Sunday 30 December 2012

IPHREHAB : ISOLATED GYM WORKOUT PLAN FOR WEEK

IPHREHAB

Isolated movement Exercise program for normal population in safe environment in a normal gym set-up. 

Back and Biceps exercise in same day (as both these muscle group work together as agonist and Synergist to each other). These muscles can be trained in different time durations and days, as it depend upon condition and goal required.


Shoulder and Triceps exercise in same day (as both these muscle group work together as agonist and Synergist to each other). These muscles can be trained in different time durations and days, as it depend upon condition and goal required.

15 Reps in One Set.
30-45 sec rest in between sets of same exercise.
2 minutes rest in between two exercise sets.

Day one :
(Shoulder n Triceps)(core training)
1. Treadmill on incline and try to go to maximum (i.e 10) in a gradual manner with increase in inclination of two units after 2.5 mins. (Total 15 min)
REST 2 MINUTES
2. Shoulder dumbbell press three sets standing with increase in weight and abs contracted(stomach squeeze).
REST 2 MINS
3. Rear deltoids on machine three sets (or bent over shoulder fly for rear deltoids and trapezius )
REST 2 MINS
4. Lateral deltoid (lateral shoulder raise ) or side fly for shoulders.
REST 2 MINS
5. Barbell shoulder raise front (with core incorporated and stomach squeeze). 
REST 2 MINS
6. Standing overhead One arm triceps extension three sets with abs contracted.
REST 2 MINS
7. Bent over triceps extension on bench with abs contracted (single arm bent over rowing position for triceps extension )
REST 2 MINS
8. Overhead Double arm triceps extension with dumbbell.
REST 2 MINS
9. Abs - static leg raises or leg raise on bench and hold three sets ( hold more then 25 sec )
10. Bench cycling for 30 rep each set and three sets.


Day 2
Abdominals  and Core training
1. Push up three sets with abs contracted one set 15 each
2. Step up on stairs and 20 from each side.
3. Squats as to sit on chair squat with knees behind the toes while going down..
4. Push up position and mountain walk.
5. Cycling (specifically for abs)
6. Bur-pee i.e.  push up and stand and clap over head.
7. Plank mountain walk .

15 Reps in One Set.
30-45 sec rest in between sets of same exercise.
2 minutes rest in between two exercise sets.

Day 3
(Back and Biceps)
1. Pull ups three sets 10 each.
2. Lateral pull down  three sets.
3. Rowing on machine with abs contracted with breathing pattern.
4. Single arm bent over rowing three sets.
5. Pitcher curl biceps curls.
6. Incline dumbbell biceps curl three sets
7. Barbell biceps curl three sets.
8. Abs leg raises(b/l)
9. Leg press(abs)& cat/camel.

Day 4
Abdominals
1. Treadmill 20 min incline
2. Crunches with knee extended
3. leg raises (both leg together)
4. leg raises 80 degree and hold with knee extended and foot towards your face.
5. cycling clockwise n anticlockwise with knee to elbow touch

15 Reps in One Set.
30-45 sec rest in between sets of same exercise.
2 minutes rest in between two exercise sets.

Day 5
(Cardio crosstrainer+Push up)
1. Barbell incline Chest press + fly 3 sets.
2. Decline dumbbell bench press 3 sets.
3. chest press with dumbbell on flat bench three sets
4. Squats with weight on barbell
5. Lunge+squats with weights and abs contracted 3 sets.
6. Leg curls 3 sets.
7. leg press seated with weights

Day 6
Abdominals and core same as day 2
abdominals and side obliques
single arm dumbbell side bend
side leg raises
abdominals exercise change according to time duration.

For more information comment and contact..CeeKay

Saturday 29 December 2012

IPHREHAB : FUNCTIONAL TRAINING AND ISOLATED EXERCISES FOR BACK AND BICEPS

IPHREHAB

IPHREHAB : FUNCTIONAL TRAINING AND ISOLATED EXERCISES FOR BACK AND BICEPS.

Functional Training:
There are many definition for functional training but in simple sense functional training involves use of compound movement with body weight and also increment it with poundages. 
Exercises like squats with side kick , push up , mountain walk modified ,squats with shoulder press with or without weight etc. and many more help a person to train and adapt to functional training and this leads to increase in cardiopulmonary efficiency with improvement in strength and endurance.

Notes :
"Compound movement training is better then isolated joint movement training"
Compound movement means movement involving more then one joint movement.
Isolated movement means movement involving one joint .

Isolated movement Exercise program for normal population in safe environment in a normal gym set-up. 
Back and Biceps exercise in same day (as both these muscle group work together as agonist and Synergist to each other). These muscles can be trained in different time durations and days, as it depend upon condition and goal required.

REST 30-60 SECONDS REST IN BETWEEN SETS.


(Back and Biceps)(core training)
1. Pull ups OR CHIN UPs three sets 10 each.
REST 2 MINUTES
2. Lateral pull down (for lats) three sets with 15 rep .
REST 2 MINUTES
3. Rowing on machine with abs contracted and stomach sqeezed and with breathing pattern. pull and exhale and release and inhale.
REST 2 MINUTES
4. Single arm bent over rowing on bench three sets with 15 rep .
REST 2 MINUTES
5. Concentration curl biceps unilateral three sets with 15 rep
REST 2 MINUTES
6. Incline bench dumbbell biceps curl three sets with 15 rep
REST 2 MINUTES
7.Barbell biceps curl three sets with 15 rep
REST 2 MINUTES
8. Abs leg raises(b/l)
9. Leg press(abs)& cat/camel

Contact and comment for more information in functional training . ck

IPHREHAB : Functional Training for Shoulder and Triceps

IPHREHAB 

Functional Training:
There are many definition for functional training but in simple sense functional training involves use of compound movement with body weight and also increment it with poundages. 
Exercises like squats with side kick , push up , mountain walk modified ,squats with shoulder press with or without weight etc. and many more help a person to train and adapt to functional training and this leads to increase in cardiopulmonary efficiency with improvement in strength and endurance.

Notes :
"Compound movement training is better then isolated joint movement training"
Compound movement means movement involving more then one joint movement.
Isolated movement means movement involving one joint .

Isolated movement Exercise program for normal population in safe environment in a normal gym set-up. 
Shoulder and Triceps exercise in same day (as both these muscle group work together as agonist and Synergist to each other). These muscles can be trained in different time durations and days, as it depend upon condition and goal required.

REST 30-60 SECONDS REST IN BETWEEN SETS.


Day one :
(Shoulder n Triceps)(core training)
1. Treadmill on incline and try to go to maximum (i.e 10) in a gradual manner with increase in inclination of two units after 2.5 mins. (Total 15 min)
REST 2 MINUTES
2. Shoulder dumbbell press three sets standing with increase in weight and abs contracted(stomach squeeze).
REST 2 MINS
3. Rear deltoids on machine three sets (or bent over shoulder fly for rear deltoids and trapezius )
REST 2 MINS
4. Lateral deltoid (lateral shoulder raise ) or side fly for shoulders.
REST 2 MINS
5. Barbell shoulder raise front (with core incorporated and stomach squeeze). 
REST 2 MINS
6. Standing overhead One arm triceps extension three sets with abs contracted.
REST 2 MINS
7. Bent over triceps extension on bench with abs contracted (single arm bent over rowing position for triceps extension )
REST 2 MINS
8. Overhead Double arm triceps extension with dumbbell.
REST 2 MINS
9. Abs - static leg raises or leg raise on bench and hold three sets ( hold more then 25 sec )
10. Bench cycling for 30 rep each set and three sets.

Contact and comment for more information in functional training . ck

Friday 3 August 2012

IPHREHAB :TENNIS ELBOW TESTS AND EXAMINATION WITH CAUSES

IPHREHAB

TENNIS ELBOW TESTS ANS EXAMINATION WITH CAUSES

PHYSICAL EXAMINATION:
*point tenderness typically occurs over ECRB origin at the lateral epicondyle.
*tenderness may be more generalised over the common extensor wad insertion at the lateral epicondyle
*pain is often exacerbated by wrist extension against resistance with the forearm pronated
*elbow extension may be mildly limited

Mills test :
With this test, pain occurs over the lateral epicondyle when the wrist and fingers are completely flexed. This can be positive in tennis elbow case.

Maudsleys test:
The patient may feel pain on resisted extension of the middle finger at the MCP joint when the elbow is fully extended.

EVALUATION:
Note the sensory paresthesis in the superficial radial nerve distribution to rule out a radial tunnel syndrome.
Radial tunnel syndrome is the most common cause of refractory lateral pain and coexists with lateral epicondylitis in 10% of patients.

*Cervial nerve roots should be examined to rule out cervical radiculopathy .

OTHER CONDITIONS TO RULE OUT INCLUDES:
#bursitis of the bursa below the conjoined tendon,chronic irritation of the radiohumeral joint or capsule
#radiocapitellar chondromalacia or arthritis
#radial neck fracture
#panners disease
#little league elbow
#osteochondritis dissecans of the elbow

Tennis Elbow Causes 
Any repetitive motion of the wrist, including tennis, hedge clipping, excessive use of a hammer or screwdriver, painting, or any activity that requires excessive constant gripping or squeezing can cause the condition known as tennis elbow. 

IPHREHAB : TENNIS ELBOW OR LATERAL EPICONDYLITIS

IPHREHAB

What is Tennis Elbow ?
Tennis elbow is an injury to the muscles and tendons on the outside (lateral aspect) of the elbow that results from overuse or repetitive stress. The narrowing of the muscle bellies of the forearm as they merge into the tendons create highly focused stress where they insert into the bone of the elbow. If one hyper extends an elbow in any sport, this may be classified as tennis elbow. Anyone who does a lot of work involving lifting at the elbow or repetitive movements at the wrist is susceptible to tennis elbow. The medical term is lateral epicondylitis. 


TENNIS ELBOW
LATERAL  EPICONDYLITIS (TENNIS ELBOW)

Lateral Epicondylitis is defined as a pathologic condition of the wrist extensor muscles at their origin on the lateral humeral epicondyle. The tendinous origin of the extensor carpi radialis brevis (ECRB) is the area of most pathologic change.

Changes can also be found in the musculotendinous structures of the extensor carpi radialis longus,extensor carpi ulnaris and extensor digitorum communis. Overuse or repetitive trauma in this area causes fibrosis and microtears in involved tissues.

Nirschl referred to the microtears and the vascular ingrowth of the involved tissues as angiofibroblastic hyperplasia. Degenerative process should be termed tendinosis.

Most patients with lateral epicondylitis are between the ages of 30 and 55 years and many have poorly conditioned muscles. 95% of tennis elbow occurs in non-tennis players. 10 to 15 % of regular tennis players experience tennis elbow symptoms of varying degree in their tennis lives.
 The most common cause in tennis players is a "late" mechanically poor backhand that places excess force across the extensor wad i.e. the elbow "leads" the arm.

Other contributing factors includes-
1. incorrect  grip size
2. string  tension
3. poor  racquet "dampening"
4. underlying  weak muscles of the shoulder,elbow,and arm

Tennis grips that are too small often exacerbate or cause tennis elbow.
History of repetitive flexion-extension or pronation-supination activity and overuse is obtained.

Causes of lateral epiconylitis:
#Tightly gripping a heavy briefcase is a very common cause.
#raking leaves
#baseball
#golfing
#gardening
#bowling 

Wednesday 1 August 2012

IPHREHAB :NPTE BOOKS TO PREPARE

IPHREHAB

Complete Names of books Needed For NPTE

Important Books:
Sullivan guide
Blue Book
Kisner
Magee
Red guide
kendall
Norkins

Joint structure and function- by pamela k. levangie and cynthia c. norkins.(biomechanics book)(reference book)
Physical Therapy board review by michael dunway(practice question book)
NPTE review and study guide by o'sullivan and siegelman.(main book for NPTE .also called red guide)
Physical Rehabilitation Assessment and treatment by o'sullivan Schmitz(reference book)
orthopedic Physical assessment by David J. Magee (vvvvvvvv imp for special tests pictures and xray pics)
Blue book U can only get after taking 2 days course from www.therapyed.com or old from from some student.(take latest 4.0 version)
Muscle testing and function by ~ Florence Peterson Kendall (Author), Elizabeth Kendall mccreary(read the compensatory movements)
PTEXAM, Physical Therapist: The Complete Study Guide (Paperback) by Scott M. GIles.

Exams needed to be solved:
Peat 200 questions : This is the closest to NPTE
Micheal Dunaway 400 Ques
Sullivan guide 600 Ques
Blue book 200 Ques
Therapyed online Exam 200 Ques
Scott and Gills 800 Ques

IPHREHAB: NPTE TIPS FOR PTs

IPHREHAB

NPTE-Tips
Here are the few things that you need to know before appearing for NPTE:

What ever u read ,try to understand each and every word together with cramming it.
Do not put much time in reading whole of kisner and Magee.

The Special tests in maggee are very important but just concentrate on the ones given in RG. Special tests based questions are usually photo based.Focus on RG tests but see the pictures from magee.RG is the "mool mantra" to clear NPTE.If u are really thorough with it u can crack the exam easily.

The red sullivan is good for some reading...Read all PNF techniques thoroughly.
I wud like to mention one important thing as far as ANATOMY is concerned.Please don't go about reading all the origin insertion .....u r just expected to know the rough idea form which bone to where ,,,and nerve courses general idea.the nerve supply is EXTREMELY IMPORTANT!For this BB and RG charts are too good.

Blood supply is important,nerve supply Very imp and also the dermatomes n myotomes extremely imp.The blue book Charts are awesome.learn each and every word of it.Don't feel surprised if half of ur test is based on these!!

Biomechanics..I just did it frm RG n BB.Focus on Knee and shoulder joint.Examiner's fav!
Kisner....Basically concentrate on pictures of Joint mobilisation and Postures
UVR ,SWD,IR,LASER.... r omitted! Focus on currents.
All condts in RG n BB are imp for all the systems.Focus on other systems in BB.
Pharma from BB is IMPORTANT.

Don't refer to any other books for pathology n dermatology!Focus on wounds

Kendall...Do the ankle, knee n hip compensatory motions tables.Extremellllllllly Important!Pay spl attention.
KNEE....MOST FAVORITE TOPIC FOR EXAMINERS!
GAIT.....EVEN MORE FAVOURITE!!! Do all the tables in RG n BB
. really piss u off with this topic.I suggest to go thru this topic DAILY , learn them thoroughly each day of ur prep together with compensatory motions.BB Charts and RG charts are like " life line" for Gait questions.
-----------------------
X-rays: Study thru maggee pics ...don't focus much on it!
ECG:i think RG is good for this..Questions usually have ECG strips so my notes will help u.
Wheelchair,prosthetics,orthotics very imp.Learn daily,
Postures:Be good in this!

Study plan for NPTE
1st and 2 nd week:
Review guide(RG) and blue book (BB) reading
complete reading both these books by end of the 2 weeks or 3 weeks. Mark the Important stuff ,payspecial attention to the tables
Sunday: On the sunday of the 2nd week , take the 1 st practise test of the BB.
( do not take tension for getting a low score,ur just takin the test as a practise so that u understand the nature of the questns that are asked in the exam)PLEASE spend time in analyising your weak areas.Please!!!
3rd week: Again read RG AND BB but this time lil more in detail, (pay attention to values,tests,nerve supply etc etc)
Sunday: again take the test of RG( 3rd sunday)
4th week RG N BB reading( being thorough with .... tables ,nerves ,muscles actions,MMT , pay attention to small details) .
Sunday : take another test --3rd test
5th week : RG AND BB revision
sunday: The RG TEST
6th week and 7th week : Focus on your week areas and take other tests.
Happy preperations!

AND REGARDING WHAT I STUDIED FOR THE EXAM,
Don't be upset if u are not good in research.I just studied red guide and blue book..I did likliehood ratio from internet.do read the chart of values(u will get online).
FROM REDBOOK READ CERTAIN TOPICS LIKE SPINAL CORD INJURIES,ORTHOTICS,PROSTHETICS AND WHEEL CHAIR.
REVIEW GUIDE AND BLUE BOOK: Do EACH QUESTION PAPER as many times as u can, this will help you TO ANALYSE THE QUESTIONS VERY FAST IN THE MAIN EXAM.I did the same. Please read all the charts of bb ans rg daily.daily means daily.They are vvvvvvvvvvv imp for exam.

IPHREHAB : NPTE FOR PTs IN USA

IPHREHAB

If you are a Foreign PT (physiotherapist) seeking career in USA
Here is the process of starting your career as a physical therapist in USA:


1. Just sit quietly and give yourself sometime and think which STATE you are planning to work in as a PT.


2. Decided? Now let's move ahead.


3. Apply to one of the Credential evaluation agencies to find out if your education is equivalent to USA entry level education.


You can apply to one of these agencies depending upon the state you are interested in:-
a) www.fccpt.org
b) www.cgfns.org
c) www.ierf.org


FCCPT COVERS THE MAXIMUM NUMBER OF JURISDICTIONS.SO FOR LONG TERM APPLYING WITH THIS AGENCY IS BENEFICIAL.LIKE IF IN FUTURE YOU WANT TO APPLY FOR SOME OTHER STATE'S EVALUATION,THERE IS NO NEED OF REQUESTING YOUR DOCUMENTS AGAIN FROM YOUR ACADEMIC INSTITUTION, AS FCCPT KEEPS YOUR PAPERS WITH THEM FOR A LONG TIME.
IERF DOES NOT HAVE VISA SCREENING SERVICE SO THOSE WHO NEED WORK PERMIT OR H1, ITS BETTER TO GO FOR CGNFS OR FCCPT.


4) Credential evaluation can take a long time upto 6-7 months .All depends on the agency you choose and the time your academic institutions take to send over your documents to USA.(better use fedex account ) 


5)while you have applied for educational evaluation,don't waste time:- you have three choices:-


i) If u need H1,better start preparing for "TOEFL".And get done with it.The score requirements differ with states so better check with agencies not with state boards because TOEFL is required only for Visa Screening not for PT license.


ii) Few country PT always get some deficiency in general credits like INDIA.(i know this because I am an Indian).So giving few Clep exams won't hurt.i did the same.this will save time in future.Don't go for lab courses as you don't know which compulsory lab course will u get.So better opt for English.Science etc.


iii) Read the reference books for NPTE as u won't get time for them later.I mentioned in my earlier post regarding the reference books.


6) If u do not have a social security number u have to apply for a alternate identification number(AIN) which will b required when u register for the NPTE.This can be applied here:-
http://www.fsbpt.org/download/AINApp_20090105.pdf

7) Apply to required state board of education.And fill their application for PT License.
u can send them application even now as u apply to one of the agencies (fccpt,ierf,cgfns).they will again open a file for u and keep and as soon as they receive doc or report from the agency ,they will give you a green signal to appear for NPTE.this 7th step can differ a bit depending upon the state.


8) After TOEFL, start preparing for NPTE so that as soon as evaluation is complete and state board sends u approval letter ,u can apply to fsbpt for a ATT(approval to test).This will give a 2 months eligibility period starting frm around the date u apply,so apply for att only once sure of giving the exam within coming 2 months.
Also after this 2 months eligibility period u have to agian apply for another Att n pay the fees again.The site is www.fsbpt.org


5) Once Att letter is in ur hand register for a date with prometric.they have centres all around.u can choose which suits u according to the available day and date.And all the best for the exam.


So thats all ...the process looks very lengthy n confusing but dont worry...just apply for credential evaluation for now..the rest will take no time. In fact a few will be done while waiting for evaluation to be complete.
Have patience !


Hope this helps......

Tuesday 31 July 2012

IPHREHAB : Childhood Hip Problems

IPHREHAB



Childhood Hip Problems:


Developmental Dysplasia
When the hips are dislocated or out of position in infancy, the joint may not develop properly. While this is not usually painful as a child, it will lead to early arthritis and problems with walking.


Legg-Calve-Perthes Disease
Also called Perthes disease, this is a problem similar to osteonecrosis (see above) but in childhood. If severe, it can lead to permanent damage to this hip joint and early arthritis.


When do you need to call your doctor about your hip pain?
If you are unsure of the cause of your symptoms, or if you do not know the specific treatment recommendations for your condition, you should seek medical attention. Treatment of hip pain must be directed at the specific cause of your problem. Some signs that you should be seen by a doctor include:

  • Inability to walk comfortably on the affected side
  • Injury that causes deformity around the joint
  • Hip pain that occurs at night or while resting
  • Hip pain that persists beyond a few days
  • Inability to bend the hip
  • Swelling of the hip or the thigh area
  • Signs of an infection, including fever, redness, warmth
  • Any other unusual symptoms



What are the best treatments for hip pain?
Treatment depends entirely on the cause of the problem. Therefore, it is of utmost importance that you understand the cause of your symptoms before embarking on a treatment program. If you are unsure of your diagnosis, or the severity of your condition, you should seek medical advice before beginning any treatment plan.


Some common treatments for hip pain are listed here. Not all of these treatments are appropriate for every condition, but they may be helpful in your situation.


Rest: The first treatment for most conditions that cause hip pain is to rest the joint, and allow the acute inflammation to subside. Often this is the only step needed to relieve hip pain. If the symptoms are severe, crutches or a cane may be helpful as well.


Ice and Heat Application: Ice packs and heat pads are among the most commonly used treatments for inflammation. So which one is the right one to use, ice or heat? And how long should the ice or heat treatments last? Read on for more information about ice and heat treatment.


Stretching: Stretching the muscles and tendons that surround the joint can help with some causes of hip pain. A good routine should be established, and following some specific suggestions will help you on your way.


Physical Therapy: Physical therapy is an important aspect of treatment of almost all orthopedic conditions. Physical therapists use different modalities to increase strength, regain mobility, and help return patients to their pre-injury level of activity.


Anti-Inflammatory Medication: Nonsteroidal anti-inflammatory medications, commonly referred to as NSAIDs, are some of the most frequently prescribed medications, especially for patients with hip pain caused by problems such as arthritis, bursitis, and tendonitis.


Treatment Basics

  • Physical Therapy
  • Ice and Heat Treatment
  • Stretching Out

Treatment Medications
Anti-Inflammatory Medications


Hip Pain Evaluation
Find A Doctor

IPHREHAB : HIP PAIN..

IPHREHAB Hip pain is common problem, and it can be confusing because there are many causes. It is important to make an accurate diagnosis of the cause of your symptoms so that appropriate treatment can be directed at the underlying problem. If you have hip pain, some common causes include: Arthritis 

Arthritis is among the most frequent causes of hip pain, and there are many treatments available. If conservative treatments fail, hip replacement surgery is an option.

 Trochanteric Bursitis Trochanteric bursitis is an extremely common problem that causes inflammation of the bursa over the outside of the hip joint. 

 Tendonitis Tendonitis can occur in any of the tendons that surround the hip joint. The most frequently encountered tendonitis around the hip is iliotibial band (IT band) tendonitis. 

 Osteonecrosis Osteonecrosis is a condition that occurs when blood flow to an area of bone is restricted. If an inadequate amount of blood flow reaches the bone, the cells will die and the bone may collapse. One of the most common places for osteonecrosis to occur is in the hip joint. 

 Lumbar Pain - Referred Symptoms Many back and spine problems can cause symptoms around the buttocks and hip. The most common problems that refer pain to the hip region are herniated discs and sciatica. 

 Snapping Hip Syndrome Snapping hip syndrome is a word used to describe three distinct hip problems. The first is when the IT band snaps over the outside of the thigh. The second occurs when the deep hip flexor snaps over the front of the hip joint. 
Finally, tears of the cartilage, or labrum, around the hip socket can cause a snapping sensation. 

 Muscle Strains Strains of the muscles around the hip and pelvis can cause pain and spasm. The most common strains are groin pulls and hamstring strains. 

 Hip Fracture Hip fractures are most common in elderly patients with osteoporosis. Treatment of broken hips requires surgery to either replace the broken portion or repair it with a metal plate and screws. 

 Stress Fracture Stress fractures of the hip are most common in athletes who participate in high-impact sports, such as long distance runners. Treatment usually is successful by avoiding the impact activities.

Monday 28 May 2012

IPHREHAB :OCCUPATIONAL THERAPIST ASSESSMENT AND INTERVENTION FOR MOTOR LEARNING

IPHREHAB

Assessment
  • OCCUPATIONAL THERAPIST Assessment includes:
  1. Dynamic evaluation, watching client during occupational performance, including responses to cues.
  2. Collaboration with client to determine occupational problems and priorities.
  3. Evaluation of person, task, & context, to determine appropriate OT interventions.
Assessment
  • OT evaluations may incorporate manual muscle tests, range of motion, strength & endurance tests, which directly relate to problems with specific task performance.
  • Sensory & perceptual evaluations stem from client-identified problems with those aspects of task performance.
  • Cognitive evaluations may further clarify difficulties with awareness, goal identification, motor planning, and generalization of learning.
INTERVENTION
  • Client-centered role/task selection
  • Discussion of OT assessment results
  • Collaboration which includes therapeutic use of self in determining and/or raising level of client self-awareness
  • Imparting information on current evidence with regard to a choice of approaches
  • Practice of needed skills in natural settings
Motor Learning Interventions
  • Prevention of injury/dysfunction through splinting, positioning, educating, & sensitization to relevant environmental cues.
  • Promoting function through individualized task problem-solving & collaborative experimentation about the best way to accomplish the task.
  • Practicing whole tasks, not isolated parts.
  • Providing skill practice in varied contexts during daily routines.
  • Providing randomized practice (changing parameters or circumstances).
  • Providing intermittent feedback during task performance or summarized at end.
  • Encouraging self-evaluation & error detection (both KP & KR).
Interventions
  • Modify task demand in order to achieve task goal (use e-mail instead of telephone to communicate with others; use alarm to remember next step).
  • Modify contextual factors in order to achieve task goal (use bolsters to position for active movement in playing a game).
Intervention: Constraint-Induced Movement Therapy
  • Contemporary variation of task-focused approach for stroke survivors (1 year post-stroke).
  • Consists of “constraining” nonaffected arm, forcing use of affected limb for performing daily tasks. 
  • In 2-week experiment, “constrained” group showed significantly greater motor skills, carry over to life tasks, and maintenance of gains in 2-year follow-up.
  • Original study replicated (Blanton & Wolf, 1999) shows that 20% to 25% of clients with chronic stroke symptoms may benefit from this approach.
Please make your own copy of article. Focus on distinctions made between traditional & contemporary OT approaches. 

IPHREHAB : MOTOR LEARNING , FUNCTION AND DYSFUNCTION AND CHANGE WITH MOTIVATION

IPHREHAB


FUNCTION & DYSFUNCTION
  • Gentile (1992): early & late stages of learning
  • Fitts & Posner (1967):
  1. Cognitive stage of motor learning (understanding of task, experimentation)
  2. Associative stage: refined practice
  3. Autonomous stage: skill relatively automatic
  4. Example: child learning to climb stairs
Function 
  • Degrees of freedom: refers to gradual increase in smoothness of performance of skilled movement. Example: using a hammer.
  • Specific definitions for function & dysfunction have not been defined in occupational therapy (Kaplan & Bedell, 1999). 
  • Definition of dysfunction in OT must include all three components: person, environment, & occupation.
CHANGE & MOTIVATION
  • Holistic approach: OT ALWAYS incorporates practice of perception and movement within the context of SPECIFIC TASKS. 
  • Client centered: Motivation comes naturally when clients and/or families set priorities for tasks to be accomplished & goals to be achieved. 
  • Systems approach begins with role performance, considering the best combination of remediation, adaptation, & compensation in order to promote client-identified level of functioning to fulfill desired roles.
Change
  • Change occurs through learning process.
  • Recovery may be:
  1. Spontaneous, without benefit of intervention
  2. Forced recovery, function gained through therapeutic intervention, such as – example?
  3. Adapted or functional recovery, attained through altering methods or contexts within which client accomplishes a task
Postulates of Change, cont.
  • Defined in Pediatrics by Kaplan & Bedell. Motor skills more likely to improve when:
  1. Match between child’s ability, task, & context.
  2. Child understands expectation & receives clear guidance
  3. Independent problem-solving encouraged
  4. Just right challenge (zone of proximal development).

IPHREHAB : MOTOR LEARNING WITH Learning Theory and Behavior modification

IPHREHAB


Learning Theory (Behavior Modification)
Non-Associative Learning:
  • Habituation: desensitization that results from repeated exposure to a nonpainful stimulus (e.g., Ignore stimuli that trigger nonfunctional responses)
  • Sensitization: increased responsiveness (e.g., Pay attention to safety features, such as water on the floor, or obstacles in one’s path)
Learning
  1. Associative Learning:
  • Classical & operant conditioning (considers past and current environmental influences)
  • Procedural learning: performed without conscious attention (develops slowly through many repetitions to become habitual, stored in brain as “movement schema”) (e.g., walking)
  • Declarative learning: results in knowledge that can be consciously recalled, requiring awareness, attention, and reflection (e.g., words)
Learning
  • Variable practice, using motor/perceptual skills under varying conditions, works best for generalization of learning
  • Contextual interference, using motor perceptual skills in random order, increases spontaneous use for new tasks
  • Individual characteristics, such as level or experience & intellectual ability influences motor learning
  • Transfer of learning occurs more easily when tasks are similar (Toglia – near transfers)
Learning
  • Schmidt’s “schema theory” uses sets of general rules that apply in variety of contexts
  • Schema: a generalized motor program that consists of 4 parts:
  1. Initial situation
  2. Parameters used
  3. Outcome (knowledge of result)
  4. Sensory consequence (how movement feels)
  • Example: swinging a golf club or donning a coat
Learning
  • Newell’s Ecological Theory clarifies the role of perceptions in motor learning.
  1. Recognition of goal or task
  2. Regulatory cues (sensitize to what is relevant to the task)
  3. Knowledge of Performance (KP): feedback during performance, how movement felt
  4. Knowledge of Result (KR): feedback on goal achievement

IPHREHAB : MOTOR LEARNING FROM PAST TO PRESENT

IPHREHAB

 MOTOR LEARNING FROM PAST TO PRESENT

  • Aim is to replaces Motor Control (NDT, etc.) as a more evidence-based approach to all forms of movement disorders across the lifespan (CP, TBI, CVA, etc.)
  • Backdrop for Task Oriented approach defined by Horak (1991), Shumway-Cook & Woolacott (2001) and Mathiowetz, Bass Haugen & Flinn (in Trombly & Radomsky, 2002). 


Basic Assumptions

Motor Control – It is the ability to regulate and/or direct the mechanisms essential to movement (Shumway-Cook & Woolacott, 2001). AKA “neuromaturational” or “hierarchical” or “bottom up” theories of re-acquisition of voluntary movement.

Motor learning – Set of processes associated with practice or experience leading to relatively permanent changes in the capacity for producing skilled action (Shumway-Cook & Woollacott, 2001). Combines neuroscience with  systems & learning theory.

Assumptions, cont.
  • Based in principle of neural plasticity – the ability of the nervous system to modify neural connections to perform more efficiently.
  • Short term (working memory) – needed for learning new movements 
  • Long term (save/retrieve) – needed for lasting change
  • Motor learning occurs naturally during task performance (supports a task focused approach)
Systems Theory
  1. Systems approach includes a consideration of :
  • Client factors: health condition, dysfunction or damage, age, gender, etc.
  • Occupations: meaningful or preferred tasks
  • Environment: all relevant contexts.
  1. Systems include sensorimotor, psychosocial, cognitive, and performance contexts (physical, socioeconomic & cultural characteristics of the task itself and the broader environment) (Mathiowetz & Bass Haugen, 1994).
  2. Consistent with occupation-based models


Monday 19 March 2012

IPHREHAB: Can Creatine be termed as a Steroid?

IPHREHAB

Can Creatine be termed as a Steroid?

Creatine is a nitrogenous organic acid occurring naturally in all vertebrates. Creatine helps to supply energy to muscle and nerve cells. The body manufactures, stores and uses creatine for pursuits which require bursts of energy – like running at a high speed. Unfortunately creatine reserves within the body can only supply energy from creatine for a very short period of time.

Creatine has quite often been likened to anabolic steroids, because it provides the user with higher amounts of energy and increases lean muscle mass. But nothing could be further from the truth. Though both anabolic steroids and creatine enhance performance, and both are ingested as sports supplements, the basic difference lies in the chemical structure of the two. Anabolic steroids like testosterone are hormones, while creatine is a protein available in the body.

Chemical Structure of Creatine Mono hydrate

 
When this is compared to testosterone – one of the most popular anabolic steroids, distinct differences can be found.

 
From the structures it is apparent that the linear bonded creatine is different from the helical testosterone. 

Steroids are of two varieties – anabolic steroids promote generation of new cells and promote growth. Androgynous steroids are responsible for exerting masculine features in the body, like growth of facial hair and deepening of the voice. Most steroids however have both anabolic and androgynous capabilities. For example testosterone promotes growth and masculine features in males. This is vastly different from the effects of creatine, which in essence, increases ones energy to perform. Thus, a bodybuilder on creatine becomes capable of running an extra mile, or lifting extra weight due to the excess energy within his body. This in turn, helps him develop his body quicker. Creatine also has an effect of absorbing water, which increases the water mass of muscles.

Creatine can be classified as a dietary health supplement, as one can consume, theoretically, enough creatine rich food – like red meat, to substitute supplementation. This cannot be done in the case of steroids, which are released within the human body by specific glands, at specific ages and in specific quantities. To amplify the effects of steroids, they have to be ingested through supplements.

Creatine can be said to be closer to vitamins than steroids or hormones. Since creatine is an amino acid(as can be understood from its structure) it is similar to glutamine, and arginine – both used to enhance performance. Creatine supporters have even claimed that taking creatine is not any more unnatural than taking a multivitamin.

Creatine may not be as harmful for the body as steroids are, but studies on the effect of creatine on the body are limited. According to independent reports, organizations like the WTA, ITF, NBA and FIFA are seeking to ban the use of creatine among their athletes. The International Olympic Committee does not specifically ban creatine but it does ban the use of ergogenic acids. Creatine falls under this group due to its performance enhancing capacities.

Thus, a consultation with a physician is imperative before taking creatine, to verify dosage and length of time one should use creatine.

IPHREHAB :How is Creatine Different from Steroids?

IPHREHAB
How is Creatine Different from Steroids?


QUESTION:
16-year-old boy is really into sports. He's on the football team and baseball team, and he spends a lot of time working out and lifting weights with his friends. Recently, he started taking creatine to build muscle and improve his performance. I was alarmed when I found out, but he assures me that creatine is natural and safe. Is this true? What's the difference between creatine and steroids?

Performance-enhancing supplements like creatine, which is sold over-the-counter, are gaining fast popularity among middle school and high school students, even though they are not recommended for children under 18. In a recently study by the American Academy of Pediatrics, 44 percent of high school seniors admitted using creatine. Creatine is a naturally occurring substance that is found in low doses in foods. Proponents say it can safely add muscle and improve strength and endurance, but there is serious concern among doctors about the possible long-term effects of taking it in high doses. Furthermore, because creatine is marketed as a supplement, it isn't held to the strict standards of the Food and Drug Administration. It is also, like steroids, banned from athletic organizations like the NFL, NCAA, and the International Olympic Committee.

Anabolic steroids are also used by athletes to enhance performance, but these are extremely powerful and dangerous drugs that help to build muscle tissue by acting like the male hormone testosterone. Relying on anabolic steroids to improve athletic ability is not only illegal, it can be extremely harmful, especially for teenagers. Steroids can have an extreme effect on stunting growth.

 Other side effects include:
• Severe acne
• Baldness
• Sleep problems
• Headaches
• Nausea and vomiting
• Diarrhea
• High blood pressure, heart disease and strokes
• Liver damage
• Aggressive, violent behavior
• Severe mood swings (also depression and anxiety attacks)
• Hallucinations and paranoia

Additionally, steroids cause males to produce less of their own testosterone, which can result in impotence, gynecomastia (increased breast size) and reduced sperm count. In females, steroids can lead to reduced breast size, deeper voice, increased facial and body hair, and menstrual problems.

Remember, athletic ability depends on more than just muscle mass. Genetics, age, diet, training, dedication, and perserverance all play a part in how a young adult plays sports. Using steroids or supplements is not only cheating, it can cause numerous health problems. Until safety can be established, I would discourage your son from taking creatine.

IPHREHAB: Dengue Fever Remedy

IPHREHAB

Dengue Fever Remedy

I would like to share this interesting discovery from a classmate's son who has just recovered from dengue fever. Apparently, his son was in the critical stage at the ICU when his blood platelet count drops to 15 after 15 liters of blood transfusion.

His father was so worried that he seeks another friend's recommendation and his son was saved. He confessed to me that he gave his son raw juice of the papaya leaves. From a platelet count of 45 after 20 liters of blood transfusion, and after drinking the raw papaya leaf juice, his platelet count jumps instantly to 135.
 Even the doctors and nurses were surprised. After the second day he was discharged. So he asked me to pass this good news around.
Accordingly it is raw papaya leaves, 2pcs just cleaned and pound and squeeze with filter cloth. You will only get one tablespoon per leaf.. So two tablespoon per serving once a day. Do not boil or cook or rinse with hot water, it will lose its strength.
 Only the leafy part and no stem or sap. It is very bitter and you have to swallow it like "Won Low Kat". But it works.

*Papaya Juice - Cure for Dengue*
You may have heard this elsewhere but if not I am glad to inform you that papaya juice is a natural cure for dengue fever. As dengue fever is rampant now, I think it's good to share this with all.

A friend of mine had dengue last year.. It was a very serious situation for her as her platelet count had dropped to 28,000 after 3 days in hospital and water has started to fill up her lung. She had difficulty in breathing. 
She was only 32-year old. Doctor says there's no cure for dengue. We just have to wait for her body immune system to build up resistance against dengue and fight its own battle. She already had 2 blood transfusion and all of us were praying very hard as her platelet continued to drop since the first day she was admitted.

Fortunately her mother-in-law heard that papaya juice would help to reduce the fever and got some papaya leaves, pounded them and squeeze the juice out for her. The next day, her platelet count started to increase, her fever subside. 
We continued to feed her with papaya juice and she recovered after 3 days!!!

Amazing but it's true. It's believed one's body would be overheated when one is down with dengue and that also caused the patient to have fever papaya juice has cooling effect. Thus, it helps to reduce the level of heat in one's body, thus the fever will go away.
 I found that it's also good when one is having sore throat or suffering from heat.

Please spread the news about this as lately there are many dengue cases. It's great if such natural cure could help to ease the sufferings of dengue patients.

Furthermore it's so easily available.
Blend them and squeeze the juice! It's simple and miraculously effective!!