Musculoskelatal physiotherapy

Musculoskelatal physiotherapy (MP) is a non-invasive intervention which uses therapeutic movement to help overcome problems with everyday movements that are predominantly a consequence of pain. MP is an interesting choicegiven that the pain of tissue insult galvanises the neuromuscular system into preventing or inhibiting movement in the interests of undisturbed repair. (For a variety of well-known reasons this situation may persist beyond the period presumed necessary for primary repair.) In order to overcome such a barrier successfully, movements administered or prescribed by MP must not only fail to increase pain; ideally they should be pain free and perhaps directly capable of diminishing that which is already present. Together, this implies that the neurological mechanism(s) underlying the clinical efficacy of MP is, at least in part, some type of 'desensitisation' or inhibitory process. Three distinct movement-mediated inhibitory mechanisms for achieving this effect are proposed. Several lines of evidence now endorse (passive) movement-evoked arousal of descending pain inhibitory systems. Though temporary, the respite afforded via this mechanism could be put to functionally significant use by resourceful clinicians. A rather more durable desensitising mechanism is likely to occur with what is known as 'habituation'. Usually described in terms of (non-associative) learning theory, habituation is effectively a potentially lingering type of 'activity-dependent' presynaptic inhibition. Finally, and still in the area of learning theory, the 'robust' extinction of aversive memories would constitute a potent and lingering type of neural inhibitory mechanism for non-painful therapeutic movement. Behavioural and synaptic molecular mechanisms associated with this phenomenon are discussed along with their potential relevance to clinical MP.

More Research Needed On Preventing Hamstring Injuries

A brand new systematic review into the research of hamstring injuries has revealed that not enough is known about the effectiveness of current prevention methods for one of the most common sports injuries.

The review by physiotherapist and Northumbria University graduate Elliott Goldman, 29, has revealed that only six key pieces of research on prevention methods for the injury have been published internationally - despite hamstring injuries blighting the careers of some of the world's top footballers and having a direct impact on the bottom line of clubs worldwide.

Now Elliott is calling on physiotherapists and coaches, from the top flight sports clubs right down to grass roots level, to help prevent hamstring injuries by incorporating prevention techniques, which have been highlighted as being effective in current research, into their prevention programmes.

Physical Therapy Exercise Shown To Lower Postnatal Depression Risk In New Mothers

A physical therapy exercise and health education program is effective in improving postnatal well-being and reducing the risk for postnatal depression (PND), according to a randomized controlled trial published in the March issue of Physical Therapy, (PTJ) the scientific journal of the American Physical Therapy Association (APTA).

Postnatal depression (PND) is a major health issue affecting up to 13% of all new mothers throughout the world, with most cases beginning in the first 3 months of the postnatal period. Although its duration varies among mothers, it is thought to be determined by sociocultural factors, such as self-esteem of the mother, the childbirth experience, and the availability of support and local services.

Previous studies have shown that general exercise improves mood states in younger and older women, improves well-being, and leads to a reduction in depressive symptoms in mothers diagnosed with PND. However, no studies have evaluated the benefits of group physical therapy exercise approaches to improve psychological health outcomes of women postnatally.

Differences Between Occupational Therapy and Physical Therapy

Occupational therapy primarily focuses on evaluating and improving a persons functional abilities. An occupational therapist does not directly treat a person's injury but helps a person optimize their independence and ability to accomplish their daily activities following an injury or in situations of physical impairment. Occupational therapy has to do with improving life skills and often involves adaptive tools at times customized by the therapist. An occupational therapist will also often do on-site assessments of both the home environment and work environment and give recommendations on suitable adaptations of each to allow for a better quality of life.

Physical therapy is focused more on treating a persons injury itself and on helping to prevent injuries. The physical therapist will diagnose and treat the physical source of the problem; the injured tissues and structures. A physical therapist is trained extensively on anatomy and themusculoskeletal system resulting in a physical therapist usually being more knowledgeable about musculoskeletal injuries and rehabilitation than a medical doctor.

Although the two health care professions have distinct differences in their focus there can often be some crossover between OT and PT. For example, an occupational therapist is often involved in educating people on how to prevent and avoid injuries, as well as educating people about the healing process. Physical therapists in turn often help people improve their ability to do their daily activities through education and training. While there is this crossover between professions both play very important roles and are more specialized in their areas of expertise. In many situations,health-care professionals from both fields should be involved in injury recovery.

How to Do Exercises for Stroke Victims

After a stroke, a person can suffer minimal or severe disabilities depending on the location and size of damage in the brain. Some of the serious problems can be paralysis or weakness of one side of the body, inability to stand or walk, inability to hold onto objects, difficulty understanding or speaking words, not being able to read or do simple arithmetic, feeling confused, and having bowel and bladder problems. This can be devastating both to the family and to the loved one who suffered the stroke.
The good news is that some stroke survivors can experience amazing recoveries; so it is important to start stroke rehabilitation as early as possible. A team of health professionals typically consisting of doctors, nurses, a physical therapist, an occupational therapist, a speech and language therapist, a psychologist or counselor, and a dietician will work together to help the stroke victim recover. In the hospital a rehabilitation exercise program is started early, as soon as the stroke victim is medically stable.
A professional physical therapist evaluates the patient for range of motion, strength on the affected and unaffected side, bed mobility, transfers from bed to wheelchair, balance, and gait (walking). After the evaluation, the physical therapist plans an individualized exercise program that will fit the patient. The goals will be to increase range of motion, strength, balance, and independent walking with or without assistive device (e.g., cane or walker).

Stroke Survivors Benefit From Robot Tuition

Shaking hands with a robotic arm could be a new way to help stroke patients learn to use their arms again. Researchers writing in BioMed Central's open access Journal of NeuroEngineering and Rehabilitation report a pilot trial of the 'Braccio di Ferro' (Iron arm) robot in 10 patients.

Elena Vergaro, from the University of Genoa, Italy, worked with a team of researchers from the Italian Institute of Technology, Genoa, to develop the robotic aid. She said, "Our preliminary results from this small group of patients suggest that the scheme is robust and promotes a statistically significant improvement in performance. Future large-scale controlled clinical trials should confirm that robot-assisted physiotherapy can allow functional achievements in activities of daily life".

The researcher's robot assists patients as they attempt to guide its 'hand' in a figure-of-eight motion above a desk, pulling in the correct direction and resisting incorrect movements to a minutely controlled degree. This interactive assistance allows for alternating levels of help, encouraging patients to re-learn how to use their arms.
Vergaro said, "Stroke survivors perform arm movements in abnormal ways, for example by elevating the shoulder in order to lift the arm, or leaning forward with the torso instead of extending the elbow. Use of such incorrect patterns may limit their ability to achieve higher levels of movement ability, and may lead to repetitive use injuries.
By demonstrating the correct movements, a robot can help the motor system of the subject learn to replicate the desired trajectory by experience".

Using Magic Tricks To Treat Children With Locomotor Disabilities

It's often hard to motivate youngsters with physical disabilities. But a new approach from a Tel Aviv University researcher bridges the worlds of behavior and science to help kids with paralysis and motor dysfunction improve their physical skills and inner confidence - using a trick up her sleeve called "magic."

Dr. Dido Green of Tel Aviv University's School of Health Professionals developed an innovative yet remarkably simple series of therapeutic exercises for children and young adults based on sleight-of-hand tricks used by professional magicians. Dr. Green and her magicians used sponge balls, elastics and paper clips to teach the children how to perform the challenging, fun and engaging exercises.

She started her foundational research at the Evelina Children's Hospital funded by the Guy's and St. Thomas' Hospital Charity, Performing Arts Programme in London.

Making physical therapy fun

"Children with motor disorders like hemiplegia - or paralysis on one side of the body - perform routine exercises with their hands and wrists to be able to carry out basic functions such as opening a door, doing up their zipper, or closing buttons," explains Dr. Green, an occupational therapist with a masters degree in clinical neuroscience and a Ph.D. in psychomotor development of children. "Not only did the kids get a kick out of the magic tricks, they loved doing the exercises every day."

Dr. Green hopes to create summer "magic camps" for disabled children in both the U.K. and Israel, and will further investigate the benefits of magic for improving motor development of children with disabilities.

Her initial research, now in the process of publication in a peer-reviewed journal, looked at a sample of nine children. "We had a hunch that learning magic tricks could do wonders for kids' movement problems, but we wanted to see if the kids would actually practice them," says Dr. Green.

The children practiced ten minutes a day over four to six weeks, resulting in a significant and measurable change in motor skills. "It was a big enough effect to make us want to marry the concept of magic with more specific treatment regimes important for motor learning," says Dr. Green.

In the next part of the study, Dr. Green will bridge the worlds of behavioral therapy with science. She plans not only to give a large group of U.K. and Israeli kids intensive magic training to help improve their motor skills, but also to look into their brains to see if there is a neurological effect.