2012年1月10日星期二

Exercises & Advice For Parkinson Patient

TEN BASIC EXERCISES FOR THE PARKINSON PATIENT

1. Bring the toes up with every step you take. In Parkinson's disease, "you never make a move", without lifting the toes.

2. Spread the legs (10 inches) when walking or turning, to provide a wide base, a better stance, and to prevent falling. It may not look "beautiful," but neither does falling.

3. For greater safety in turning, use small steps, with feet widely separated. Never cross one leg over the other when turning. Practice walking a few yards and turn. Walk in the opposite direction and turn. Do so fifteen minutes a day.

4. Practice walking into tight corners of a room, to overcome fear of close places.

5. To insure good body balance, practice rapid excursions of the body. Backward, forward and to the right and left, five minutes, several times a day. Don't look for a wall when you think you are falling. It may not be there. Your body will always be there to protect you, if you will practice balance daily.

6. When the legs feel frozen or "glued" to the floor, a lift of the toes eliminates muscle spasm and the fear of falling. You are free to walk again.

7. Swing the arms freely when walking. It helps to take body weight off the legs, lessens fatigue, and loosens the arms and shoulders.

8. If getting out of a chair is difficult, rise with "lightning speed," to overcome the "pull of gravity." Sitting down should be done slow, with body bent sharply forward, until one touches the seat. Practice this at least a dozen times a day.

9. If the body lists to one side, carry a shopping bag loaded with books or other weights in the opposite hand to decrease the bend.

10. Any task that is difficult, such as buttoning a shirt. or getting out of bed, if practiced 20 times it day, becomes easier the 21st time.




FOR TIGHT MUSCLES AND POOR POSTURE

STANDING

1. Stand ln front of a wall, facing it about 8" away. Raise arms and reach as high as possible toward the top of the wall. Lean toward the wall and stretch.

2. With your back to the wall, alternate raising legs as high as possible by bending the knee as if marching in place.

3. Holding on to something secure, squat down as far as possible, bending knees; then come up.


SITTING

1. Sitting in straight-back chair, place your arms behind the chair and bring your shoulders back as far as possible; raise your head up and look at the ceiling.

2. Sitting In the same chair, grip the ends of a broom or mop stick with both hands, try to raise it over your head until you get it behind your head. Keep head and shoulders as erect as possible.

3. Sitting in same chair, place one leg at a time on another chair and press the knee straight. Keep it there 15 minutes. Try both legs together.

4. Sitting in a chair, raise legs up from the knee alternately, as if stamping your feet.


LYING ON A FIRM BED OR FLOOR

1. Lie on the floor or bed, flat on your back; try to press your body to the floor as flat as possible. Move your head from right to left as far as possible. Make sure your head, shoulders, back, and knees touch the surface.

2. Lie on the floor or bed on your abdomen. Do the following one by one:
  1. Put your hands behind back and look up to ceiling, trying to raise your chest off the floor.
  2. Kick your legs alternately, as if swimming.
  3. Turn your head from right to left.


FOR BETTER BALANCE

1. Stand with hands on hips, feet spread apart:
  1. Practice marching in place
  2. Practice raising leg straight out to the rear.
  3. Practice raising leg out to the side.
  4. Practice drawing a circle with the leg.
2. Standing with hands at side, feet spread apart:
  1. Lean forward and back
  2. Lean to both sides
  3. Lean in a circular motion and reverse the motion


FOR WALKING

1. When walking, REMEMBER:
  1. Take as large a step as possible
  2. Raise your toes as you step forward, hitting ground with your heels
  3. Keep legs apart and posture straight
  4. Swing arms and look straight ahead - your feet know where the floor is located.
2. Collect a dozen magazines; lay them out in a straight line. Space them so that you can take as long a step as possible. Practice walking over these magazines without stepping on them.

3. For a better swing to arms, walk holding a rolled magazine in each hand; keep elbows straight.

4. Practice walking sideways, backwards, and take big steps.


FOR TURNING

1. When practicing turning:
  1. Keep feet spread-apart and head high
  2. Use small steps; rock front side to side
  3. Raise legs from the knees
2. If you feel glued to the floor:
  1. Raise your head, relax back on your heels and raise your toes
  2. Rock from side to side, bend knees slightly and straighten up and lift your toes
  3. It sometimes helps if the arms are raised in a sudden short motion


FOR GETTING IN AND OUT OF A CHAIR

1. If you become glued a few steps before you reach the chair, try this: Don't aim for the chair but some object past it. Pass the chair as closely as possible and as you go by it sit down.

2. To sit down, bend forward as far as possible and sit down slowly. Get close to the chair. Do not fall into the chair.

3. To get up, move to the edge of the chair, bend forward and push up vigorously using your arms; try to count 1 2 3 GO! If you have a favorite armchair, raise the back legs with 4" blocks. This will help you to get up easily. Don't let people drag you up by your arms, but help you by pulling you under your arms, or with a slight push on your back.



FOR GETTING OUT OF BED

1. Place blocks under the legs of the head of the bed. This will elevate the head of the bed, & make it easier for you to sit up and swing the legs off the bed.

2. A knotted rope tied to the foot of the bed can help you to pull yourself up.

3. To get to a sitting position, shift the body down and rock yourself by vigorously, throwing your arms and legs toward the side of the bed.



FOR USING YOUR ARMS AND HANDS

1. Practice buttoning and unbuttoning your clothes; practice cutting food and writing. Squeeze a ball or work with "Silly Putty." Keep your fingers busy many times a day. Tear paper; take coins out of the pocket; play the piano.

2. Always try to dress yourself completely. Use shoehorns, elastic laces, or extra-long shoelaces to get a better grip. Dress in the most relaxed and comfortable position, sitting or standing, but make sure you are in a safe position.

3. To keep elbows straight and shoulders loose, install a pulley in doorway, place a chair under it or slightly in front. Stretch your arms and shoulders in all directions. By working the pulley when seated, you can get a more vigorous pull.



FOR GREATER SAFETY IN BATHTUB AND TOILET

If it is difficult to sit down in a bathtub, try the following:

1. Place a bench, stool or chair inside the tub; have the legs sawed off to tub height. Sit on the chair and soap yourself. Use shower to rinse, or rubber shower extension.

2. Bathtub grab bars are available. Purchase only those that attach securely.

3. Raised toilet seats are commercially available.

4. Toilet armrest for getting on and off the toilet are available.



FOR SPEECH, FACE AND CHEWING DIFFICULTIES

1. Practice singing and reading aloud with forceful lip movements. Talk into a tape recorder, if one is available.

2. Practice making faces in front of a mirror. Recite the alphabet and count numbers with exaggerated facial motions. Massage your face with vigor when washing and bathing.

3. When chewing food, chew hard and move the food around; avoid swallowing large lumps.


Sex During Pregnancy





Couples often worry about having sex during pregnancy. They may be afraid that having sex could cause a miscarriage or harm the baby. With a normal pregnancy, sex is safe into the last weeks of pregnancy. In fact, some studies suggest that having sex during pregnancy is associated with a lower risk of delivering too early!


The baby is well-cushioned by amniotic fluid and the strong muscles of the uterus. There is also a thick mucus plug that seals the cervix and helps to protect against infection.


It is best to talk to your doctor or nurse midwife about your specific situation to make sure you are considered at low risk for complications such a pre-term labor or miscarriage. Your doctor may advise you to limit your sex if there are signs or complications during your pregnancy.


Women whose cervix seems to be opening early, and those with bleeding or an abnormally located placenta (placenta previa) should not have sex while they are pregnant.



Changes In Sexual Drive

You and your partner may experience fluctuations in sexual drive during the pregnancy. This is common during the different phases of pregnancy and will be different for everyone.
During the FIRST trimester many women experience extreme breast tenderness, fatigue, nausea, vomiting, and an increased need to urinate that might decrease their sexual drive. Some couples have a feeling of increased closeness that may influence their sexual desires.


Many women find that during the SECOND trimester the initial symptoms have gone away and they have an increased desire for sex. One theory for the increased desire is the increased blood supply in the pelvic region. Some women find freedom from birth control appealing and this adds to the continued sense of special closeness with their partner.
The desire for sex may change again in the THIRD trimester.


Your abdomen is very large, which may make it awkward for you to have sex. Some women feel physically unattractive, while others may feel an increased sense of desirability.


The key to dealing with changes in sexual desire is to communicate your feelings and thoughts with your partner. Even with the changing desires for sex during pregnancy, some women have an increased desire for physical affection, gentle touching, and cuddling.


Sex Position:
Position 1.

Straddle your partner as he lies on his back. This way, there'll be no weight on your abdomen and you can control the depth of penetration.





Position 2.
Straddle your partner as he sits on a sturdy chair.









Position 3.
Lie side-by-side with your partner facing your back and entering from behind.

Position 4.

Yourself on your knees and elbows. Your partner kneels and enters from the rear.

Position 5.

Your bottom to the side or foot of the bed and lie back with your knees bent and feet perched at the edge of the mattress. (After your first trimester, wedge a pillow under one side so you're not completely flat on your back.) Your partner kneels or stands in front of you.


'Unsafe' Sex

If you have oral sex, air should not be blown into your vagina. This can cause an air embolism or an air bubble to get in your bloodstream and block a blood vessel. This is extremely uncommon, but can be fatal to you and your baby.


When Limitations May Be Needed

There are some conditions or complications with pregnancy that may impact having sexual intercourse. Your health care provider may advise you to limit or avoid sex if you have one of the following conditions:
  • A history of miscarriage
  • A history of pre-term labor
  • Vaginal bleeding or cramps
  • Leakage of amniotic fluid or breaking of water
  • Incompetent cervix (the cervix or opening of the uterus is weak and opens prematurely, which increases the risk for miscarriage or premature delivery)
  • Placenta previa (the structure that provides nourishment to the baby is in front of the cervix or in the lower part of the uterus, instead of the usual location at the top of the uterus)
  • Pain with intercourse
  • Infection
You should call your health care provider if you are unsure whether sex is safe for you. If you have any symptoms that you are unsure about, such as pain, bleeding, discharge, or contractions after sex, contact your doctor.


TALK TO YOUR MAN ABOUT YOUR FEELINGS,
YOUR CONCERNS, AND MOST OF ALL,
YOUR EXCITEMENT DURING THIS SPEAL TIME.
ENJOY IT..

2011年10月17日星期一

What types of problem can physiotherapy help?

What types of problem can physiotherapy help?
Virtually any condition that affects your muscles, joints, or nerves can be helped by physiotherapy. Common problems include:
  • Painful conditions such as arthritis
  • Back and neck pain,
  • Problems affecting children including cerebral palsy
  • Upper limb work-related problems, also know as repetitive strain injury (RSI)
  • Musculoskeletal Injury
  • Post Operative Rehabilitation such as Post TKR,THR,SLAP Repair.
  • Asthma and other breathing difficulties
  • Sports injuries
  • Stroke and other neurological problems.
  • Parkinsonism
Also provided Physiotherapy home visit for those inmobility patient.

Throughout the treatment or re-training program, physio will work with you to help you learn to manage your condition independently for the longer term.

Physiotherapy deals with movement at all stages of life. I hope you will move well and stay well.

REMEMBER: Use It Or Lost It.

What is physiotherapy?

What is Physiotherapist??

Physiotherapy uses a variety of techniques to help your muscles and joints work to their full potential. It can help repair damage by speeding up the healing process and reducing pain and stiffness. Physiotherapists also have an important role in rehabilitation, for example, helping people who have had strokes to relearn basic movements. However, physiotherapists don’t just offer treatment; their advice can help you prevent problems from returning or even from happening in the first place.

Group Photo With Patient from Indonesia


Attending Courses with Raj


2011年8月24日星期三

Home Exercises After Total Knee Replacement(TKR)

Total Knee Replacement
From Wikipedia, the free encyclopedia
Knee replacement, or knee atthroplasty, is a common surgical procedure most often performed to relieve the pain and disability from degenerative arthritis, most commonly osteoarthritis, but other arthritides as well.Major causes of debilitating pain include meniscus tears, osteoarthritis, cartilage defects, and ligament tears.
Knee replacement surgery can be performed as a partial or a total knee replacement.In general, the surgery consists of replacing the diseased or damaged joint surfaces of the knee with metal and plastic components shaped to allow continued motion of the knee.
Incapacitating pain from injury or arthritis of the knee that affects everyday activities -- particularly walking and standing -- is the main reason to consider knee replacement surgery. The procedures for knee replacement have changed significantly in the last few years. Surgeons now have access to improved prostheses, and it's rarely necessary any more to cut through muscle to access the knee joint for surgery. The "muscle-sparing approach" allows a surgeon to employ computer-navigated equipment to align the knee implant.


Home Exercises after total knee replacement

SITTING OR BACK LYING


  1. Quad Set Exercise
    1. Tighten the muscles on top of the thigh as tightly as possible and hold.
      1. Pull your toes back.
      2. Push the back of your knee down to the floor.
      3. Try to push out and up through the heel.
    2. Pull 10 seconds, trying every second to pull even tighter.
    3. Relax 5 seconds.
    4. Repeat for 2 sets of ten times. Rest 60 seconds between sets.

  1. Knee Extension with Leg Lift
    1. Start as above, but with a full toilet paper roll under your heel.
    2. Push knee down.
    3. Lock it.
    4. Lift leg up.
    5. Then lower to roll.
    6. Repeat for 2 sets of 10 times.  

  1. Drake Exercise
    1. Tighten top of thigh muscles.
    2. Hold this for 2 seconds.
    3. While maintaining hold, raise leg 4 " from floor.
    4. Hold this position for 2 counts (1-1000, 2-2000).
    5. While maintaining tension, lower leg to floor.
    6. Hold tension for 2 counts while leg is down.
    7. Rest for 5 counts.
    8. Repeat for 2 sets of 10 times.


  1. Static Hold Exercise
    1. Place a hard, round object or toilet paper roll under your knee to hold it at a height of 4-6".
    2. Keep back of knee in contact with object at all times.
    3. Lift heel off table as high as possible.
    4. Straighten knee and tighten top of thigh as tight as possible.
    5. Hold for 5 seconds.
    6. Rest for 5 seconds.
    7. Repeat for 2 sets of 10 time.
  2. Heel Slide
    1. Lie on back with legs out straight and back flat.
    2. Slide one heel up, bringing knee toward chest.
    3. Then slide heel back down.
    4. Repeat for 2 sets of 5 times.
  3. Flexion and Extension
      1. Sit on something high enough to keep foot off the floor.
      2. Bend the knee as far back as possible.
      3. Straighten knee as far forward as possible and hold it straight.
      4. Then relax. (Like pumping on a swing.)
      5. Repeat for 3 sets of 10 times.
  4. Assisted Knee Flexion
      1. Sit as above.
      2. Place ankle of good leg over ankle of operated leg.
      3. Gently push ankles back, bending knees.
      4. Hold and then relax.
      5. Repeat for 2 sets of 5 times.
  5. Assisted Knee Flexion
      1. Lying on your stomach, bend involved knee up.
      2. Use uninvolved leg to help push knee into more flexion.
      3. Hold for 10 seconds.
      4. Repeat for 2 sets of 5 times.
  6. Straight Leg Raise
      1. Tighten the muscles on top of the thigh as tightly as possible and hold.
      2. Raise the entire leg holding the knee as tight as possible. Hold 5 seconds.
      3. Lower leg and rest 2 seconds.
      4. Repeat for 2 sets of 10 times.
      5. Rest 1 minute between sets.