Stroke Treatment – How Physiotherapy plays an important role?

Physical therapists specialize in treating disabilities related to motor and sensory impairments. They are trained in all aspects of anatomy and physiology related to normal function, with an emphasis on movement. They assess the stroke survivor’s strength, endurance, range of motion, gait abnormalities, and sensory deficits to design individualized rehabilitation programs aimed at regaining control over motor functions. Physical therapists help survivors regain the use of stroke-impaired limbs, teach compensatory strategies to reduce the effect of remaining deficits, and establish ongoing exercise programs to help people retain their newly learned skills.Stroke related problems can be treated by  Physiotherapy especially by the Experienced Physiotherapist in JP Nagar and Bannerghatta Road – Pro Physiotherapy.

Experienced Physiotherapist in JP Nagar.

Disabled people tend to avoid using impaired limbs, a behavior called learned non-use. However, the repetitive use of impaired limbs encourages brain plasticity. and helps reduce disabilities. Strategies used by physical therapists to encourage the use of impaired limbs include selective sensory stimulation such as tapping or stroking, active and passive range-of-motion exercises, and temporary restraint of healthy limbs while practicing motor tasks. The result of a Stroke is loss of function in the affected part of the brain. The person may have difficulty controlling movement on one side of the body, affecting the head, arm, leg and face. Speech, vision, swallowing, bowel and bladder can also be affected. The person’s emotions, ability to concentrate and memory may also change.

It is vital that you recognize the signs of a stroke early and seek medical attend. New treatments if administered in a certain space of time from the onset of symptoms can result in little or no deficits but early intervention is the key.

Physiotherapy plays an important role in stroke rehabilitation. After a detailed assessment, our highly skilled Physiotherapists and Experienced Physiotherapist in JP Nagar will plan rehabilitation programmed considering your lifestyle and home environment. Treatment may include guided movements of limbs, and relearning how to sit, stand, walk and other everyday activities. A falls screen may also be of benefit.

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Current interventions in the management of knee osteoarthritis

No specific cure for OA exists and the severity of condition varies from individual to individual. Hence, a more generic approach to current treatment methods revolves around some combination of non-pharmacological and pharmacological treatment modalities. Mostly, all exercise programs for knee OA should be practical, albeit simple, but should be helpful in gradual and progressive cure of the condition. Each program should be individually designed for proper accommodations based on the severity, age, gender, weight, lifestyle, and the individual’s functional capabilities. These program settings should typically not involve any high-impact axial loading and should allow for proper rest intervals as set forth by the individual’s needs toward the frequency, intensity, and duration of the treatment. The goal of the program should be to decrease pain, increase the range of motion, increase the overall functional strength, educate about posture and gait, as well as to improve physical fitness levels and mobility.Pro Physiotherapy is the Top Physiotherapist in Bangalore.

Top Physiotherapist in Bangalore.

Weight reduction is one of the first and unproblematic measures that can be taken to reduce knee OA. Studies of OA have constantly shown that overweight people have higher rates of knee OA than non-overweight control subjects. This is due to the fact that force across the knees is 3–6 times the body weight; therefore, people who have more mass cause extreme forces on their knees, leading to the early onset or steady progression of knee OA condition.2] Individuals who are overweight may have circulation problems, possibly including a cartilage growth problem or a bone problem, which has the ability to cause cartilage breakdown or affect the bone underneath the cartilage, thereby leading to OA. Finally, overweight people have higher bone mineral densities, and high bone mineral density (or the absence of osteoporosis) may itself be a risk factor for OA. Weight loss is therefore a logical step to relieve pain in these joints and to slow the progression of degenerative arthritis. According to a study conducted by Mao-Hsiung Huang and group, pain reduction and improvement of walking speed in various degrees of severity of arthritis was observed in the OA population undergoing prescribed weight loss procedures.Suggestions from the Top Physiotherapist in Bangalore — Stress affects the condition of arthritis.

Apart from weight reduction and avoiding activities that exert excessive stress on the joint cartilage, there has been no specific treatment to prevent cartilage degeneration or to repair damaged cartilage in OA. Therefore, for the past several years, research has focused on determining the causes of knee OA and to discover how to stop the progression of the disease, aside from lowering the effects such as pain and discomfort by therapy. Some studies have even hoped to help reform the lost cartilage to return the knee back to health. A potential technique that can augment cartilage growth (stem cell tissue engineering approaches) is the use of electromagnetic field therapy (EFT). Modulation of cell signaling events by weak electromagnetic fields is associated with binding of hormones, antibodies, and neurotransmitters to their specific binding sites. Pulsed electromagnetic fields (PEMF) treatment preserves the morphology of articular cartilage and retards the development of OA lesions. However, while supply limitations of stem cells can be overcome, the lack of tissue quality, specifically in the preparation of the differentiated stem cells toward the articular cartilage phenotype is still a major challenge for the researchers.

However, the most widely used remedy for knee OA is rehabilitation and physical therapy (PT). PT has proved to be useful in helping patients with pain and mobility. Fitness walking, aerobic exercise, and strength training have all been reported to result in functional improvement in patients with OA of the knee. Having a clinical PT program has the benefits of onsite direction and availability of sophisticated equipment. By and large, various studies have shown that having these added benefits contributes to program adherence and overall higher outcomes while in the care of the PT. These programs may be divided into PT at rehabilitation center under the supervision and monitoring of doctors and trained specialists and the other one carried out through personal care as prescribed by medical practitioner at home.

Rehabilitation-centered approach

Specialist at Pro Physiotherapy will also treat problems related to Osteoarthritis and stand as the Top Physiotherapist in Bangalore.

The specific programs that are typically run are a combination of programs such as strength training, aquatic, Tai Chi, aerobic, and hydrotherapy. Strength training, being the most common treatment approach for the management of patients with functional limitations, is prescribed to address the need to increase muscular strength and joint stability for improving in WOMAC pain scores and overall health benefits. The common equipment used is based on fundamentally different movement progression and resistance patterns such as isotonic (unchanged tension but change in length), isometric (no change in length or angle), and isokinetic (constant resistance with variation in speeds). Though isometric activities show effective results in reducing pain levels, they are avoided when working with the elderly due to increases seen in heart rate and blood pressure, which could be contraindicative to other co-morbidities. Typically the programs last for 6–24 weeks with an average of 8 weeks, while working at an average frequency of three sessions per week for an average duration of 30 min each.

Aerobic exercise programs may make OA patients feel better, help reduce the joint pain, and make it easier for them to perform daily tasks. Exercise programs under medical supervision should be balanced with rest and joint care. Aerobic programs truly border both clinical (rehabilitation) and home programs. Regardless of the setting, this program type was found to be effective for reducing pain in hip and knee. Patients are typically recommended to exercise between 50% and 70% target heart rate for a minimum of 30 min, 3 times a week, for overall weight management, health benefits, and a reduction in pain which was noted after a 6-month program.

Yoga therapy for osteoarthritis rehabilitation

Although many people think yoga involves twisting the body into pretzel-like poses, it can be safe and effective for people with OA. Yoga’s gentle movements can aid to build body strength, flexibility, and balance, and reduce arthritis pain and stiffness. The slow, controlled physical movement of joints is helpful for the arthritis patients. It improves the blood circulation in joints, removing unwanted toxins and other waste products. However, the problem is if the patient tries to move his limbs and joints then pain increases, which may lead to task avoidance, thereby further increasing the problem. So, it is a vicious cycle, i.e., because of pain no movements and because there is no movement, the situation becomes even worse. So, the patient should keep doing the movements which are possible for him/her. A pilot study conducted by the University of Pennsylvania, School of Medicine, examined one type of yoga, Iyengar yoga, suitable for people with OA of the knee. After an 8-week course of weekly 90-min beginner classes, there was a statistically significant reduction in pain, physical function, and mood, indicating the positive effects of yoga therapy for OA rehabilitation.

Tai Chi is a Chinese martial art that is primarily practiced for its health benefits, including a means for dealing with tension and stress. It emphasizes complete relaxation, and is essentially a form of meditation, or what has been called “meditation in motion.” Unlike the hard martial arts, Tai Chi is characterized by soft, slow, flowing movements that emphasize force, rather than brute strength. Though it is soft, slow, and flowing, the movements are to be executed precisely. Tai Chi as a form of therapy was typically conducted within the clinical setting and followed a host of different focus styles (Sun, Wu, Yang, Baduanjin, and Qigong), all of which were used as an intervention protocol for hip and knee OA. Each Tai chi session on average ran a length of 8–24 weeks with a frequency of one to five sessions per week at a length of 20–60 min. The use of Tai Chi showed significant improvements in reducing pain levels, and ultimately good program adherence. Out of all the styles selected, the Yang style (comprising 13 basic body movements) proved to have the best results.

physiotherapy clinic in bannerghatta road

Use Cold Laser Therapy and Control Your Pain.

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Cold Laser Therapy or Low Level Laser Therapy (LLLT) is a treatment that utilizes specific wavelengths of light to interact with tissue and is thought to help accelerate the healing process. It can be used on patients who suffer from a variety of acute and chronic conditions in order to help eliminate pain, swelling, reduce spasms and increase functionality.

How Cold Lasers Work? 

Top physiotherapist near you in JP Nagar.

Cold lasers are handheld devices used by the clinician and are often the size of a flashlight. The laser is placed directly over the injured area for 30 seconds to several minutes, depending on the size of the area being treated and the dose provided by the cold laser unit.

During this time, the non-thermal photons of light that are emitted from the laser pass through the skins layers (the dermis, epidermis, and the subcutaneous tissue or tissue fat under the skin). This light has the ability to penetrate 2 to 5 centimeters below the skin at 90mw and 830 nm.

Once the light energy passes through the layers of skin and reaches the target area, it is absorbed and interacts with the light sensitive elements in the cell. This process can be compared to photosynthesis in plants – sunlight is absorbed by plants, which is then converted to usable energy so that the plant can grow.

When cells absorb this light energy, it initiates a series of events in the cell that is theorized to eventually result in normalizing damaged or injured tissue, a reduction in pain, inflammation, edema and an overall reduction in healing time by increasing intracellular metabolism.

Types of Conditions Treated by Cold Lasers:

Physiotherapist near you in Bannerghatta Road.

Cold laser therapy can stimulate all cell types including muscle, ligament, cartilage, nerves, etc., so a number of conditions can be treated by cold laser therapy. Some of conditions that may typically be treated by cold laser therapy include:

Arthritis pain

Back pain

Carpal tunnel syndrome

Fibromyalgia pain

Knee pain

Neck pain

Tendonitis

Effectiveness of Cold Laser Therapy

Physiotherapist in JP Nagar

For years, physicians have been using cold laser therapy on patients who are seeking effective, alternative methods for pain relief. Since 1967 there have been over 2,500 clinical studies published worldwide. Many of these studies are double-blinded, placebo-controlled and have demonstrated cold laser therapy to be a proven method for pain relief.

Effectiveness of Cold Laser Therapy

Potential Cold Laser Therapy Disadvantages

Cold laser therapy does have several disadvantages.

Patients do not typically get full relief or resolution from their pain symptoms after the first treatment. It takes a series of treatments, usually 8 to 30, depending on the severity and duration of the condition.

Patients often have to return to the doctor for treatments at least 2 to 4 times per week. Old injuries may be aggravated for a few days after treatments, but for most patients this sensation is short term, lasting for a couple of days.

Physiotherapy clinic near you in JP Nagar.

Low-level laser therapy (LLLT) is thought to have an analgesic effect as well as a biomodulatory effect on microcirculation. This study was designed to examine the pain-relieving effect of LLLT and possible microcirculatory changes measured by thermography in patients with knee osteoarthritis (KOA). Materials and Methods: Patients with mild or moderate KOA were randomized to receive either LLLT or placebo LLLT. Treatments were delivered twice a week over a period of 4 wk with a diode laser (wavelength 830 nm, continuous wave, power 50 mW) in skin contact at a dose of 6 J/point. The placebo control group was treated with an ineffective probe (power 0.5 mW) of the same appearance. Before examinations and immediately, 2 wk, and 2 mo after completing the therapy, thermography was performed (bilateral comparative thermograph by AGA infrared camera); joint flexion, circumference, and pressure sensitivity were measured; and the visual analogue scale was recorded. Results: In the group treated with active LLLT, a significant improvement was found in pain (before treatment [BT]: 5.75; 2 mo after treatment: 1.18); circumference (BT: 40.45; AT: 39.86); pressure sensitivity (BT: 2.33; AT: 0.77); and flexion (BT: 105.83; AT: 122.94). In the placebo group, changes in joint flexion and pain were not significant. Thermographic measurements showed at least a 0.5°C increase in temperature—and thus an improvement in circulation compared to the initial values. In the placebo group, these changes did not occur. Conclusion: Our results show that LLLT reduces pain in KOA and improves microcirculation in the irradiated area.

 Physiotherapy clinic near you in Bannerghatta road.

References

1. van Breugel H.H.F.I. Bär P.R.D. Power density and exposure time of He-Ne laser irradiation are more important than total energy dose in photo-biomodulation of human fibroblasts in vitro. Lasers Surg. Med. 1992;12:528–537. [PubMed]

2. Tamura K. Hosoya S. Hiratsuka K. Abiko Y. Laser stimulation of CDC46 gene expression in murine osteoblasts. Laser Ther. 1998;10:25–31.

3. Lam T.S. Abergel R.P. Meeker C.A. Castel J.C. Dwyer R.M. Uitto J. Laser stimulation of collagen synthesis in human skin fibroblasts cultures. Lasers Life Sci. 1986;1:61–77.

4. Nagasawa A. Kato K. Negishi A. Bone regeneration effect of low-level lasers including argon laser. Laser Ther. 1991;3:59–62.

5. Barushka O. Yaakobi T. Oron U. Effect of low-energy laser (He-Ne) irradiation on the process of bone repair in the rat tibia. Bone. 1995;16:47–55. [PubMed]

6. Longo L. Evangelista S. Tinacci G. Sesti A.G. Effects of diodes laser silver arsenide aluminium (GaAlAs) 904 nm on healing of experimental wounds. Laser Surg. Med. 1987;5:444–448. [PubMed] 

https://www.prophysiotherapy.in

7. Lievens P. The influence of laser treatment on the lymphatic system and on wound healing. Laser. 1988;1(2):6–12.

8. Mester E. Examinations concerning biomedical effects of the laser ray. Doctor of the Academy Dissertation. 1971.

9. Öri L. Öri Z. Gervain M. Computer processing of telethermograms in urological diseases, Part I (Image digitalization and an overview of the hardware) Kórház és Orvostechnika [Hospital and Medical Technologies] 1988;26(1):13–14.

10. Gervain M. Öri Z. Computer processing of telethermograms in urological diseases, Part II (principles and methods) Kórház és Orvostechnika [Hospital and Medical Technologies] 1988;26(1):15–18.

11. Bjordal J.M. Johnson M.I. Iversen V. Aimbire F. Lopes-Martins R.A. Photoradiation in acute pain: a systematic review of possible mechanisms of action and clinical effects in randomized placebo-controlled trials. Photomed. Laser Surg. 2006;24:158–68. [PubMed]

12. Bjordal J.M. Lopes-Martins R.A. Iversen V.V. A randomised, placebo controlled trial of low level laser therapy for activated Achilles tendinitis with microdialysis measurement of peritendinous prostaglandin E2 concentrations. Br. J. Sports Med. 2006;40:76–80. [PMC free article] [PubMed]

13. Castano A.P. Dai T. Yaroslavsky I., et al. Low-level laser therapy for zymosan-induced arthritis in rats: importance of illumination time. Lasers Surg. Med. 2007;39:543–550. [PMC free article] [PubMed]

14. Barabás K. Double-blind examination of the effect of different laser types in rheumatoid arthritis. Summary of a Candidate of Sciences dissertation. 1991.

15. Ohshiro T. Low-Level Laser Therapy: A Practical Introduction. New York: John Willey and Sons; 1988. pp. 56–62.

16. Yoh K. Sato N. Maruo S. A clinical trial for treatment of chronic pain in orthopedic diseases by using 150 mW diode laser system—result of double blind test. Chronic Pain. 1994;13:96–100.

17. Hoshino H. Saitoh A. Funami S. Fukushima K. Satoh K. Ogawa S. The effect of low reactive-level laser therapy in the field of orthopedic surgery. Chronic Pain. 1994;13:101–109.

18. Kouno A. Yonezawa T. Abe Y. Ono T. Fujimasa I. The evaluation of pain therapy with low power. A comparative study of thermography and double blind test. Biomed. Thermol. 1993;13:102–1.

19. Gam A.N. Thorsen H. Lonnberg F. The effect of low-level laser therapy on musculo-skeletal pain a metaanalysis. Pain. 1993;52:63–66. [PubMed]

20. Kitchen S.S. Partridge C.J. A review of low-level laser therapy. Physiotherapy. 1991;77:161–168.

21. Ohshiro T. Calderhead R.G. Progress in Laser Therapy. Chichester (UK): John Wiley and Sons; 1991.

Articles from Photomedicine and Laser Surgery are provided here courtesy of Mary Ann Liebert, Inc.

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