to birth (congenitally). A contracture is a condition in which a joint becomes permanently fixed in a bent (flexed) or straightened (extended) position, completely or partially restricting the movement of the affected joint. When congenital contractures occur only in one body area, it is not referred to as arthrogryposis but rather an isolated congenital contracture. The most common form of an isolated congenital contracture is clubfoot. When arthrogryposis affects two or more different areas of the body, it may be referred to as arthrogryposis multiplex congenita (AMC). The most common form of AMC is amyoplasia. Arthrogryposis and arthrogryposis multiplex congenita are sometimes used interchangeably.
The symptoms of AMC are present at birth (congenital). However, specific symptoms and physical findings can differ greatly in range and severity from one person to another. In most cases, affected infants have contractures of various joints. The joints of the legs and arms are usually affected, the legs are affected more often than the arms. The joints of the shoulders, elbows, knees, wrists, ankles, fingers, toes, and/or hips are also commonly affected. In addition, the jaws and back may also be affected in individuals with AMC. In most cases, AMC occurs randomly, for no apparent reason (sporadic). More than 400 different conditions can cause isolated or multiple contractures and the causes, genetics, specific symptoms, and severity of these disorders vary dramatically. Over 125 genes have been identified as responsible for different types of arthrogryposis.
Signs & Symptoms
The most common universal symptom of AMC is limited or absent movement around small and large joints (contractures). The contractures are present at birth (congenital). The muscles of the affected limbs may be underdeveloped (hypoplastic), resulting in a tube-shaped limb with a soft, doughy feeling. Soft tissue webbing may develop over the affected joints.
In addition to joint abnormalities, other findings occur with greater frequency in individuals with AMC. These include abnormally slender long bones of the arms and legs and cleft palate, a condition in which the roof of the mouth fails to fuse together leaving a groove across the top of the mouth. In males, the testes may fail to descend into the scrotum (cryptorchidism). Intelligence may or may not be affected. Approximately one-third of individuals with AMC may have structural or functional abnormalities of the central nervous system.
Additional symptoms associated with AMC are related to the underlying disorder that causes the condition in each individual. The specific symptoms and their severity can vary dramatically based upon the underlying cause. Two of the most common forms of AMC are Amyoplasia and a group of genetic disorders called the distal arthrogryposes.
Amyoplasia is the most common form of AMC. Amyoplasia is a disorder characterized by multiple contractures of the joints. The shoulders may be internally rotated and drawn inward (adducted), the elbows are usually extended, and the wrists are usually flexed. In most affected individuals, the fingers are flexed and stiff. Although in most reports, the distal joints (i.e., those joints farthest away from the center of the body) are usually more severely affected, the shoulders and hips (which are proximal joints) often have significant contractures. Affected individuals usually have severe clubfoot. Some affected individuals may have dislocated hips. In some cases, a birthmark (a splotchy reddish birthmark also called a “Stork mark”) may be found at birth on the face. Individuals with amyoplasia usually have normal intelligence, no significant craniofacial abnormalities, and no other serious abnormalities of internal organs (visceral abnormalities). However, about 10% of individuals with amyoplasia have abdominal abnormalities such as gastroschisis (a condition in which a hole is present in the wall of the abdomen allowing the intestines to intrude out of the abdominal space) or intestinal atresia (blockage of the intestine). Another 10% have squashed or missing distal fingers or toes. Amyoplasia is common in one of monozygotic twins. Amyoplasia appears to be sporadic and not recur in families.
The distal arthrogryposes are a specific subgroup of AMC. This subgroup is characterized by multiple congenital contractures. Common symptoms include contractures of two or more areas of the body, less involvement of the proximal joints (those joints closest to the center of the body), and highly variable expressivity, which means that specific symptoms vary greatly even among individuals with the same disorder and even in the same family. At least 10 different forms of distal arthrogryposis have been identified including Freeman-Sheldon syndrome, Gordon syndrome, trismus-pseudocamptodactyly syndrome, multiple pterygium syndrome and Sheldon-Hall syndrome. (For more information on these disorders, choose the specific disorder name as your search term in the Rare Disease Database.)
Causes
The cause of AMC depends on the specific type. For many types, the cause is not fully understood. Arthrogryposis or AMC is not a specific diagnosis, but a physical finding that can be associated with numerous disorders and conditions. AMC is thought to be related to decreased movement in utero, which can have multiple causes. Neurologic and muscle problems may well be the most common causes of decreased fetal movement, but connective tissue disorders, maternal illness, and limited space are also common causes. Some cases of AMC occur as part of rare genetic disorders that are inherited. Some cases of AMC are related to multiple factors including genetic and environmental ones (multifactorial inheritance).
AMC may occur as part of certain single-gene disorders that can be inherited as autosomal recessive, autosomal dominant or X-linked traits. AMC may also occur as part of chromosomal disorders (e.g., Trisomy 18). AMC can also occur as part of certain connective tissue disorders. In addition, some cases of AMC may occur due to abnormalities or disorders associated with improper developmental of the central nervous system or the peripheral nervous system or as part of intrinsic muscle disorders. These disorders may be genetic or may occur due to environmental factors.
The primary underlying mechanism that causes congenital contractures is believed to be decreased fetal movement during development. The joints begin to develop in a fetus around five or six weeks into pregnancy. Motion is essential for the proper development of fetal joints. A lack of fetal movement allows for excess connective tissue to form around the joints, which can result in the joint becoming fixed and/or limiting the movement of a joint. In theory, any factor that diminishes or restricts fetal movement can cause congenital contractures. Such factors would include fetal crowding (in which there is not enough room for the fetus to move around) such as when there are multiple births or uterine structural abnormalities. Restricted fetal movement can also occur secondary to maternal disorders including viral infections, drug use, trauma or other maternal illness. Low levels of amniotic fluid around the fetus (oligohydramnios) have also been linked to decreased fetal movement.
Amyoplasia, the most common form of AMC, occurs randomly (sporadically). The distal arthrogryposes, another common form of AMC, are usually inherited as autosomal dominant traits. Genetic diseases are determined by the combination of genes for a particular trait that are on the chromosomes received from the father and the mother. Dominant genetic disorders occur when only a single copy of an abnormal gene is necessary for the appearance of the disease. The abnormal gene can be inherited from either parent, or can be the result of a new mutation (gene change) in the affected individual. The risk of passing the abnormal gene from affected parent to offspring is 50 percent for each pregnancy regardless of the sex of the resulting child.
Central and peripheral nervous system disorders that are associated with AMC include a condition in which the brain and spinal cord do not close before birth (meningomyelocele), the spinal muscular atrophies, and disorders in which there is incomplete development of certain portions of the brain (e.g., anencephaly, hydranencephaly or holoprosencephaly). Most of these disorders develop due to multiple factors including genetic and environmental ones (multifactorial inheritance).
Less often, AMC may be associated with certain muscle disorders including the muscular dystrophies, certain mitochondrial disorders and a variety of genetic muscle disorders that are present at birth (congenital myopathies). Such disorders are usually inherited.
Abnormalities affecting the development of connective tissue can cause AMC as well. Connective tissue is the material between the cells of the body that gives tissues form and strength. The abnormal development of connective tissue in the joints can restrict fetal movements, potentially causing multiple contractures. A lack of joint development or the abnormal fusion of bones that are normally separate (synostosis) have also been associated with multiple congenital contractures. Several disorders, which are associated with abnormalities of connective tissue development, have been associated with multiple congenital contractures including diastrophic dysplasia, metatropic dwarfism, popliteal pterygium syndrome and Larsen syndrome.
In many cases of AMC, the exact underlying cause of the contractures cannot be identified.
Affected Populations
The number of males and females affected by AMC is approximately equal. The condition has been reported in individuals of Asian, African and European descent. Isolated congenital contractures affect approximately 1 in 500 individuals in the general population. AMC affects approximately 1 in 3,000 individuals. AMC is present at birth (congenital).
Diagnosis
A diagnosis of AMC is made based upon identification of characteristic symptoms (e.g., multiple congenital contractures), a detailed patient history, and a thorough clinical evaluation. Certain tests may be necessary to determine the underlying cause of AMC including nerve conduction, electromyography and muscle biopsy, which can help diagnose neuropathic or myopathic disorders. A nerve conduction study measures how rapidly nerves carry an electrical impulse. An electromyography is a test that records electrical activity in skeletal voluntary muscles at rest and during muscle contraction. A biopsy is a procedure in which a small amount of affected tissue (e.g., muscle) is removed and studied under a microscopic to detect characteristic changes or findings that can aid in obtaining a diagnosis. Imaging studies of the central nervous system (CNS) and comparative genomic hybridization (CGH) array are also useful studies in making diagnoses.
Standard Therapies
Treatment
The treatment of AMC is directed toward the specific symptoms that are apparent in each individual. Standard physical therapy, which can improve joint motion and avoid muscle atrophy in the newborn period is beneficial. Gentle joint manipulation and stretching exercises may also be beneficial. Removable splints for the knees and feet that permit regular muscle movement and exercise are also recommended.
In some cases, surgery may be necessary to achieve better positioning and increase the range of motion in certain joints, especially the ankles, knees, hips, elbows, or wrists. In rare cases, tendon transfers have been performed to improve muscle function. Tendons are the tissue by which muscle is attached to bone.
Genetic counseling may be of benefit for affected individuals and their families. Other treatment is symptomatic and supportive.
Investigational Therapies
Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. Government funding, and some supported by private industry, are posted on this government web site.
For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office:
Tollfree: (800) 411-1222
TTY: (866) 411-1010
Email: [email protected]
For information about clinical trials sponsored by private sources, contact:
www.centerwatch.com
For information about clinical trials conducted in Europe, contact:
https://www.clinicaltrialsregister.eu/
Supporting Organizations
Arthrogryposis Multiplex Congenita Support, Inc.
P.O. Box 6291
Spartanburg, SC 29304
Email: [email protected]
Website: http://www.amcsupport.org/
Genetic and Rare Diseases (GARD) Information Center
PO Box 8126
Gaithersburg, MD 20898-8126
Phone: (301) 251-4925
Toll-free: (888) 205-2311
Website: http://rarediseases.info.nih.gov/GARD/
March of Dimes
1275 Mamaroneck Avenue
White Plains, NY 10605
Phone: (914) 997-4488
Email: [email protected] or [email protected]
Website: http://www.marchofdimes.org and nacersano.org
NIH/National Institute of Arthritis and Musculoskeletal and Skin Diseases
Information Clearinghouse
One AMS Circle
Bethesda, MD 20892-3675 USA
Phone: (301) 495-4484
Toll-free: (877) 226-4267
Email: [email protected]
Website: http://www.niams.nih.gov/
The Arthrogryposis Group
45 Milton Road
Hanwell
LONDON, W7 1LQ United Kingdom
Toll-free: 08000284447
Email: [email protected]
Website: http://www.tagonline.org.uk
References
TEXTBOOKS
Hall JG. Arthrogryposes (Multiple Congenital Contractures). In: Emery and Rimoin’s Principle and Practice of Medical Genetics, 6th Ed. Rimoin DL, Connor JM, Pyeritz RE, Korf BR, eds., Churchill Livingstone: New York, 2012
Hall JG. Arthrogryposis. In: Management of Genetic Syndromes, 3rd Ed. Cassidy SB, Allanson JE eds., John Wiley & Sons: Hoboken, NJ, 2010; 81-96.
Jones KL. Ed. Smith’s Recognizable Patterns of Human Malformation. 6th ed. Elsevier Saunders, Philadelphia, PA; 2006:774-777.
Bamshad M. Arthrogryposis Multiplex Congenita. NORD Guide to Rare Disorders. Lippincott Williams & Wilkins. Philadelphia, PA. 2003:155.
Berkow R., ed. The Merck Manual-Home Edition.2nd ed. Whitehouse Station, NJ: Merck Research Laboratories; 2003:1524-1525.
JOURNAL ARTICLES
Bamshad M, van Heest AE, Pleasure D. Arthrogryposis: a review and update. J Bone Joint Surg Am. 2009;91:40-46.
Fassier A, Wicart P, Dubousset J, Seringe R. Arthrogryposis multiplex congenita. Long-term follow-up from birth until skeletal maturity. J Child Orthop. 2009;3:383-390.
Bevan WP, Hall JG, Bamshad M, et al. Arthrogryposis multiplex congenita (amyoplasia): an orthopaedic perspective. J Pediatr Orthop. 2007;27:594-600.
Bernstein RM. Arthrogryposis and amyoplasia. J Am Acad Orthop Surg. 2002;10:417-424.
Sells JM, Jaffe KM, Hall JG. Amyoplasia, the most common type of arthrogryposis: the potential for good outcome. Pediatrics. 1996;97:225-231.
INTERNET
Chen H. Arthrogryposis. Emedicine Journal, February 15, 2013. Available at: http://emedicine.medscape.com/article/941917-overview Accessed:February 19, 2013.
Genetic and Rare Disease Information Center (GARD). Arthrogryposis Multiplex Congenita (AMC). Available at: http://rarediseases.info.nih.gov/GARD/Disease.aspx?PageID=4&diseaseID=777 Accessed:February 19, 2013.
Years Published
1986, 1988, 1990, 1991, 1997, 1999, 2010, 2013
The information in NORD’s Rare Disease Database is for educational purposes only and is not intended to replace the advice of a physician or other qualified medical professional.
The content of the website and databases of the National Organization for Rare Disorders (NORD) is copyrighted and may not be reproduced, copied, downloaded or disseminated, in any way, for any commercial or public purpose, without prior written authorization and approval from NORD. Individuals may print one hard copy of an individual disease for personal use, provided that content is unmodified and includes NORD’s copyright.
National Organization for Rare Disorders (NORD)
55 Kenosia Ave., Danbury CT 06810 •

www.clinicaltrials.gov

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PO BOX 37907, Plot 89146
Lusaka, 10101

Royalty-eLearners (ReL) was founded in 2014 by a group of dedicated lecturers lead by Mr. Jones H. Munang’andu who wanted to share their knowledge and skil