Monday, November 22, 2010
The Nervous System
Conditions both within the body and in the environment are constantly changing. The nervous system directs the complex processes of the body's internal environment and also provides a link to the external world. This allows us to respond to changes both from internal sources as well as form external stimuli.
The nervous system is broken down into two major part: the central nervous system, which includes the brain and spinal cord, and the peripheral nervous system, which includes all nerves, which carry impulses to and from the brain and spinal cord. These include our sense organs, the eyes, the ears, our sense of taste, smell and touch, as well as our ability to feel pain.
Central Nervous System
Spinal Cord
The spinal cord is a long bundle of neural tissue continuous with the brain that occupies the interior canal of the spinal column and functions as the primary communication link between the brain and the rest of the body. The spinal cord receives signals from the peripheral senses and relays them to the brain.
The spinal cord is a long bundle of neural tissue continuous with the brain that occupies the interior canal of the spinal column and functions as the primary communication link between the brain and the rest of the body. The spinal cord receives signals from the peripheral senses and relays them to the brain.
Brain Stem
The brain stem is the part of the brain that connects the cerebrum and diencephalons with the spinal cord.
The brain stem is the part of the brain that connects the cerebrum and diencephalons with the spinal cord.
Medulla Oblongata
The medulla oblongata is located just above the spinal cord. This part of the brain is responsible for several vital autonomic centers including:
The medulla oblongata is located just above the spinal cord. This part of the brain is responsible for several vital autonomic centers including:
- the respiratory center, which regulates breathing.
- the cardiac center that regulates the rate and force of the heartbeat.
- the vasomotor center, which regulates the contraction of smooth muscle in the blood vessel, thus controlling blood pressure.
The medulla also controls other reflex actions including vomiting, sneezing, coughing and swallowing.
Pons
Continuing up the brain stem, one reaches the Pons. The pons lie just above the medulla and acts as a link between various parts of the brain. The pons connect the two halves of the cerebellum with the brainstem, as well as the cerebrum with the spinal cord. The pons, like the medulla oblongata, contain certain reflex actions, such as some of the respiratory responses.
Continuing up the brain stem, one reaches the Pons. The pons lie just above the medulla and acts as a link between various parts of the brain. The pons connect the two halves of the cerebellum with the brainstem, as well as the cerebrum with the spinal cord. The pons, like the medulla oblongata, contain certain reflex actions, such as some of the respiratory responses.
Midbrain
The midbrain extends from the pons to the diecephalon. The midbrain acts as a relay center for certain head and eye reflexes in response to visual stimuli. The midbrain is also a major relay center for auditory information.
The midbrain extends from the pons to the diecephalon. The midbrain acts as a relay center for certain head and eye reflexes in response to visual stimuli. The midbrain is also a major relay center for auditory information.
Diencephalon
The diencephalons is located between the cerebrum and the mid brain. The diencephalons houses important structures including the thalamus, the hypothalamus and the pineal gland.
The diencephalons is located between the cerebrum and the mid brain. The diencephalons houses important structures including the thalamus, the hypothalamus and the pineal gland.
Thalamus
The thalamus is responsible for "sorting out" sensory impulses and directing them to a particular area of the brain. Nearly all sensory impulses travel through the thalamus.
The thalamus is responsible for "sorting out" sensory impulses and directing them to a particular area of the brain. Nearly all sensory impulses travel through the thalamus.
Hypothalamus
The hypothalamus is the great controller of body regulation and plays an important role in the connection between mind and body, where it serves as the primary link between the nervous and endocrine systems. The hypothalamus produces hormones that regulate the secretion of specific hormones from the pituitary. The hypothalamus also maintains water balance, appetite, sexual behavior, and some emotions, including fear, pleasure and pain.
The hypothalamus is the great controller of body regulation and plays an important role in the connection between mind and body, where it serves as the primary link between the nervous and endocrine systems. The hypothalamus produces hormones that regulate the secretion of specific hormones from the pituitary. The hypothalamus also maintains water balance, appetite, sexual behavior, and some emotions, including fear, pleasure and pain.
Cerebellum
The functions of the cerebellum include the coordination of voluntary muscles, the maintenance of balance when standing, walking and sitting, and the maintenance of muscle tone ensuring that the body can adapt to changes in position quickly.
The functions of the cerebellum include the coordination of voluntary muscles, the maintenance of balance when standing, walking and sitting, and the maintenance of muscle tone ensuring that the body can adapt to changes in position quickly.
Cerebrum
The largest and most prominent part of the brain, the cerebrum governs higher mental processes including intellect, reason, memory and language skills. The cerebrum can be divided into 3 major functions:
- Sensory Functions - the cerebrum receives information from a sense organ; i.e., eyes, ears, taste, smell, feelings, and translates this information into a form that can be understood.
- Motor Functions - all voluntary movement and some involuntary movement.
- Intellectual Functions - responsible for learning, memory and recall.
Meninges
The meninges are made up of three layers of connective tissue that surround and protect both the brain and spinal cord. The layers include the dura mater, the arachnoid and the pia matter.
The meninges are made up of three layers of connective tissue that surround and protect both the brain and spinal cord. The layers include the dura mater, the arachnoid and the pia matter.
Cerebrospinal Fluid
The cerebrospinal fluid is a clear liquid that circulates in and around the brain and spinal cord. Its function is to cushion the brain and spinal cord, carry nutrients to the cells and remove waste products from these tissues.
The cerebrospinal fluid is a clear liquid that circulates in and around the brain and spinal cord. Its function is to cushion the brain and spinal cord, carry nutrients to the cells and remove waste products from these tissues.
Peripheral Nervous System
Nerves
Nerves are made up of specialized cells, which act as little wires, transmitting information to and from the central nervous system and brain. Nerves form the network of connections that receive signals (known as sensory input) from the environment and within the body, and transmit the body's responses, or instructions for action, to the muscles, organs, and glands. Nerve cells are located outside the central nervous system or spinal cord.
Nerves are made up of specialized cells, which act as little wires, transmitting information to and from the central nervous system and brain. Nerves form the network of connections that receive signals (known as sensory input) from the environment and within the body, and transmit the body's responses, or instructions for action, to the muscles, organs, and glands. Nerve cells are located outside the central nervous system or spinal cord.
Eyes
The eyes are organs that provide us with visual information from the external world, which is transmitted and interpreted by the brain.
The eyes are organs that provide us with visual information from the external world, which is transmitted and interpreted by the brain.
Ears
The ears are the organs used for both hearing and equilibrium. The ear can be divided into three sections: the outer that includes the parts of the ear we see, and the ear canal, which connects the external ear to the middle ear. It is separated from the middle ear by the tympanic membrane or eardrum. The middle ear contains three small bones that conduct sound waves. The inner ear contains sensory receptors and the mechanisms responsible for equilibrium.
The ears are the organs used for both hearing and equilibrium. The ear can be divided into three sections: the outer that includes the parts of the ear we see, and the ear canal, which connects the external ear to the middle ear. It is separated from the middle ear by the tympanic membrane or eardrum. The middle ear contains three small bones that conduct sound waves. The inner ear contains sensory receptors and the mechanisms responsible for equilibrium.
Taste
The sense of taste is perceived through the taste buds, which are located in various parts of the mouth, but are primarily concentrated on the tongue. Taste is experienced in four different ways - sweet, sour, salty or bitter. It is interesting to note, that only substances in solution can be perceived by the taste buds.
The sense of taste is perceived through the taste buds, which are located in various parts of the mouth, but are primarily concentrated on the tongue. Taste is experienced in four different ways - sweet, sour, salty or bitter. It is interesting to note, that only substances in solution can be perceived by the taste buds.
Smell
The receptors for smell are located in the upper part of the nasal cavity in the olfactory epithelium. The sense of smell can distinguish a greater variety of substances than the sense of taste. Here too, substances that are detected by these receptors must be in solution.
The receptors for smell are located in the upper part of the nasal cavity in the olfactory epithelium. The sense of smell can distinguish a greater variety of substances than the sense of taste. Here too, substances that are detected by these receptors must be in solution.
Tactile Sensation
There are several other types of receptors located throughout the body. They are considered general senses and provide us with tactile sensations including the feeling of pressure, heat, cold, pain and touch.
There are several other types of receptors located throughout the body. They are considered general senses and provide us with tactile sensations including the feeling of pressure, heat, cold, pain and touch.
Caffeine May Trigger Gout Attacks
Nov. 11, 2010 (Atlanta) -- An extra jolt or two of caffeine may trigger a gout attack in people with the painful and often disabling arthritic condition, preliminary research suggests.
"We found that overall, as the number of servings of caffeinated beverages increased, so too did the chance of having recurrent gout attacks," says Tuhina Neogi, MD, PhD, associate professor of medicine at Boston University School of Medicine.
For example, drinking four servings of caffeinated beverages in the previous 24 hours was associated with an 80% increased risk of recurrent gout attacks, compared with having no caffeinated drinks.
Drinking more than six servings of caffeinated beverages in the previous day was associated with a 3.3-fold higher risk of a flare-up, the study of 663 gout patients suggests.
When habitual and occasional caffeine drinkers were looked at separately, the link was only observed in people with gout who typically drink less than two caffeinated beverages a day, Neogi tells WebMD.
"As little as three servings a day could do it for these people," she says.
"In contrast, in people with gout who usually have two or more caffeinated beverages a day, increasing caffeine intake doesn't appear to raise the risk of gout attacks," Neogi says.
The study does not prove cause and effect, just that there appears to be an association between higher caffeine intake in the past 24 hours and an increased risk of gout attacks. People with gout who drink a lot of revved-up beverages may share some other characteristic that makes them more prone to flare-ups, researchers say.
The findings were presented here at the American College of Rheumatology's annual meeting.
Previous research has shown that, over the long term, caffeine intake is associated with lower levels of uric acid in the body and a lower risk of developing gout among people who do not have the arthritic condition, Neogi says.
The chemical structure of caffeine is very similar to that of a medication called allopurinol, which is commonly used to lower uric acid levels in people with gout, she says. Although effective at controlling gout in the long term, allopurinol can precipitate a flare-up among patients taking it for the first time, she says.
"Given the potential conflicting effects of caffeine on gout attack risk, we evaluated whether caffeinated beverage intake was associated with the risk for recurrent flare-ups," Neogi says.
Participants were asked to log on after having their next attack and answer an extensive questionnaire about medication, foods, and drinks they had consumed in the 24 hours prior to the attack. Three months after being free of flare-ups, they were asked to answer the same questions.
The researchers asked about all types of caffeinated beverages, including coffee, tea, soft drinks, and high-energy drinks such as Red Bull as well as non-caffeinated beverages.
Participants were predominantly white (89%), male (78%), and college educated (58%).
The link between increased intake of caffeinated beverages in the prior 24 hours and a higher risk for recurrent gout attacks was present even after accounting for other fluid intake.
In contrast, non-caffeinated coffee, tea, soda, and juices were not associated with an increased risk of gout attacks, Neogi says.
The researchers did not ask participants about the amount of sugar in their beverages. Therefore, the findings cannot be compared to that of another study presented at the meeting showing that women who drink one or more servings of sugary soda a day may be increasing their risk for developing gout, she adds.
That said, "It's a way to accumulate a large number of patients in a short period of time. It's good for generating hypotheses" that can then be tested in more rigorous clinical trials, Sundy tells WebMD.
Neogi defends the use of the Internet for studies like this, pointing out that it allows each person's caffeine intake prior to an attack to be compared to her intake when she is attack-free.
"That way, you don't have to have to worry about whether factors like age, weight, and lifestyle affected the results [which you do when one group of people is compared with another]. Plus, it's doubtful that caffeine affects a college-educated, high-paid person more than a poor, college dropout," she says.
Further research is needed, Neogi agrees. In the meantime, "people with gout who are already habitual caffeine drinkers probably do not need to change their habits, given that long-term caffeine intake can potentially lower uric acid levels," she says.
"But the person who doesn't drink a lot of caffeine on a regular basis should be aware that drinking more than usual may potentially trigger an attack. And I would not advise someone with gout to start drinking coffee as a way to lower uric acid levels due to its short-term effects," Neogi says.
This study was presented at a medical conference. The findings should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.
SOURCES: American College of Rheumatology 2010 Annual Scientific Meeting, Atlanta, Nov. 6-11, 2010.Tuhina Neogi, MD, PhD, associate professor of medicine, Boston University School of Medicine.John S. Sundy, MD, PhD, professor of medicine, Duke University Medical Center, Durham, N.C.
"We found that overall, as the number of servings of caffeinated beverages increased, so too did the chance of having recurrent gout attacks," says Tuhina Neogi, MD, PhD, associate professor of medicine at Boston University School of Medicine.
For example, drinking four servings of caffeinated beverages in the previous 24 hours was associated with an 80% increased risk of recurrent gout attacks, compared with having no caffeinated drinks.
Drinking more than six servings of caffeinated beverages in the previous day was associated with a 3.3-fold higher risk of a flare-up, the study of 663 gout patients suggests.
When habitual and occasional caffeine drinkers were looked at separately, the link was only observed in people with gout who typically drink less than two caffeinated beverages a day, Neogi tells WebMD.
"As little as three servings a day could do it for these people," she says.
"In contrast, in people with gout who usually have two or more caffeinated beverages a day, increasing caffeine intake doesn't appear to raise the risk of gout attacks," Neogi says.
The study does not prove cause and effect, just that there appears to be an association between higher caffeine intake in the past 24 hours and an increased risk of gout attacks. People with gout who drink a lot of revved-up beverages may share some other characteristic that makes them more prone to flare-ups, researchers say.
The findings were presented here at the American College of Rheumatology's annual meeting.
Caffeine's Chemical Structure Similar to Standard Gout Medication
Gout occurs when too much uric acid, a normal byproduct of DNA metabolism, builds up in the body. This leads to crystal formation. The crystals deposit in the joints, causing painful swelling.Previous research has shown that, over the long term, caffeine intake is associated with lower levels of uric acid in the body and a lower risk of developing gout among people who do not have the arthritic condition, Neogi says.
The chemical structure of caffeine is very similar to that of a medication called allopurinol, which is commonly used to lower uric acid levels in people with gout, she says. Although effective at controlling gout in the long term, allopurinol can precipitate a flare-up among patients taking it for the first time, she says.
"Given the potential conflicting effects of caffeine on gout attack risk, we evaluated whether caffeinated beverage intake was associated with the risk for recurrent flare-ups," Neogi says.
Short-Term Caffeine Intake Linked to Gout
The researchers turned to the Internet to recruit 633 participants who had experienced a gout attack within the past year. Medical records were used to confirm their gout diagnosis.Participants were asked to log on after having their next attack and answer an extensive questionnaire about medication, foods, and drinks they had consumed in the 24 hours prior to the attack. Three months after being free of flare-ups, they were asked to answer the same questions.
The researchers asked about all types of caffeinated beverages, including coffee, tea, soft drinks, and high-energy drinks such as Red Bull as well as non-caffeinated beverages.
Participants were predominantly white (89%), male (78%), and college educated (58%).
The link between increased intake of caffeinated beverages in the prior 24 hours and a higher risk for recurrent gout attacks was present even after accounting for other fluid intake.
In contrast, non-caffeinated coffee, tea, soda, and juices were not associated with an increased risk of gout attacks, Neogi says.
The researchers did not ask participants about the amount of sugar in their beverages. Therefore, the findings cannot be compared to that of another study presented at the meeting showing that women who drink one or more servings of sugary soda a day may be increasing their risk for developing gout, she adds.
Internet Research for Gout and Caffeine: Pros, Cons
Using the Internet to recruit patients for a study is not ideal, as it results in a self-selected sample that is interested in the topic, says John S. Sundy, MD, PhD, a gout expert at Duke University Medical Center in Durham, N.C. Also, the group as a whole would be expected to be better educated and of higher socioeconomic status than people drawn from the general population, he notes.That said, "It's a way to accumulate a large number of patients in a short period of time. It's good for generating hypotheses" that can then be tested in more rigorous clinical trials, Sundy tells WebMD.
Neogi defends the use of the Internet for studies like this, pointing out that it allows each person's caffeine intake prior to an attack to be compared to her intake when she is attack-free.
"That way, you don't have to have to worry about whether factors like age, weight, and lifestyle affected the results [which you do when one group of people is compared with another]. Plus, it's doubtful that caffeine affects a college-educated, high-paid person more than a poor, college dropout," she says.
Further research is needed, Neogi agrees. In the meantime, "people with gout who are already habitual caffeine drinkers probably do not need to change their habits, given that long-term caffeine intake can potentially lower uric acid levels," she says.
"But the person who doesn't drink a lot of caffeine on a regular basis should be aware that drinking more than usual may potentially trigger an attack. And I would not advise someone with gout to start drinking coffee as a way to lower uric acid levels due to its short-term effects," Neogi says.
This study was presented at a medical conference. The findings should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.
SOURCES: American College of Rheumatology 2010 Annual Scientific Meeting, Atlanta, Nov. 6-11, 2010.Tuhina Neogi, MD, PhD, associate professor of medicine, Boston University School of Medicine.John S. Sundy, MD, PhD, professor of medicine, Duke University Medical Center, Durham, N.C.
Thursday, November 4, 2010
Exercise Improves Physical Function, Reduces Pain for OA Patients
Patients with osteoarthritis (OA) of the knee or hip who adhere to the recommended home physical therapy exercises and physically active lifestyle experience more improvement in pain, physical function, and self-perceived effect according to a study from researchers in The Netherlands. Research also shows that maintenance of exercise behavior and physically active lifestyle after discharge of physical therapy improves the long-term effectiveness of exercise therapy in patients with knee or hip OA. Details of the study are available online and will publish in the August print issue of Arthritis Care & Research, a journal of the American College of Rheumatology.
Individuals with OA of the hip or knee experience pain, reduced muscle strength, decreased range of joint motion, and joint instability. According to the World Health Organization (WHO) OA is one of the ten most disabling diseases in developed countries. Further WHO estimates state that 80% of those with OA have limitations in movement, and 25% cannot perform major daily life activities. Often OA patients are referred to physical therapy in order to reduce impairments and improve overall physical function to meet demands of daily living. Although exercise therapy has beneficial short-term effects, earlier research has shown that after discharge of exercise therapy the positive treatment effects decline over time and finally disappear in the long-term.
The Dutch research team conducted an observational follow-up study on 150 patients with OA of the hip and/or knee who were receiving exercise therapy. The study subjects were followed for 60 months to assess adherence to self-directed exercise (during and after prescribed physical therapy treatment period) on patient outcomes of pain, physical function, and self-perceived effect. Three forms of adherence, which is defined as the subject's behavior that corresponds to agreed recommendations by his or her physical therapist, were measured—adherence to home exercises, home activities, and increased physical activity. Researchers used a self-report questionnaire to measure participants' adherence to home exercise (e.g. muscle strengthening exercises) and activity (e.g. walking or cycling). Assessment of adherence started at baseline, and then took place again at 3, 15, and 60 months.
Patient outcomes of pain and physical function were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score. The WOMAC scale ranges from best to worst, meaning lower scores represent less pain and improved physical function. Participants' physical performance was measured by the time (in seconds) it took to walk the distance of 5 meters with improvement in performance noted by a reduction in time to complete the walk.
Results show at the 3-month follow-up 57.8% of study subjects adhered to the recommended exercises and 53.8% to recommended activities. Adherence to exercise was significantly associated with a decrease in pain (-1.0 points on a scale from 0 to 20), and improvements in self-reported physical function (-2.3 points on a scale from 0 to 68) and physical performance (-0.29 seconds compared with the base-line time of 4.8 seconds to walk 5 meters (16 feet)). “Better adherence to home exercises and being more physically active improves the long-term effectiveness of exercise therapy in patients with OA of the hip and/or knee,” said lead study author, Martijn Pisters, M.Sc., PT.
A higher level of moderate or vigorous intensity physical activity was significantly associated with a decrease in pain, physical function and physical performance, as well as a positive self-perceived effect. The authors found that one hour per week more of physical activity at a moderate level resulted in an improvement in self-reported physical function of -0.24 on a scale from 0 to 68. During the physical therapy treatment period, the patients' physical activity increased by 1.5 hours of moderate or vigorous intensity physical activity per week. After the treatment period, physical activity declined by 0.5 and 1.3 hours respectively at the 15- and 60-month follow-up.
Additionally, researchers noted a decline in exercise adherence upon completion of physical therapy with only 44.1% of patients and 30.1% still exercising at the 15- and 60-month follow-up, respectively. Similarly, adherence to home activities decreased at the 15- and 60-month follow-up with only with 29.5% and 36%, respectively, of study subjects being adherent. “Future research should focus on how exercise behavior can be stimulated and maintained in the long term to improve outcomes for patients with OA,” concluded Mr. Pisters.
Article: "Exercise Adherence Improving Long-Term Patient Outcome in Patients with Osteoarthritis of the Hip and/or Knee." Martijn F. Pisters, Cindy Veenhof, Francois G. Schellevis, Jos W.R. Twisk, Joost Dekker, and Dinny H. De Bakker. Arthritis Care and Research; Published Online: March 16, 2010 (DOI: 10.1002/acr.20182); Print Issue Date: August 2010.
Individuals with OA of the hip or knee experience pain, reduced muscle strength, decreased range of joint motion, and joint instability. According to the World Health Organization (WHO) OA is one of the ten most disabling diseases in developed countries. Further WHO estimates state that 80% of those with OA have limitations in movement, and 25% cannot perform major daily life activities. Often OA patients are referred to physical therapy in order to reduce impairments and improve overall physical function to meet demands of daily living. Although exercise therapy has beneficial short-term effects, earlier research has shown that after discharge of exercise therapy the positive treatment effects decline over time and finally disappear in the long-term.
The Dutch research team conducted an observational follow-up study on 150 patients with OA of the hip and/or knee who were receiving exercise therapy. The study subjects were followed for 60 months to assess adherence to self-directed exercise (during and after prescribed physical therapy treatment period) on patient outcomes of pain, physical function, and self-perceived effect. Three forms of adherence, which is defined as the subject's behavior that corresponds to agreed recommendations by his or her physical therapist, were measured—adherence to home exercises, home activities, and increased physical activity. Researchers used a self-report questionnaire to measure participants' adherence to home exercise (e.g. muscle strengthening exercises) and activity (e.g. walking or cycling). Assessment of adherence started at baseline, and then took place again at 3, 15, and 60 months.
Patient outcomes of pain and physical function were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score. The WOMAC scale ranges from best to worst, meaning lower scores represent less pain and improved physical function. Participants' physical performance was measured by the time (in seconds) it took to walk the distance of 5 meters with improvement in performance noted by a reduction in time to complete the walk.
Results show at the 3-month follow-up 57.8% of study subjects adhered to the recommended exercises and 53.8% to recommended activities. Adherence to exercise was significantly associated with a decrease in pain (-1.0 points on a scale from 0 to 20), and improvements in self-reported physical function (-2.3 points on a scale from 0 to 68) and physical performance (-0.29 seconds compared with the base-line time of 4.8 seconds to walk 5 meters (16 feet)). “Better adherence to home exercises and being more physically active improves the long-term effectiveness of exercise therapy in patients with OA of the hip and/or knee,” said lead study author, Martijn Pisters, M.Sc., PT.
A higher level of moderate or vigorous intensity physical activity was significantly associated with a decrease in pain, physical function and physical performance, as well as a positive self-perceived effect. The authors found that one hour per week more of physical activity at a moderate level resulted in an improvement in self-reported physical function of -0.24 on a scale from 0 to 68. During the physical therapy treatment period, the patients' physical activity increased by 1.5 hours of moderate or vigorous intensity physical activity per week. After the treatment period, physical activity declined by 0.5 and 1.3 hours respectively at the 15- and 60-month follow-up.
Additionally, researchers noted a decline in exercise adherence upon completion of physical therapy with only 44.1% of patients and 30.1% still exercising at the 15- and 60-month follow-up, respectively. Similarly, adherence to home activities decreased at the 15- and 60-month follow-up with only with 29.5% and 36%, respectively, of study subjects being adherent. “Future research should focus on how exercise behavior can be stimulated and maintained in the long term to improve outcomes for patients with OA,” concluded Mr. Pisters.
Article: "Exercise Adherence Improving Long-Term Patient Outcome in Patients with Osteoarthritis of the Hip and/or Knee." Martijn F. Pisters, Cindy Veenhof, Francois G. Schellevis, Jos W.R. Twisk, Joost Dekker, and Dinny H. De Bakker. Arthritis Care and Research; Published Online: March 16, 2010 (DOI: 10.1002/acr.20182); Print Issue Date: August 2010.
Tuesday, November 2, 2010
Why Are People With Stroke More Likely To Die If Hospitalized On Weekend?
People admitted to the hospital on a weekend after a stroke are more likely to die compared to people admitted on a weekday, regardless of the severity of the stroke they experience, according to new research published in the November 2, 2010, print issue of Neurology®, the medical journal of the American Academy of Neurology.
"We wanted to test whether the severity of strokes on weekends compared to weekdays would account for lower survival rates on the weekends," said Moira K. Kapral, MD, of the University of Toronto in Ontario, Canada. Kapral was with the Institute for Clinical Evaluative Sciences in Ontario when the research was done. "Our results suggest that stroke severity is not necessarily the reason for this discrepancy."
For the study, researchers analyzed five years of data from the Canadian Stroke Network on 20,657 patients with acute stroke from 11 stroke centers in Ontario. Only the first stroke a person experienced was included in the study.
People with moderate to severe stroke were just as likely to be admitted to the hospital on weekends and weekdays, but those with mild stroke were less likely to be admitted on weekends in the study. Those who were seen on weekends were slightly older, more likely to be taken by ambulance and experienced a shorter time from the onset of stroke symptoms to hospital arrival on average.
The study found that seven days after a stroke, people seen on weekends had an 8.1 percent risk of dying compared to a 7.0 percent risk of dying for those seen on weekdays. The results stayed the same regardless of age, gender, stroke severity, other medical conditions and the use of blood clot-busting medications.
"Stroke is not the only condition in which lower survival rates have been linked for people admitted to hospitals on the weekends. The reason for the differences in rates could be due to hospital staffing, limited access to specialists and procedures done outside of regular hours," said Kapral. "More research needs to be done on why the rates are different so that stroke victims can have the best possible chance of surviving."
There were no differences found in the quality of stroke care, including brain scans and admission time, between weekends and weekdays.
The study was supported by the Canadian Stroke Network.
Source: American Academy of Neurology (AAN)
"We wanted to test whether the severity of strokes on weekends compared to weekdays would account for lower survival rates on the weekends," said Moira K. Kapral, MD, of the University of Toronto in Ontario, Canada. Kapral was with the Institute for Clinical Evaluative Sciences in Ontario when the research was done. "Our results suggest that stroke severity is not necessarily the reason for this discrepancy."
For the study, researchers analyzed five years of data from the Canadian Stroke Network on 20,657 patients with acute stroke from 11 stroke centers in Ontario. Only the first stroke a person experienced was included in the study.
People with moderate to severe stroke were just as likely to be admitted to the hospital on weekends and weekdays, but those with mild stroke were less likely to be admitted on weekends in the study. Those who were seen on weekends were slightly older, more likely to be taken by ambulance and experienced a shorter time from the onset of stroke symptoms to hospital arrival on average.
The study found that seven days after a stroke, people seen on weekends had an 8.1 percent risk of dying compared to a 7.0 percent risk of dying for those seen on weekdays. The results stayed the same regardless of age, gender, stroke severity, other medical conditions and the use of blood clot-busting medications.
"Stroke is not the only condition in which lower survival rates have been linked for people admitted to hospitals on the weekends. The reason for the differences in rates could be due to hospital staffing, limited access to specialists and procedures done outside of regular hours," said Kapral. "More research needs to be done on why the rates are different so that stroke victims can have the best possible chance of surviving."
There were no differences found in the quality of stroke care, including brain scans and admission time, between weekends and weekdays.
The study was supported by the Canadian Stroke Network.
Source: American Academy of Neurology (AAN)
Frequency Of Colds Dramatically Cut With Regular Exercise
If you want to reduce the frequency and severity of symptoms of colds you should do exercise at least five times a week and remain physically fit, US researchers report in the British Journal of Sports Medicine. They stress that not only do fit people have much fewer colds, but also when they do their symptoms are significantly milder compared to those who do not work out regularly.
Researchers from North Carolina, USA, monitored upper respiratory tract infection frequency and symptom severity over a 12-week period during autumn/winter in 2008 on 1,000 individuals aged 18 to 85. 60% of them were female and 40% were aged 19 to 39. 25% of them were over sixty years of age while 40% were middle aged.
Information was gathered on how often they did aerobic exercises. The participants were also asked to rate their levels of fitness with a 10 point validated scoring system. Other data was collected, including participants' diet, lifestyle, and recent stressful occurrences - factors which can have an impact on an individual's immune system response, the authors explained.
Cold symptoms were present for an average of 13 days during the winter and 8 days during the autumn (fall). The researchers reveal married older men seem to catch colds less often.
However, after factoring out the most significant factors linked to upper respiratory tract infections (colds) the scientists found that an individual's level of fitness as well as exercise frequency had the biggest impact in reducing occurrences and severity of colds.
Those who were physically fit and did exercise at least five times each week had a 43% to 46% lower frequency of colds compared to people who only did exercise once a week at the most.
The fittest participants had a 41% lower symptoms severity, while regular exercisers' severity of symptoms was reduced by 31%, the authors wrote.
The average American adult has two to four colds each year. US children have an average of between 6 and 10 colds annually. The economic toll of colds on the American economy is estimated to be approximately $40 billion annually.
The researchers say that exercise sessions trigger a temporary increase in immune system cells that circulate within the body. Although immune system cell levels soon return to normal after exercise, they probably improve the body's surveillance of pathogens - harmful bacteria, viruses and other organisms. Improved pathogen surveillance leads to fewer and less severe infections.
The authors concluded:
The term aerobic exercise was first used in the 1960s by Col. Pauline Potts, an exercise physiologist and Dr. Kenneth Cooper. They were both in the US Air Force. Dr. Cooper wondered why some physically strong individuals were poor at long-distance endurance sports. He used a bicycle ergometer to measure participants' ability to use oxygen. In 1968 he published a book titled "Aerobics", which included scientific programs using aerobic exercises. It became a bestseller. All current aerobic programs include Dr. Cooper's data as a baseline.
"Upper respiratory tract infection is reduced in physically fit and active adults"
David C Nieman, Dru A Henson, Melanie D Austin, Wei Sha
Br J Sports Med doi:10.1136/bjsm.2010.077875
Written by Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today
Researchers from North Carolina, USA, monitored upper respiratory tract infection frequency and symptom severity over a 12-week period during autumn/winter in 2008 on 1,000 individuals aged 18 to 85. 60% of them were female and 40% were aged 19 to 39. 25% of them were over sixty years of age while 40% were middle aged.
Information was gathered on how often they did aerobic exercises. The participants were also asked to rate their levels of fitness with a 10 point validated scoring system. Other data was collected, including participants' diet, lifestyle, and recent stressful occurrences - factors which can have an impact on an individual's immune system response, the authors explained.
Cold symptoms were present for an average of 13 days during the winter and 8 days during the autumn (fall). The researchers reveal married older men seem to catch colds less often.
However, after factoring out the most significant factors linked to upper respiratory tract infections (colds) the scientists found that an individual's level of fitness as well as exercise frequency had the biggest impact in reducing occurrences and severity of colds.
Those who were physically fit and did exercise at least five times each week had a 43% to 46% lower frequency of colds compared to people who only did exercise once a week at the most.
The fittest participants had a 41% lower symptoms severity, while regular exercisers' severity of symptoms was reduced by 31%, the authors wrote.
The average American adult has two to four colds each year. US children have an average of between 6 and 10 colds annually. The economic toll of colds on the American economy is estimated to be approximately $40 billion annually.
The researchers say that exercise sessions trigger a temporary increase in immune system cells that circulate within the body. Although immune system cell levels soon return to normal after exercise, they probably improve the body's surveillance of pathogens - harmful bacteria, viruses and other organisms. Improved pathogen surveillance leads to fewer and less severe infections.
The authors concluded:
Perceived physical fitness and frequency of aerobic exercise are important correlates of reduced days with URTI (upper respiratory tract infection) and severity of symptoms during the winter and fall common cold seasons.
What is Aerobic Exercise
Aerobic exercise improves our body's oxygen consumption - aerobic means with oxygen. Aerobic refers to the body's use of oxygen in its energy-generating process (metabolic process). Aerobic exercises are generally done with a moderate level of intensity for long periods, when compared to other forms of exercise. Typically, a bout of aerobic exercise involves warming up, exertion for at least 20 minutes, and then a cool down. This type of exercise involves mainly the large muscle groups.The term aerobic exercise was first used in the 1960s by Col. Pauline Potts, an exercise physiologist and Dr. Kenneth Cooper. They were both in the US Air Force. Dr. Cooper wondered why some physically strong individuals were poor at long-distance endurance sports. He used a bicycle ergometer to measure participants' ability to use oxygen. In 1968 he published a book titled "Aerobics", which included scientific programs using aerobic exercises. It became a bestseller. All current aerobic programs include Dr. Cooper's data as a baseline.
"Upper respiratory tract infection is reduced in physically fit and active adults"
David C Nieman, Dru A Henson, Melanie D Austin, Wei Sha
Br J Sports Med doi:10.1136/bjsm.2010.077875
Written by Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today
Knee strengthening exercise
Troy shares the top knee strengthening and stability exercises that help prevent injury in and around the knee and joint. A practical demonstration of how to perform a proper squat and lunge with proper alignment is also covered.
Coffee, Tea Linked to Lower Brain Cancer Risk
Researchers Say Antioxidants in Coffee and Tea May Explain Possible Reduction in Risk
By Katrina Woznicki
WebMD Health News
Oct. 22, 2010 -- Drinking about a half cup or more of coffee or tea per day is associated with a 34% reduction in the risk for glioma, a type of brain tumor, researchers report.
Researchers led by Dominique Michaud, DSc, an investigator at Brown University, and colleagues analyzed data from the European Prospective Investigation into Cancer and Nutrition longitudinal study, which includes more than 410,000 people from nine countries who were followed for about 8.5 years.
Participants answered questionnaires about their coffee and tea intake, as well as other dietary habits. Information about cancer diagnoses was obtained from national cancer registries and medical insurance records.
Overall, researchers found that drinking 100 mL or more of coffee or tea a day was linked to a reduced risk of glioma brain tumors. Men who were coffee and tea drinkers had a greater reduction in risk than women.
The study was not designed to establish a cause-and-effect relationship between drinking coffee or tea and developing brain or spinal cord tumors; researchers only observed a connection. The researchers say more studies are needed to validate these observations.
During the study period, there were 343 cases of glioma (165 men and 178 women) and 245 cases of meningioma (54 men and 191 women) diagnosed. The meninges are the tissues surrounding and protecting the brain and spinal cord. There was no association of the amount of coffee and tea drunk daily and the development of meningioma.
Coffee consumption was highest in Denmark and lowest in Italy. Tea consumption was highest in the U.K. and lowest in Spain. People who drank greater amounts of coffee or tea were often older, more educated, smoked, and had a lower body mass index -- a measurement of height and weight.
The findings are published in the November issue of American Journal of Clinical Nutrition.
Coffee and tea are very high in antioxidants, which may explain the possible protective effect against some types of brain tumors, the researchers say. However, brewing methods vary greatly country to country, which could affect the concentration of antioxidants in a given cup.
Coffee and tea are two of the most popular beverages around the world. Drinking coffee and tea has also been associated with being protective against other types of cancers and brain disorders, including Alzheimer's disease, Parkinson's disease, and liver cancer. According to the National Cancer Institute, every year there are 22,020 new cases and 13,140 deaths from brain tumors and other nervous system tumors in the U.S.
SOURCES: News release, American Society of Nutrition.Michaud, D. American Journal of Clinical Nutrition, November 2010; vol 92: pp 1145-1150.National Cancer Institute.
By Katrina Woznicki
WebMD Health News
Oct. 22, 2010 -- Drinking about a half cup or more of coffee or tea per day is associated with a 34% reduction in the risk for glioma, a type of brain tumor, researchers report.
Researchers led by Dominique Michaud, DSc, an investigator at Brown University, and colleagues analyzed data from the European Prospective Investigation into Cancer and Nutrition longitudinal study, which includes more than 410,000 people from nine countries who were followed for about 8.5 years.
Participants answered questionnaires about their coffee and tea intake, as well as other dietary habits. Information about cancer diagnoses was obtained from national cancer registries and medical insurance records.
Overall, researchers found that drinking 100 mL or more of coffee or tea a day was linked to a reduced risk of glioma brain tumors. Men who were coffee and tea drinkers had a greater reduction in risk than women.
The study was not designed to establish a cause-and-effect relationship between drinking coffee or tea and developing brain or spinal cord tumors; researchers only observed a connection. The researchers say more studies are needed to validate these observations.
During the study period, there were 343 cases of glioma (165 men and 178 women) and 245 cases of meningioma (54 men and 191 women) diagnosed. The meninges are the tissues surrounding and protecting the brain and spinal cord. There was no association of the amount of coffee and tea drunk daily and the development of meningioma.
Coffee consumption was highest in Denmark and lowest in Italy. Tea consumption was highest in the U.K. and lowest in Spain. People who drank greater amounts of coffee or tea were often older, more educated, smoked, and had a lower body mass index -- a measurement of height and weight.
The findings are published in the November issue of American Journal of Clinical Nutrition.
Coffee and tea are very high in antioxidants, which may explain the possible protective effect against some types of brain tumors, the researchers say. However, brewing methods vary greatly country to country, which could affect the concentration of antioxidants in a given cup.
Coffee and tea are two of the most popular beverages around the world. Drinking coffee and tea has also been associated with being protective against other types of cancers and brain disorders, including Alzheimer's disease, Parkinson's disease, and liver cancer. According to the National Cancer Institute, every year there are 22,020 new cases and 13,140 deaths from brain tumors and other nervous system tumors in the U.S.
SOURCES: News release, American Society of Nutrition.Michaud, D. American Journal of Clinical Nutrition, November 2010; vol 92: pp 1145-1150.National Cancer Institute.
The Alarming Symptoms Of Low Blood Pressure
Sometimes, it has been noticed that low blood pressure also goes unnoticed for long periods because of its lack of defined signs and symptoms.
If your blood pressure level is low, it can cause various problems and disorders. The organs of the body will start malfunctioning and they may suffer permanent damages. Because of the low blood pressure there would be insufficient flow of blood to the brain, which can make the sufferer feel light-headed, dizzy, or he may even faint.
Apart from all these, the body also shows some sort of symptoms that are typical when you are suffering from low blood pressure. Here are some of the symptoms of low blood pressure:
1) Light-headedness
2) Dizziness
3) Palpitations
4) Blurred vision
5) Discomfort in the chest
6) Fainting or near fainting
7) Anxiety
8) Fatigue
9) Headache/migraine
10) Shortness of breath
11) Intolerance to heat
12) Feeling cold all over
13) Bloating after meals
14) Cognitive impairment
15) Numbness or tingling sensations
16) Generalized weakness
17) Reduced pulse pressure upon standing
18) Low back pain
19) Excessive sweating
If your blood pressure level is low, it can cause various problems and disorders. The organs of the body will start malfunctioning and they may suffer permanent damages. Because of the low blood pressure there would be insufficient flow of blood to the brain, which can make the sufferer feel light-headed, dizzy, or he may even faint.
Apart from all these, the body also shows some sort of symptoms that are typical when you are suffering from low blood pressure. Here are some of the symptoms of low blood pressure:
1) Light-headedness
2) Dizziness
3) Palpitations
4) Blurred vision
5) Discomfort in the chest
6) Fainting or near fainting
7) Anxiety
8) Fatigue
9) Headache/migraine
10) Shortness of breath
11) Intolerance to heat
12) Feeling cold all over
13) Bloating after meals
14) Cognitive impairment
15) Numbness or tingling sensations
16) Generalized weakness
17) Reduced pulse pressure upon standing
18) Low back pain
19) Excessive sweating
Monday, November 1, 2010
Monday, October 25, 2010
Are You Using the Right Electrical Stimulation and Ultrasound Treatment?
The technology behind electrical stimulation and ultrasound treatments continues to change. Unfortunately, the administration of electrical stimulation and ultrasound treatments hasn’t always kept pace with the changing technology. Physical therapists recently had the opportunity to learn the correct way to complete electrical stimulation and ultrasound treatments at a seminar sponsored by Advantage Medical Rehab Equipment and Supplies.
The one-day seminar provided physical therapists with a comprehensive overview of the history, theories and proper administration of ultrasound and electrical stimulation treatments. Participants learned the correct frequency and time required to correctly achieve a 1 to 4 degree rise in tissue temperature when using an ultrasound. The guidelines for achieving a rise in tissue temperature are outlined below:
Seminar participants also learned proper techniques for completing nerve blocks, pain modulation, muscle re-education, tissue healing, edema management and other electrical simulation and ultrasound treatments. A few simple things physical therapists can do to immediately improve electrical stimulation and ultrasound treatment administration include:
1. Avoid using ultrasound gel warmers. When heated, the viscosity of the ultrasound gel decreases and reduces the efficiency of sound wave transmittal.
2. Take it easy. During an ultrasound treatment, gently glide the ultrasound head on top of the gel along the patient’s body. Do not press so hard on the device that the gel pushes out from the sound head. The added pressure can make the treatment less effective and more painful for the patient.
3. Use quality electrodes. The type of electrodes you use impacts outcomes. Mesh electrodes may cost less but do not conduct electricity as well as carbon based electrodes. To provide patients with the best possible outcomes invest in carbon-based electrodes.
4. Take time to consider the patient before doing a treatment. Take your patient’s age, health and purpose of treatment into consideration. Use this information to determine the right frequency to use for the treatment you’re planning to give.
5. Talk with patients prior to giving a treatment. Help patients understand how the treatment works, how they can expect the treatment to feel and any risks and benefits associated with the procedure.
The one-day seminar provided physical therapists with a comprehensive overview of the history, theories and proper administration of ultrasound and electrical stimulation treatments. Participants learned the correct frequency and time required to correctly achieve a 1 to 4 degree rise in tissue temperature when using an ultrasound. The guidelines for achieving a rise in tissue temperature are outlined below:
| Tissue Temperature Rise (Degrees Centigrade) | 1.0 MHz Frequency (1.0 w/cm2) Time Required | 3.0 MHz Frequency (1.0 w/cm2) Time Required | ||
| 1 | 2 minutes 32 seconds | 51 seconds | ||
| 2 | 5 minutes 4 seconds | 1 minute 42 seconds | ||
| 3 | 7 minutes 35 seconds | 2 minutes 32 seconds | ||
| 4 | 10 minutes 6 seconds | 3 minutes 22 seconds |
1. Avoid using ultrasound gel warmers. When heated, the viscosity of the ultrasound gel decreases and reduces the efficiency of sound wave transmittal.
2. Take it easy. During an ultrasound treatment, gently glide the ultrasound head on top of the gel along the patient’s body. Do not press so hard on the device that the gel pushes out from the sound head. The added pressure can make the treatment less effective and more painful for the patient.
3. Use quality electrodes. The type of electrodes you use impacts outcomes. Mesh electrodes may cost less but do not conduct electricity as well as carbon based electrodes. To provide patients with the best possible outcomes invest in carbon-based electrodes.
4. Take time to consider the patient before doing a treatment. Take your patient’s age, health and purpose of treatment into consideration. Use this information to determine the right frequency to use for the treatment you’re planning to give.
5. Talk with patients prior to giving a treatment. Help patients understand how the treatment works, how they can expect the treatment to feel and any risks and benefits associated with the procedure.
Tuesday, October 19, 2010
Plantar Fascitis
Background
Plantar fascitis is , a repetitive strain injury of the medial arch and heel, is one of the most common causes of foot pain. It is an inflammation of the dense, fibrous connective tissue structure originating from the medial tuberosity of the calcaneus. It has 3 portions :- medial, lateral and calcaneal and the largest is calcaneal.
The function of the plantar fascia is twofold: statically, it stabilizes the medial longitudinal arch; dynamically, it restores the arch and aids in reconfiguring the foot for efficient toe-off. When this tissue
becomes damaged, pain and/or weakness may develop in the area.
Risk factors
A runner’s gait can be separated into two phases: the stance phase and the swing phase. During the stance phase, the foot contacts and adapts to the ground surface; during the swing phase, the leg accelerates forward and prepares for ground contact. The stance phase consists of the following four sub-phases: initial contact, loading response, midstance, and terminal stance. During initial contact, the heel contacts the ground surface. The loading response occurs immediately after initial contact, ending
when the contralateral foot lifts off of the ground surface. The midstance phase starts when the contralateral foot lifts off of the ground surface; the contralateral leg is now the swing leg. The midstance phase ends as the tension on the gastrocnemius, soleus, and achilles tendon of the stance leg causes the heel to lift off of the ground surface. The terminal stance phase begins when
the heel lifts off of the ground and ends when the swing leg contacts the ground
The subtalar joint consists of the articulation of the undersurface of the talus with the calcaneus.Movement of the subtalar joint is pivotal in transforming the foot from a rigid lever during initial ground contact to a mobile shock absorber during loading response and early midstance, and back into a rigid lever as the foot prepares for toe-off. The two primary movements that occur at the subtalar
joint (STJ) are pronation and supination.
Symptoms
Treatment
Literature indicates that plantar fasciitis may be successfully treated using a conservative approach.An understanding of the anatomy and kinematics of the foot and ankle, the static and dynamic function of the
plantar fascia during ambulation, and knowledge of the contributing risk factors associated with plantar fasciitis aid in developing a proper treatment and preventative protocol for this condition.
General principles of treatment
SRICE
electrotherapy- ultrasound, TENS, cold pack, cryo
Plantar fascia stretching
1.Cross your affected leg over your other leg.
2.Using the hand on your affected side, take hold of your affected foot and pull your toes back towards shin. This creates tension/stretch in the arch of the foot/plantar fascia.
3.Check for the appropriate stretch position by gently rubbing the thumb of your unaffected side left to right over the arch of the affected foot. The plantar fascia should feel firm, like a guitar string.
4.Hold the stretch for a count of 10. A set is 10 repetitions.
5.Perform at least 3 sets of stretches per day. You cannot perform the stretch too often.
Calf stretch
Stand facing a wall with your hands on the wall at about eye level. Put the leg you want to stretch about a step behind your other leg.Keeping your back heel on the floor, bend your front knee until you feel a stretch in the back leg. Hold the stretch for 15 to 20 seconds. Repeat 4 times.
Deep friction massage of the plantar fascia- Apply gentle pressure across the entire foot as you smoothly glide down the foot. This will help loosen the tendon and direct tissue towards the heel to either help prevent or heel a bone spur, a condition which often goes hand in hand with plantar fasciitits.
Exercises
Oran anti-inflammatories have variable results. Ex : cyclooxygenase
Myofascial techniques have been shown to stimulate fibroblast proliferation, leading to collagen synthesis that may promote healing of plantar fasciitis by replacing degenerative tissue with a
stronger and more functional tissue. There is considerable clinical evidenceto support the effectiveness
Plantar fascitis is , a repetitive strain injury of the medial arch and heel, is one of the most common causes of foot pain. It is an inflammation of the dense, fibrous connective tissue structure originating from the medial tuberosity of the calcaneus. It has 3 portions :- medial, lateral and calcaneal and the largest is calcaneal.
becomes damaged, pain and/or weakness may develop in the area.
Risk factors
- overweight
- training errors
- lack of stretching before sports
- repetitive strain injuries of foot
- occupations
- foot wear
- flat foot deformity
- prolonged standing, walking
A runner’s gait can be separated into two phases: the stance phase and the swing phase. During the stance phase, the foot contacts and adapts to the ground surface; during the swing phase, the leg accelerates forward and prepares for ground contact. The stance phase consists of the following four sub-phases: initial contact, loading response, midstance, and terminal stance. During initial contact, the heel contacts the ground surface. The loading response occurs immediately after initial contact, ending
when the contralateral foot lifts off of the ground surface. The midstance phase starts when the contralateral foot lifts off of the ground surface; the contralateral leg is now the swing leg. The midstance phase ends as the tension on the gastrocnemius, soleus, and achilles tendon of the stance leg causes the heel to lift off of the ground surface. The terminal stance phase begins when
the heel lifts off of the ground and ends when the swing leg contacts the ground
joint (STJ) are pronation and supination.
- pain occurs when placing foot on the ground at very first in the morning
- swelling occurs
- limmited range of motion in severe cases
- inferior heel pain
Treatment
Literature indicates that plantar fasciitis may be successfully treated using a conservative approach.An understanding of the anatomy and kinematics of the foot and ankle, the static and dynamic function of the
plantar fascia during ambulation, and knowledge of the contributing risk factors associated with plantar fasciitis aid in developing a proper treatment and preventative protocol for this condition.
General principles of treatment
- examine lower extremity for possible factors :- pes cavus or pes planus, LLD, fat pad atrophy,signs of arthritis
- review questions for possible traning errors or overuse findibgd in runners and atheletes
- identify poor shoe wear, hard walking, or running surface,supinator or pronators like wear of running shoes
- assessment of tight calfs and hamstring that may contribute to this condition
- treatment are more aggressive or more invasive if first phase is unsuccessful
- patient education- to ensure patient does exs at home, time table
SRICE
electrotherapy- ultrasound, TENS, cold pack, cryo
Plantar fascia stretching
1.Cross your affected leg over your other leg.
2.Using the hand on your affected side, take hold of your affected foot and pull your toes back towards shin. This creates tension/stretch in the arch of the foot/plantar fascia.
3.Check for the appropriate stretch position by gently rubbing the thumb of your unaffected side left to right over the arch of the affected foot. The plantar fascia should feel firm, like a guitar string.
4.Hold the stretch for a count of 10. A set is 10 repetitions.
5.Perform at least 3 sets of stretches per day. You cannot perform the stretch too often.
Calf stretch
Stand facing a wall with your hands on the wall at about eye level. Put the leg you want to stretch about a step behind your other leg.Keeping your back heel on the floor, bend your front knee until you feel a stretch in the back leg. Hold the stretch for 15 to 20 seconds. Repeat 4 times.
Deep friction massage of the plantar fascia- Apply gentle pressure across the entire foot as you smoothly glide down the foot. This will help loosen the tendon and direct tissue towards the heel to either help prevent or heel a bone spur, a condition which often goes hand in hand with plantar fasciitits.
Exercises
- Marble lift- Put marbles on the floor next to a cup. Using your toes, try to lift the marbles up from the floor and put them in the cup.Repeat exercise 15 times.
- Toe curls on towel- curl up your toes on towel. Try to grab the towel with your toes. Hold for 10 seconds and do 20 reps
- Balance exercises on wobble board
- ROM exercises for ankle and toes
- Flared stable heel to help control heel stability
- Firm heel counter to control hindfoot
- Soft cushioning of the heel, raising the heel 12-15mm higher than the sole
- Well molded achilles pad
- Avoid rigid leather dress shoes that increase torque on the achilles tendon
Oran anti-inflammatories have variable results. Ex : cyclooxygenase
Myofascial techniques have been shown to stimulate fibroblast proliferation, leading to collagen synthesis that may promote healing of plantar fasciitis by replacing degenerative tissue with a
stronger and more functional tissue. There is considerable clinical evidenceto support the effectiveness
of deep tissue procedures in treatment of strain/sprain injuries.
Referrence
Department of Foot and Ankle surgery- Kaiser permanente
Kinesiology of the Musculoskeletal system- Donald A.Neumann
Monday, October 18, 2010
Friday, October 15, 2010
Antenatal exercise and Back care
Antenatal exercises are aimed to :-
Below are some good video on antenatal exerices together with some notes on the exercises in pdf format.
Back_care
- improve rom of joints especially at your pelvic floor
- abdomen strengthening and especially pelvic floor to prevent urine leaking
- maintaining a good upright posture through your pregnancy
- teaching relaxation techniques through your pregnancy
- teaching breathing control to assist you during labour
Below are some good video on antenatal exerices together with some notes on the exercises in pdf format.
Back_care
Spinal Cord Injury Assessment form
This is an assessment form produced by the American Spinal Injury Association. It is intended for use in patients who have suffered a spinal cord injury. It includes motor, sensory and functional assessment
Spinal Cord Injury[1]
Spinal Cord Injury[1]
Wednesday, October 13, 2010
Yoga Found To Be Beneficial For Childhood Cancer Patients And Their Parents
A new study reports that yoga can reduce the stress of cancer diagnosis and treatment experienced by childhood cancer patients and their parents. The findings were published in the September/October 2010 edition of Journal of Pediatric Oncology Nursing, published by the Association of Pediatric Hematology/Oncology Nurses (APHON).
"Parents and adolescents showed a decrease in anxiety and increase in sense of well-being" following yoga sessions conducted for the study, the authors wrote. Megan V. Thygeson, BA, Mary C. Hooke, PhD, RN, CNS, CPON, Jeanine Clapsaddle, MA, LAMFT, CCLS, Angela Robbins, MS, RN, CNP, and Kristin Moquist, MA, RN, CNP, CPON wrote the study, which they conducted at the Children's Hospitals and Clinics of Minnesota.
"Yoga is emerging as an effective complementary therapy in adult oncology," the authors wrote, "promising benefits for decreasing symptom distress including fatigue, insomnia, mood, and stress resulting in improved quality of life." The authors explored a new area, focusing on childhood cancer patients and their families, noting that parents experience stress and anxiety because of the uncertainty of the disease and the suffering of their children.
Children in the study between the ages of 7-12 did not show any change in their anxiety or sense of well-being. However, adolescents between the ages of 13-18 years and the parents of hospitalized patients showed significant improvement.
"Teens reported that that they felt relaxed and calmer, and that it (yoga) was fun," the authors wrote. Parents detailed even greater benefits. Parents found the yoga sessions were relaxing, allowed them to stretch their muscles and strengthen their bodies, and relieved stress. They felt better about themselves, and those who participated in the sessions with their children felt it helped them bond with their children.
Yoga lowers heart rate and blood pressure and improves circulation and oxygenation. It also improves muscle tone, circulation, pulmonary function, coordination and flexibility. "Larger studies are needed to evaluate the influence of yoga on other distressing patient symptoms such as fatigue, sleep disturbance, pain and nauseam" the authors wrote.
Source:
Association of Pediatric Hematology/Oncology Nurses (APHON)
"Parents and adolescents showed a decrease in anxiety and increase in sense of well-being" following yoga sessions conducted for the study, the authors wrote. Megan V. Thygeson, BA, Mary C. Hooke, PhD, RN, CNS, CPON, Jeanine Clapsaddle, MA, LAMFT, CCLS, Angela Robbins, MS, RN, CNP, and Kristin Moquist, MA, RN, CNP, CPON wrote the study, which they conducted at the Children's Hospitals and Clinics of Minnesota.
"Yoga is emerging as an effective complementary therapy in adult oncology," the authors wrote, "promising benefits for decreasing symptom distress including fatigue, insomnia, mood, and stress resulting in improved quality of life." The authors explored a new area, focusing on childhood cancer patients and their families, noting that parents experience stress and anxiety because of the uncertainty of the disease and the suffering of their children.
Children in the study between the ages of 7-12 did not show any change in their anxiety or sense of well-being. However, adolescents between the ages of 13-18 years and the parents of hospitalized patients showed significant improvement.
"Teens reported that that they felt relaxed and calmer, and that it (yoga) was fun," the authors wrote. Parents detailed even greater benefits. Parents found the yoga sessions were relaxing, allowed them to stretch their muscles and strengthen their bodies, and relieved stress. They felt better about themselves, and those who participated in the sessions with their children felt it helped them bond with their children.
Yoga lowers heart rate and blood pressure and improves circulation and oxygenation. It also improves muscle tone, circulation, pulmonary function, coordination and flexibility. "Larger studies are needed to evaluate the influence of yoga on other distressing patient symptoms such as fatigue, sleep disturbance, pain and nauseam" the authors wrote.
Source:
Association of Pediatric Hematology/Oncology Nurses (APHON)
Tuesday, October 12, 2010
Monday, October 11, 2010
How to apply Shortwave diathermy
Many of us not really knows much about short wave diathermy. Here's a brief note on it and a video on how to apply shortwave diathermy for patients
Short waved diathermy is the therapeutic elevation of temperature in the tissue by means of an oscillating electric current.
The tissue and body organs are overheated, which increases local metabolism, supports absorption of chronic inflammatory, post-injury and post-operation infiltrates, improves tissue elasticity and has analgetic effects.
Indication: chronic diseases of joints, tissue and sinews, chronic inflammations, both gyneacological and urological, post-operation states, urge incontinence
Contraindication: cardiostimulator, direct application to metal implants, malignant tumors, acute inflammations, bleeding states, tromboflebitis etc. During the menstrual period the procedure cannot be applied to patient´s stomach, as well as to growth zones.
The procedures must always be prescribed by the doctor.
Duration: 10 - 15 minutes.
Shortwave Diathermy
Short waved diathermy is the therapeutic elevation of temperature in the tissue by means of an oscillating electric current.
The tissue and body organs are overheated, which increases local metabolism, supports absorption of chronic inflammatory, post-injury and post-operation infiltrates, improves tissue elasticity and has analgetic effects.
Indication: chronic diseases of joints, tissue and sinews, chronic inflammations, both gyneacological and urological, post-operation states, urge incontinence
Contraindication: cardiostimulator, direct application to metal implants, malignant tumors, acute inflammations, bleeding states, tromboflebitis etc. During the menstrual period the procedure cannot be applied to patient´s stomach, as well as to growth zones.
The procedures must always be prescribed by the doctor.
Duration: 10 - 15 minutes.
Shortwave Diathermy
Book Review : Essentials of Cardiopulmonary Physical Therapy 2nd edition
This comprehensive textbook of cardiopulmonary physical therapy presents balanced and integrated coverage of the cardiac and pulmonary systems, covering anatomy and physiology, pathophysiology, assessment and treatment.
Case studies at the end of every chapter provide students with a realistic understanding of actual clinical practice.
- Presents balanced and integrated coverage of the cardiac and pulmonary systems.
- Provides a logical structure closely related to most courses: anatomy and physiology, pathophysiology, assessment and treatment, which enables the book to be used in pathophysiology courses, assessment courses, etc.
Sunday, October 10, 2010
Glenohumeral Joint Mobilization tecnhiques
JOINT MOBILZATION
Joint Mobilization is a technique used to increase the range of motion of an injured limb. It is also used to align the articulating surfaces of a joint and to reduce joint play.
To understand the concept of joint mobilization, it is important to understand the types of movements a joint can perform. The first types are called physiological movements such as flexion, extension, abduction and adduction. The second type of movements, which is the principle on which joint mobilization is based, are accessory movements such as spins, rolls, and glides. Here are their definitions:
Spins- rotation of a segment around a stationary axis. An example of this is the radioulnar joint
Glides- specific point on one articulating surface comes in contact with many points on another
Roll - Many points on one articulating surface comes in contact with many points on another
The key principle of joint mobilization is known as the concave-convex rule. The rule states: If a concave surface is moving on a convex surface, then the glide will occur in the same direction as the roll. If a convex surface is moving on a concave, then the glide is in the opposite direction of the roll.
Below are some examples on how glenohumeral joint mobilization techniques.
Joint Mobilization is a technique used to increase the range of motion of an injured limb. It is also used to align the articulating surfaces of a joint and to reduce joint play.
To understand the concept of joint mobilization, it is important to understand the types of movements a joint can perform. The first types are called physiological movements such as flexion, extension, abduction and adduction. The second type of movements, which is the principle on which joint mobilization is based, are accessory movements such as spins, rolls, and glides. Here are their definitions:
Spins- rotation of a segment around a stationary axis. An example of this is the radioulnar joint
Glides- specific point on one articulating surface comes in contact with many points on another
Roll - Many points on one articulating surface comes in contact with many points on another
The key principle of joint mobilization is known as the concave-convex rule. The rule states: If a concave surface is moving on a convex surface, then the glide will occur in the same direction as the roll. If a convex surface is moving on a concave, then the glide is in the opposite direction of the roll.
Below are some examples on how glenohumeral joint mobilization techniques.
Principles of Examination
Here's a brief notes on the aspects to look on when you are doing an assessment or examination on a patient
Physiotherapy Assess Men 1
referrence
david j.magee orthopaedic physical assessment 4th edition
- tell patient what you are doing
- test normal ( uninvolved ) side first
- do active movements first then passive movements, then resisted isometric movements
- painful movements are done last
- apply overpressure with care to test and feel
- repeat movements or sustain certain postures or positions if history indicates
- do resisted movements in resting position
- with passive movements and ligamentous testing, both the degree and quality ( end feel ) of opening are important
- with ligamentous testing, contractions must be held for 5 seconds
- with myotome testing, contractions must be held for 5 seconds
- warn patient of possible exacerbations
- maintain the dignity of the patient
- refer if necessary
Physiotherapy Assess Men 1
referrence
david j.magee orthopaedic physical assessment 4th edition
Saturday, October 9, 2010
Friday, October 8, 2010
Referring to the previous article that Ive taken from WEB PT : here's a brief summarization on what is GPR
Global Postural Re-education (GPR) The technique is known as Souchard's Global Postural Re-education and it employs a series of gentle movements to realign spinal column joints and strengthen and stretch muscles that have become tight and weak from underuse.
It was developed in France 25 years ago, GPR is only now being introduced in the United States.
This treatment, which has been successfully used in Europe for many years, follows the same principal as other muscle-release, posture retraining techniques.
GPR because is becoming accepted by mainstream doctors. Internet searches for the term “GPR,” brings up mainly Orthodox medical sites. You might note these sites make no mention of any other similar treatments that have been around in North America for years.
Most importantly, anything that helps to recognize "muscle release therapy" is a very good thing, and we never look a gift horse in the mouth. No matter how this highly successful treatment method is brought out of the dusty closets of practicing physicians it will prove of immense benefit to the hundreds of millions of people who make up that 95% of back and neck pain for which there is no apparent diagnosis.
In addition to that, Ive added a video on GPR technique which is useful for you all
Global Postural Re-education (GPR) The technique is known as Souchard's Global Postural Re-education and it employs a series of gentle movements to realign spinal column joints and strengthen and stretch muscles that have become tight and weak from underuse.
It was developed in France 25 years ago, GPR is only now being introduced in the United States.
This treatment, which has been successfully used in Europe for many years, follows the same principal as other muscle-release, posture retraining techniques.
GPR because is becoming accepted by mainstream doctors. Internet searches for the term “GPR,” brings up mainly Orthodox medical sites. You might note these sites make no mention of any other similar treatments that have been around in North America for years.
Most importantly, anything that helps to recognize "muscle release therapy" is a very good thing, and we never look a gift horse in the mouth. No matter how this highly successful treatment method is brought out of the dusty closets of practicing physicians it will prove of immense benefit to the hundreds of millions of people who make up that 95% of back and neck pain for which there is no apparent diagnosis.
In addition to that, Ive added a video on GPR technique which is useful for you all
PT Today : Souchard's global postural re-education relieves back pain
April 18, 2008 - Fox News( WEB PT )
PT News: Innovative Physical Therapy Relieves Back Pain
A person with chronic back pain is in too much discomfort to perform the exercise on his own. A physical therapist guides the process, stretching the muscles along the spinal column while the patient is in the specified positions.
There are two basic positions: standing up and lying down with the knees bent. While in each of these positions, the patient places his arms at his side and tries to open them wider and wider.
"The therapist helps you to find the level you're comfortable with, as you keep increasing the range of motion," Estol says.
When Back Pain Treatments Fail
Estol says medications and surgery for severe and chronic back pain typically have limited or no benefit.
That's why he decided to try the new method on 102 patients with chronic back pain associated with severe degenerative disc disease of the spine. Patients with degenerative disc disease can experience back pain so debilitating that they can't bend, stretch or, sometimes, even get out of a chair without help.
Five Months of Treatment
The participants had severe pain for an average of seven months; 82 had lower back pain and 20 had neck pain. About half were women.
"The patients had tried almost all combinations of treatments you could think of, including regular physical therapy, bed rest, anti-inflammatory medications, acupuncture, and epidural injections," Estol says. "Quite a few had already had surgery and others were scheduled for surgery when we treated them."
Importantly, three-fourths couldn't walk more than 10 blocks without stopping, he says. Thirty-five percent had pain so severe they couldn't walk more than five blocks and had to stop working or playing sports.
The treatment included two GPR sessions during the first week, then one session a week for an average of five months. Participants also practiced breathing techniques and were given a home exercise program.
Back Pain Relieved in Nearly All
The findings showed that 92 of the 102 people reported pain relief and were able to return fully to their daily activities.
For 85 percent of the patients, the improvement was noted after just three weeks of treatment. And after an average of almost two years, the pain has not recurred, Estol says.
Cautious Optimism
Other researchers at the meeting were cautiously optimistic.
Albert Lo, MD, PhD, assistant professor of neurology at Yale University in New Haven, Conn., and a moderator of the session at which the findings were presented, says a success rate of 90 percent in patients with chronic back pain "is very unusual and begs for further investigation."
"If the findings are reproducible in [future studies], GPR could be a very exciting adjunctive therapy for patients with chronic neck and back pain," he tells WebMD.
By Charlene Laino, reviewed by Michael W. Smith, MD
SOURCES: American Academy of Neurology 57th Annual Meeting, April 9-16, 2005, Miami Beach, Fla. Conrado Estol, MD, PhD, Neurologic Center for Treatment and Rehabilitation, Buenos Aires, Argentina. Albert Lo, MD, PhD, assistant professor of neurology, Yale University, New Haven, Conn
PT News: Innovative Physical Therapy Relieves Back Pain
An innovative physical therapy technique may relieve back pain even when all other treatments fail.
The technique, called Souchard's global postural re-education -- or GPR for short -- employs a series of gentle movements to realign spinal column joints and strengthen and stretch muscles that have become tight and weak from underuse.
"GPR corrects the patient's posture and decompresses the spinal canal," says Conrado Estol, MD, PhD, of the Neurologic Center for Treatment and Rehabilitation in Buenos Aires, Argentina. He presented his study at the American Academy of Neurology 57th Annual Meeting.
Return to Daily Activities
"In our study, nine in 10 people with chronic back pain due to disc disease significantly improved and were able to return to their usual daily activities -- usually within five months."
GPR can also help the 95 percent of adults who will suffer acute back pain injury at some point in their lives, he tells WebMD.
Developed in France, GPR is only now being introduced in the United States.
Patient, Therapist Work Together
A person with chronic back pain is in too much discomfort to perform the exercise on his own. A physical therapist guides the process, stretching the muscles along the spinal column while the patient is in the specified positions.
There are two basic positions: standing up and lying down with the knees bent. While in each of these positions, the patient places his arms at his side and tries to open them wider and wider.
"The therapist helps you to find the level you're comfortable with, as you keep increasing the range of motion," Estol says.
When Back Pain Treatments Fail
Estol says medications and surgery for severe and chronic back pain typically have limited or no benefit.
That's why he decided to try the new method on 102 patients with chronic back pain associated with severe degenerative disc disease of the spine. Patients with degenerative disc disease can experience back pain so debilitating that they can't bend, stretch or, sometimes, even get out of a chair without help.
Five Months of Treatment
The participants had severe pain for an average of seven months; 82 had lower back pain and 20 had neck pain. About half were women.
"The patients had tried almost all combinations of treatments you could think of, including regular physical therapy, bed rest, anti-inflammatory medications, acupuncture, and epidural injections," Estol says. "Quite a few had already had surgery and others were scheduled for surgery when we treated them."
Importantly, three-fourths couldn't walk more than 10 blocks without stopping, he says. Thirty-five percent had pain so severe they couldn't walk more than five blocks and had to stop working or playing sports.
The treatment included two GPR sessions during the first week, then one session a week for an average of five months. Participants also practiced breathing techniques and were given a home exercise program.
Back Pain Relieved in Nearly All
The findings showed that 92 of the 102 people reported pain relief and were able to return fully to their daily activities.
For 85 percent of the patients, the improvement was noted after just three weeks of treatment. And after an average of almost two years, the pain has not recurred, Estol says.
Cautious Optimism
Other researchers at the meeting were cautiously optimistic.
Albert Lo, MD, PhD, assistant professor of neurology at Yale University in New Haven, Conn., and a moderator of the session at which the findings were presented, says a success rate of 90 percent in patients with chronic back pain "is very unusual and begs for further investigation."
"If the findings are reproducible in [future studies], GPR could be a very exciting adjunctive therapy for patients with chronic neck and back pain," he tells WebMD.
By Charlene Laino, reviewed by Michael W. Smith, MD
SOURCES: American Academy of Neurology 57th Annual Meeting, April 9-16, 2005, Miami Beach, Fla. Conrado Estol, MD, PhD, Neurologic Center for Treatment and Rehabilitation, Buenos Aires, Argentina. Albert Lo, MD, PhD, assistant professor of neurology, Yale University, New Haven, Conn
Mulligan Taping Techniques- Tennis Elbow
A good video on Mulligan taping technique for tennis elbow.
Treat and Rehabilitate - by Anusha Sehgal and Mark Reyeneker
My first time ever being interviewed by the vice editor of Kunang-kunang magazine :)
Sacroiliac joint stretch
Here's a vidoe on sacroiliac joint stretch for back and leg pain
http://www.youtube.com/watch?v=uuozn0i-De8&feature=fvsr
http://www.youtube.com/watch?v=uuozn0i-De8&feature=fvsr
Tennis Elbow and Exercise Protocol
Tennis Elbow
Background
It is also called as lateral epicondylitis. It is defined as a pathlogic condition of wrist extensor muscles at their origin on lateral humeral epicondyle.
The tendinous region of extensor carpi radialis (ERCB) is the area of most pathologic changes
techniques. The application of heat and massage is one of the most effective treatments for removing
scar tissue and speeding up the healing process of the muscles and tendons.
and tendons that have been injured.
Phase 2 : Rehabilitation
Gentle stretching exercise
Gentle stretching exercises including wrist
flexion (bending the wrist down), extension
(bending the wrist up). The elbow should
be fully straightened. These stretches
should be held for 20-30 seconds and
repeated 5-10 times, at least twice a day.
Vigorous stretching should be avoided - do
not stretch to the point of pain that
reproduces your symptoms
Strengthening exercise
With the elbow bent and the wrist supported perform the following exercises:
Wrist Extension. Place 1 lb. weight in hand with palm facing downward; support
forearm at the edge of a table or on your knee so that only your hand can move.
Raise wrist/hand up slowly, and lower slowly.
Wrist Flexion. Place 1 lb. weight in hand with palm facing upward; support
forearm at the edge of a table or on your knee so that only your hand can move.
Bend wrist up slowly, and then lower slowly
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Begin this elbow strengthening exercise with a resistance band around your hand as demonstrated at the figure above. Your elbow should be at your side and bent to 90 degrees. Slowly rotate your forearm against the resistance band so your palm faces down. Perform 3 sets of 10 repetitions as far as possible and comfortable without pain
.jpg)
Biceps Curl
Begin this elbow strengthening exercise with a resistance band under your feet and around your hands as demonstrated as the figure above. Your back and elbows should be straight. Slowly bend your elbows against the resistance band tightening your biceps. Perform 3 sets of 10 repetitions as far as possible and comfortable without pain.
Advanced exercises
.jpg)
Biceps Preacher Curl
Begin this elbow strengthening exercise kneeling over a Swiss ball and holding a light weight as demonstrated as above. Your back and elbows should be straight. Slowly bend your elbow tightening your biceps. Perform 3 sets of 10 repetitions as far as possible and comfortable without pain.
I hope all this information had helped you all. :)
Below is the link to the video on the exercises for tennis elbow.Feel free to watch it
http://www.youtube.com/watch?v=ayTzSzYFUxM&feature=fvst
By, Anusha Sehgal
Referrence
Background
It is also called as lateral epicondylitis. It is defined as a pathlogic condition of wrist extensor muscles at their origin on lateral humeral epicondyle.
The tendinous region of extensor carpi radialis (ERCB) is the area of most pathologic changes
Risk factors
- Most patients are 30 to 50 years
- 95% occurs in tennis players
- Active in sports activities
- Poorly conditioned muscles
Symptoms
- pain or tenderness on the outer side of the elbow bony prominence
- pain when you straighten or raise your wrist and hand
- pain made worse by lifting a heavy object
- pain when you make a fist, grip an object, shake hands, or turn door handles
- pain that shoots from the elbow down into the forearm or up into the upper arm
Physical Examination
- Point of tenderness is examined
- Muscle strength
- Range of motion- Active and passive
- Resisted isometric movements
- Special test : Cozen's test, Mill's test - will be discussed below
- Neck- pain of elbow may be referred to the neck as well
Special test for Tennis elbow
Cozen's test
The examiner stabilizes the elbow with a thumb over the lateral epicondyle. Pain in the lateral epicondyle is seen with patient making a fist, pronating the forearm, radially deviating and extending the wrist against resistance by the examiner. Passive extension of the elbow with forced flexion of the wrist may precipitate pain at the lateral epicondyle
You can view the video on how the test is done
Mills test
With this test, pain occurs over the lateral epicondyle when the wrist and fingers are completely flexed.There's a video on how the test is done
Positive signs of Examination
- point of tenderness typically occuring at ERCB origin at lateral epicondyle
- the tenderness will be generalized over the common extensor wad insertion at the lateral epicondyle
- pain often gets worst by wrist extension against resistance with forearm pronated (palm down)
- elbow extension is limited
- neck pain and stiffness
- bursitis
- cozen's test,mills test : positive
Physiotherapy Treatment
Phase 1
Tennis elbow is a soft tissue injury of the muscles and tendons around the elbow joint, and thereforer should be treated like any other soft tissue injury. Immediately following an injury, or at the onset of pain,the R.I.C.E regime should be employed. This involves
Rest
Ice
Compression
Elevation
The next phase of treatment (after the first 48 to 72 hours) involves a number of physiotherapy
techniques. The application of heat and massage is one of the most effective treatments for removing
scar tissue and speeding up the healing process of the muscles and tendons.
Once most of the pain has been reduced, it is time to move onto the rehabilitation phase of your
treatment. The aim of this phase it to regain the strength, power, endurance and flexibility of the muscleand tendons that have been injured.
Phase 2 : Rehabilitation
Gentle stretching exercise
flexion (bending the wrist down), extension
(bending the wrist up). The elbow should
be fully straightened. These stretches
should be held for 20-30 seconds and
repeated 5-10 times, at least twice a day.
Vigorous stretching should be avoided - do
not stretch to the point of pain that
reproduces your symptoms
Strengthening exercise
With the elbow bent and the wrist supported perform the following exercises:
Wrist Extension. Place 1 lb. weight in hand with palm facing downward; support
forearm at the edge of a table or on your knee so that only your hand can move.
Raise wrist/hand up slowly, and lower slowly.
Wrist Flexion. Place 1 lb. weight in hand with palm facing upward; support
forearm at the edge of a table or on your knee so that only your hand can move.
Bend wrist up slowly, and then lower slowly
Forearm Rotation. Grasp dumbell (wrench, or some similar device) in hand with
forearm supported. Rotate hand to palm down position, return to start position (dumbell
perpendicular to floor), rotate to palm up position, repeat. To increase or decrease
resistance, by move hand farther away or closer towards the head of the dumbell
Theraband exercise for tennis elbow
Begin this elbow strengthening exercise with a resistance band around your hand as demonstrated at the figure above. Your elbow should be at your side and bent to 90 degrees. Slowly rotate your forearm against the resistance band so your palm faces up. Perform 3 sets of 10 repetitions as far as possible and comfortable without pain.
Biceps Curl
Begin this elbow strengthening exercise with a resistance band under your feet and around your hands as demonstrated as the figure above. Your back and elbows should be straight. Slowly bend your elbows against the resistance band tightening your biceps. Perform 3 sets of 10 repetitions as far as possible and comfortable without pain.
Advanced exercises
.jpg)
Biceps Preacher Curl
Begin this elbow strengthening exercise kneeling over a Swiss ball and holding a light weight as demonstrated as above. Your back and elbows should be straight. Slowly bend your elbow tightening your biceps. Perform 3 sets of 10 repetitions as far as possible and comfortable without pain.
I hope all this information had helped you all. :)
Below is the link to the video on the exercises for tennis elbow.Feel free to watch it
http://www.youtube.com/watch?v=ayTzSzYFUxM&feature=fvst
By, Anusha Sehgal
Referrence
- S brent brotzman, Kevin E.Wilk : Clinical Orthopaedic Rehabiltation 2nd edition 1996
- http://www.sportsinjuryclinic.net/
- http://www.medicine.net.com/
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