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Post-Stroke Rehabilitation with Physical Therapy

In the United States more than 700,000 people suffer a stroke each year. Approximately 2/3 of these individuals survive the cerebral vascular accident and require rehabilitation (relearn skills that are lost when part of the brain is damaged). The goals of rehabilitation are to help survivors become as independent as possible and to attain the best possible quality of life.

Physical therapists specialize in treating disabilities related to motor and sensoryInstructor And Elderly Patient Undergoing Water Therapy impairments. They are trained in all aspects of anatomy and physiology related to normal function, with an emphasis on movement.  They assess the patient’s strength, endurance, range of motion, gait abnormalities and sensory deficits to design individualized rehabilitation programs aimed at regaining control over motor functions.

Functions compromised when a specific region of the brain is damaged by stroke can sometimes be taken over by other parts of the brain. This ability to adapt and change is known as neuroplasticity. Physical therapists help the patient regain the use of stroke-impaired limbs, teach compensatory strategies to reduce the effect of remaining deficits and establish ongoing exercise programs to help people retain their newly learned skills. The repetitive use of impaired limbs encourages brain plasticity!

In general, physical therapy emphasizes practicing isolated movements, repeatedly changing from one kind of movement to another and rehearsing complex movements that require a great deal of coordination and balance. Balance retraining may consist of walking up or down stairs or moving safely between obstacles.  People too weak to bear their own weight can still practice repetitive movements during hydrotherapy (water providing a sensory stimulation and allowing for weight support) or while being partially supported by a harness.  A recent trend in physical therapy emphasizes the effectiveness of engaging in goal-directed activities, such as playing games, to promote coordination, balance and movement strategies.

If you or your loved one has had a stroke, be sure to be evaluated by a physical therapist as they can substantially help people achieve the best possible long-term outcome.

Caring for Parkinson’s Disease with Physical Therapy

Recent research findings have shown that a minority of clients with Parkinson’s do fine without any form of rehabilitation.  However, the majority of studies have shown that clients improved in their ability to do daily living activities in response to physical therapy rehabilitation.  62% of research participants who received physical therapy intervention had a successful outcome relative to 38% of the participants in the control group who had a successful outcome.  (Murphy & Tickle-Degnen, 2011).  In another research project, Tests Predict Falls in Parkinson’sPatients, published in the June 23, 2010 issue of Neurology, looked at 101 Parkinson’s patients who were able to walk without aids.  They tested for symptoms such as visual function, balance, gait, strength, reaction time and proprioception.  Those who did poorly on the balance tests, mobility tests and coordinating multi-joint movements were more prone to falls (42%).

Physiotherapist With Patient In RehabilitationPeople with minor motor system disorders to severe disorders will find that physical therapy can help with the rigidity, slow movement patterns, postural instability, impaired balance and coordination that seem to evolve along with this disease.  The physical therapist will evaluate for Functional Gait Testing, Functional Reach Testing, Timed Get Up and Go Test, Bed mobility screening and orthopedic evaluations for mobility and strength.

After the evaluation, the physical therapist may set up a specific exercise or movement lesson that uses high amplitude movements that overcome bradykinesia and hypokinesia (activating excessively slow motion).

My personal experience with Parkinson’s patients is one of inquiry, fun and resolution.  We even use dance as a means of increasing balance and coordination.  When it is a mobility problem like getting out of bed, the physical therapist will create a home program with specific exercises for your needs.  When it is a postural instability issue, we will work with balance/gait on different surfaces as well as strengthening for your back, legs, abdomen and torso.

Let the field of physical therapy evaluate and assess what we can do for you!

Caring for Multiple Sclerosis with Physical Therapy

Multiple sclerosis had been known as being the most common inflammatory demyelinating disease of the Central Nervous System (CNS). It will be good to know that there is a team of practitioners that have experience with helping you with some of its risk factors. Clinically, MS is characterized by multiple and varying signs and symptoms and be unpredictable and fluctuating periods of remissions and exacerbations. The symptoms consisting of sensory losses with visual, temperature sensitivities and paresthesias will require specific medical attention. The symptoms consisting of motor dysfunction such as weakness in the extremities, difficulty with gait, coordination or balance can be helped by the education and skills of a physical therapist.

Physiotherapist With Patient In RehabilitationA physical therapy evaluation and treatment strategy will assist in specific exercises for the weakness that develops by using functional manual skills that stimulate the central nervous system at the time of the movement pattern. They will work with gait training to evaluate for any equipment you may need for comfort and safety. They have been trained in detailed vestibular rehabilitation for balance and coordination issues that may come up during those fluctuating periods of exacerbation.

Difficulties with speech or chewing and swallowing can occur if the cranial nerves are affected. The physical therapist has been trained in helping to free nerve pathways with fascial release techniques. Any urinary frequency, urinary urgency, incontinence, retention or hesitancy can be particularly trained by a therapist who specializes in visceral manipulation (working with the organs fascia) or pelvic floor techniques for muscle retraining.

Physical TherapyFor the client with MS, treatment should take place in the coolest temperature setting possible. Physical therapy is initiated at an early stage to maintain joint range of motion within your pain tolerance and to monitor muscle strength until active exercises can be initiated. It is very important to provide you with active exercises that are at a level consistent with your muscle strength. The physical therapist can help you with all the precautions and functional movement patterns you need to know for your progression back to better health.