Physical therapy for bed ridden person

 

 INTRODUCTION:

                                A bedridden person is someone who is unable to leave their bed due to illness, injury or disability . Being bedridden can lead to various health complications like painful bed sores, blood circulation and respiratory problems, depression and contractures, due to lack of activity for long periods . It is important to ensure proper nursing and caring for your loved one confined to the bed. Here are some tips to prevent and manage the common health risks of bedridden patients:

1. Pressure sores or decubitus ulcers: One of the most unfortunate and preventable complications that can occur are bedsores. Bedsores can develop in a person who is bedridden or immobile. Pressure laid on the skin and tissues that covers the bony areas of the body are at biggest risk for breaking down.                                                                                                                                                                                                                            This occurs from prolonged lying down or sitting in one position, compounded by poor nutrition, dry and wet skin, and shearing force on the skin as they are moved for change of dressing or clothes. The area under attack suffers from poor blood circulation, and shearing force rips the skin covering leading to infective, painful deep ulcers.                                                                                                                                              Such an area can be anywhere in the body that rests on a surface, or secured tightly by tubes and left for a period of time without being shifted across as considered ideal. People with bed sores (pressure ulcers) can experience great pain, discomfort, depression and reduced quality of life.                                                                                                                                            Also read- Benefits of Physical therapy for my health and fitness                                                                                                    The aim of the attendant or carrier should be to prevent, minimize and manage pressure sores. Here are some tips:                                                                                                      Routine regular turning and repositioning of their loved ones in bed. Utilizing cotton to underlay and clothes that comes in direct contact with skin, this absorbs sweat and promotes skin breathe through. Use of bedding that is soft and non-plastic in nature.                                                                                                               Use of moisture absorbent sheets to avoid the skin bathe in the body fluids. Encouraging time out of bed. Use of frames, slings or slide sheets to mobilize, rather than pull, push that can cause shearing force on the skin. Provide passive range of motion exercise regularly and encourage active movements of body as far as possible.

2. Pneumonia: Position in bed can be varying rather than supine or facing ceiling every time. Prone or semi prone position of lying will assist better aeration of lungs and also break from pressure areas.                                                                                        Also read- What is Physical therapy of Respiratory disease

3. Constipation: Bedridden patients are at risk of constipation due to lack of physical activity. Encourage a high-fiber diet and adequate fluid intake to prevent constipation .

4. Contractures: Contractures are the shortening and hardening of muscles due to lack of movement. Encourage range-of-motion exercises to prevent contractures .

5. Deformity and Stiffness: Encourage range-of-motion exercises to prevent deformity and stiffness .

6. Recurrent Urinary Tract Infection (UTI): Bedridden patients are at risk of UTIs due to the use of catheters. Ensure that the catheter is clean and changed regularly .

7. Depression: Bedridden patients are at risk of depression due to lack of social interaction and physical activity. Encourage social interaction and activities that the patient enjoys .

Also read- What is the relationship between Physical therapy and Mental Health

Physical Therapy INTERVENTION:

                             What does an Bed Ridden Individual Suffers From Excluding His/ Her Disease

                                        > Muscle Wasting (Atrophy)

                                        > Decreased Vital Capacity of Lungs ( Difficulty in Deep Breathing)

                                        > Bed Sore is the Result Of Limited Body Movement

                                        > ADL activities --- An Individual Depend on Others For Basic Daily                                                                              Routine activity like Brushing, Eating, Dressing.

ROLE OF PHYSICAL THERAPY: 

                                                 A Physical therapist Evaluates the Condition of Bed Ridden Individual and Makes a Treatment Plan Accordingly. Musculoskeletal examination from head to toe is the key factor for correct diagnosis and treatment.

  If you or someone you know is bedridden, it’s important to stay active and exercise your body during this time. Exercise can help maintain health and fitness, and prevent muscle loss . Here are some physical therapy-approved exercises that can be done while bedridden:

1. Kegels: Kegels are excellent for strengthening the pelvic floor muscles. Having good strength here can help during delivery and in recovery after childbirth. Here’s how you should perform the Kegel exercise: Lie on your back on a bed or floor. Pull the muscles around your vagina and uterus inwards as if you were stopping urine or gas from passing.

2. Arm and Shoulder Strengthening: Moving your arms and upper body through its full range of motion is helpful for maintaining flexibility and strength in your arms. Doing an exercise called arm abductions is great for that. For that, move your arms away from your body sideways or horizontally. Lift them as high as possible until the palms of both hands touch above your head. Return to the starting position. You can add weights if you can manage it. Just make sure that you are either sitting with a good posture while you do this or lying on a flat surface.

3. Static Quads: Your quadriceps muscles (these are on the front of your thigh) are essential for walking and standing. Their job is to straighten your knees or bring them in full extension. Thus maintaining its strength while in bed is important. Lie down on your back or sit in bed with your legs straight. Place a rolled towel or a small pillow under your knee. Press the pillow down with your knee so that your ankle is elevated off of the bed. Hold for 10 seconds. Relax. Repeat exercise 10 times and do three sets, thrice a day.

4. Whole-body Bed-based Exercises: Discover head, upper-body, lower-body, and whole-body bed-based exercises.

Please note that these exercises are not a substitute for professional medical advice. Consult a doctor or physical therapist before starting any new exercise regimen.

CONCLUSION:

If you don't want to be bed ridden and not depend on others for your daily living start your physical therapy today. A Physical therapist will help you to become independent, physically, mentally strong  and live a confident life as never before.

  

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Physical therapy Versus Surgery for Stress Urinary Incontinence

Introduction: 

                        Stress urinary incontinence is an involuntary loss of urine during physical activity like sneezing, coughing, laughing, singing, dancing etc, and many more.it is a common health problem among women that negatively affects quality of life.

Urinary incontinence is a medical condition where an individual loses control over their bladder. It can range from occasional leaks when coughing or sneezing to sudden and strong urges to urinate that cannot be controlled. The severity of the condition varies from person to person and can be caused by everyday habits, underlying medical conditions, or physical problems.

Facts About Incontinence:

1. Urinary incontinence affects up to 33% of adults in the United States.
2. It is twice as common in women compared to men .
3. Urinary incontinence is not a normal part of aging, but the prevalence of urinary incontinence increases with age .
4. Pregnancy and vaginal childbirth put tremendous pressure on pelvic tissues, including the bladder, urethra, nerves, and pelvic floor muscles. It’s common for women to leak urine during pregnancy and for a short time after delivery .
5. Urinary incontinence is a symptom of another problem. Leaking urine is a sign there’s a problem somewhere along the urinary tract, such as nerve damage, muscle weakness, blockages, or infection.

If you are experiencing urinary incontinence, it is important to seek medical advice as it can negatively impact your quality of life and indicate a more serious underlying condition. Treatment options include simple lifestyle and dietary changes, along with physical therapy.

Please note that this response is for informational purposes only and is not intended to replace professional medical advice. If you are experiencing urinary incontinence, please consult your doctor for proper diagnosis and treatment.

Related article- how do you know when you need physical therapy?

Test:

We performed a multicenter, randomized trial to compare physiotherapy and  surgery in women with stress urinary incontinence. Crossover between groups was allowed. The primary outcome was subjective improvement, measured by means of the Patient Global Impression of Improvement at 12 months.

→ A successful outcome between surgery and physical therapy raises the question of whether all women with moderate-to-severe stress-predominant urinary incontinence should initially be treated with physical therapy or should immediately undergo surgery as initial treatment.

→ The diagnosis of stress urinary incontinence was based on a demonstration of leakage of urine on straining or coughing at a bladder volume of at least 300 ml. 

→ Do you experience urine leakage related to physical activity, coughing, or sneezing?  was observed during a cough stress test at a bladder volume of at least 300 ml.

Result:

→ Pelvic-floor muscle training (physical therapy) is generally regarded as first-line management for the condition.

 → Physical therapy was performed by certified pelvic physical therapists and pelvic muscle floor training for stress urinary incontinence was performed.

→ Women were educated about the function of the pelvic-floor muscles, bladder function, and how to perform a correct pelvic-floor muscle contraction. They were also taught to perform a short muscle contraction before an increase in intra-abdominal pressure, such as that associated with sneezing.

→ If a woman was unable to contract her pelvic-floor muscles, touch, tapping, and massage were applied to increase awareness of these muscles. Biofeedback-assisted or functional electro-stimulation could be used as we use in electrotherapy which is a part of physical therapy.

Pelvic floor exercises and physical therapy can help alleviate incontinence issues. According to a source, pelvic floor exercises can help strengthen the pelvic floor muscles and improve bladder control. The exercises are designed to help both men and women with incontinence issues. The most common types of urinary incontinence are stress incontinence and urge incontinence. Stress incontinence is caused by increased pressure in the abdomen, while urge incontinence is caused by a muscle spasm or dysfunction in the bladder. Mixed incontinence is when both stressors and urges cause leakage. Physical therapy can help with all types of incontinence.

 physical therapists can help with incontinence by designing treatment programs to improve pelvic floor muscle strength and help people gain control over the condition.

Incontinence Products for Women :

There are many incontinence products available for women. Some of the popular products include:

1. Tena Incontinence Underwear For Women: These are super absorbent and come in a pack of 16. They are priced at $23.50 .
2. Because Premium Incontinence Pads For Women: These are individually wrapped liners that come in a pack of 20. They are priced at $16.99 
3. TENA Proskin Incontinence Underwear For Women: These come with maximum absorbency and are priced at $14.49 .
4. Depend FIT-FLEX Incontinence Underwear For Women: These come with maximum absorbency and are priced at $32.24 .

Please note that these are just a few examples of the many products available. It’s important to choose a product that meets your specific needs. You may want to consult with your Physical therapist or a healthcare professional to determine which product is best for you.

Conclusion:

After performing all the test and under supervision for a period of 12 months it came to a conclusion that physical therapy should be the first line of treatment for incontinence. Because it has no side effects as compare to surgery in which there are complications in body after surgery.

physical therapy is a non invasive technique which has zero side effects on our body so if a patient doesn't improve her condition by physical therapy she should go for surgery as a second option.

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Ankylosing spondylitis test,what if HLA-B27 test is Positive ?

 Introduction: Ankylosing spondylitis test,what if HLA-B27 test is Positive ?

Ankylosing Spondylitis is an inflammatory joint disease in which the joints of the body start sticking and stiffness goes on increasing. This is a rare type of arthritis and is more common in Men than in women. Getting its lab test shows that this disease is present in  body, the name of the test is HLAB27.

The centers for Disease control and prevention's NHANES ( National Health and Nutrition Examination Survey) study now estimates that at least 1.7 millions adults in the U.S. have  ankylosing spondylitis, while 3.2 million have a form of axial Spondyloarthritis.

SYMPTOMS and Sign:

1. There is stiffness and pain in whole body after waking up in morning ( Morning Stiffness)

2. Ankylosing spondylitis mostly affect the spine, damages spinal column specially sacrum joint, costocondral joint, neck pain and sometimes tiredness.

3. If we talk about the investigation, then after getting X-ray done, the spine looks like  Bamboo spine and in pathology test if  HLAB27 is positive, it is clear that you have ankylosing Spondylitis.

4. If there is swelling along with pain, don't ignore it and start your physical therapy treatment as soon as possible.

5. Posture becomes stiff day by day and small routine tasks such as getting out of bed, climbing stairs, sitting down, toilet sitting all cause pain and discomfort.

Related article - how do you know when you need physical therapy ?

TREATMENT:

Physical therapy is the most important treatment in Ankylosing spondylitis. The sooner you start, the more effective it will be. Your therapist will prepare a treatment plan which includes

1. Stretching Exercises

2. Breathing Exercises

3. Range of Motion Exercises

4. Strengthening Exercises

5. Manual Techniques

6. Electrotherapy Modalities

You yourself will feel the difference in your body after doing physical therapy. You can take the help of Painkillers  to reduce the pain, but don't take too much otherwise it will spoil your metabolism.

 Other Names of This Condition

* Marie-Stuempell  disease

* Spondyloarthritis

* Bechterew disease

* Spondylarthritis ankylopoietica

* Axial spondylarthritis

Here are some exercises shown in the video by physical therapist so you can do it at home.

 

Important note about Ankylosing spondylitis:

There are some important points about Ankylosing spondylitis in which you never get this important thing in any book or syllabus, these are some practical points which can only be experienced by a physical therapist. According to work experience and knowledge of physical therapist states that

➤ Sour food item such as pickle can worsen your condition of Ankylosing  spondylitis making your body more hard and painful if you eat it on regular basis.

➤ To suppress the symptoms of Ankylosing spondylitis it is important to do regular  exercises, but you cannot do it just after getting out  from bed in morning. As morning Stiffness is a classical symptom of Ankylosing spondylitis so it is very difficult and painful to do exercises just after getting out from bed.

➤ In winter season the inflammation of spondylitis rapidly increases so it is very important to take care of your health specially in the winter season as compared to any other seasons.

➤ Coming to the age of 40 it is important to build the strength of muscles and bones in your body, so try to include some weight lifting exercises 5 days a week. This will certainly decrease the inflammatory process of Ankylosing spondylitis.

➤ Keeping one self physically active and paying attention to your posture can greatly help you minimize the long term effects of this condition. Keep that thing in mind that too much rest will increase the stiffening in your spine.

➤ Try to do exercises in a systematic manner for example, hot shower or hot water fomentation followed by stretching exercises will ease your body and makes it more flexible rather than doing exercise without warm up.

➤ Deep breathing exercises are helpful in chest expansion and proper lung function in person with Ankylosing spondylitis. 

➤ Swimming is one of the best forms of exercise because it uses lots of muscles and joints without affecting them. And the water supports the weight of your body. Swimming provides a great overall workout that improve your flexibility stamina and strength. 

➤ If your sleep is disturbed by spondylitis then just take a warm bath before bed so that it helps in getting a good sound sleep and also ease the body pain. Your head and neck should stay in line with the rest of your body when you are in bed, also a medium firm bed will be more comfortable for you to sleep.

Conclusion:

You cannot cure Ankylosing Spondylitis from the root but regular physical therapy session can completely stop it. After completing the whole physical therapy session some stretching and breathing exercises along with hot water fomentation are taught by the therapist so you can do it at home and feel better,

I hope you like this article informative and helpful, please let me know in the comment section.

facial palsy physical therapy

 Introduction:

Facial paralysis or bells palsy is also called 7th cranial nerve ( facial nerve) is caused by injury. In this the face becomes crooked, the eyes doesn't close completely, mouth doesn't open completely, the cheeks do not enlarge, Dribbling of saliva on one side, slurred speech. All these symptoms are seen in facial palsy.

It is estimated that around 30,000 to 40,000  Americans suffer from facial palsy every year, with the age between 20 to 40 years. 

 

How does the facial nerves work? 

  There are 12 pairs of cranial nerves in our head, each side of the face has its own facial nerve. So damaging the right facing nerve will only affect right side of the face and vice versa. Each nerve starts at the brain and enters the face to the front of the ear where it then divides into five separate branches. These branches supply the muscles which are used for facial expression. Tears, saliva production and taste are also controlled by the facial nerve in many different ways. 

 Causes:

1. Hypertension or simply called high BP is one of the main reasons of bells palsy.

2. Diabetes

3. Brain infection like Meningitis, Encephalitis, Brain Tumor, haemorrage, can also cause paralysis.

4. If dengue or bone fever increases, facial paralysis may occur.

Classification of facial nerve injuries

There are three different kinds of facial nerve injury: 

1. Mild- when the facial nerve is just concussed or bruised and recovers within 6 to 8 weeks

2. Moderate- in this the patient nerve is more severely damaged but still retains its outer layer. The nerve begins to show the first science of recovery at about 12 weeks as it slowly repairs itself at the rate of around 1 mm per day.

3. Severe- in this the facial nerve is more severely damaged and recovery is much slower and always incomplete. sometimes in the nerve is completely severed and surgical repair is needed to restore facial function.

Related article - how do you know when you need physical therapy ?

Physical therapy Examination:

• Ask the patient to open and close both eyes 
• Smile with showing all teeth
• To blow the cheeks
• Raise both the eyebrows
• Ask to open and close the mouth
• Lost facial expression
• Forehead wrinkling                                                                                                                                                                       Treatment:

Use pills to control blood pressure and diabetes but Physical therapy 

 is the best treatment for Facial Palsy. A Physical therapist examine

 and evaluates the condition and treats accordingly with

 facial stimulation ( Electrotherapy ) and some Facial Exercises

 for Bell's palsy condition. Within no time, the puffiness of the face

 gets completely cured, regular Physical therapy session gives 100%

 result. Later on Exercises are taught by therapists by

 which Paralysis doesn't repeat anymore.

Gentle massage of the facial muscles can also be performed and taught by physical therapist to the patient, so that he/she can repeat and perform the exercises at home several times a day. The aim of facial massage is to reduce muscle spasm and increase flexibility to regain normal muscle tone of facial muscles.

Related article - myofascial-pain-release

Performing home exercises in front of a mirror provides a visual feedback for the person to do it correctly and can see the progression day by day. 

Is Facial Physical Therapy Safe ? 

Yes physical therapy is a safer option for facial palsy treatment, there are no side effects of this treatment and it is a better option as compared to any other form of treatment. Facial paralysis patient recovery differs from each other regarding time taken for recovery, but Sooner or later every patient gains 100% recovery from bells palsy. 

➤ Home exercise such as blowing a balloon stimulates the muscles of cheeks and helps in regaining the normal muscle tone

 ➤ Also chewing a gum constantly provide movement at the temporal mandibular ( jaw )  joint which influences surrounding muscles. 

 ➤ Taping the eyes closed at night ensure the prevention of corneal ulceration.

      Complications of bells palsy

Usually it is seen that a mild case of bells palsy typically disappears within a month also but recovery from a more sewer case in which the face was completely paralyzed can very according to time. Some complications may include: 

•  Irreversible damaged to facial nerve.

•  Irregular regrowth of nerve fibers which result in involuntary contraction of certain muscles when your trying to move other muscles. For example, when you laugh or smile the eye on the affected side may close.

•  Partial or complete blindness of the eye that won't close. This is caused by excessive dryness and scratching of the clear protective covering of the eye that is cornea.

    Prevention of bell's palsy

Unfortunately there is nothing you can do to prevent bell's palsy. It's linked to certain viral infections, but not everyone who has those viral infections developed Bell's palsy. 

If you have risk factors for the condition, like diabetes, obesity or high blood pressure, managing them well me help reduce your risk.                                                 

Surgery for facial paralysis

Facial nerve decompression is an option in cases of virally induced facial nerve palsy and also bell's palsy, however this has not shown significantly positive outcomes compared to conventional physical therapy treatment. 

Conclusion

In condition like facial palsy or bell's palsy physical therapy treatment should be the first line of treatment as compared to any other form of medical management. You should go first to a physical therapist for its treatment  rather than anything else.