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Postural orthostatic Tachycardia Syndrome (POTS): Needs Rehabilitation Therapy

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Postural orthostatic tachycardia syndrome (POTS) is the most common of several kinds of dysautonomia, characterized by dysfunction of the autonomic nervous system showing with signs of orthostatic intolerance with or without related orthostatic hypotension and extreme autonomic excitation. Along with musculoskeletal signs of POTS and its known associations with other clinical entities like Ehlers-Danlos syndrome, POTS constitute an unusual treatment challenge of which the orthopaedic surgeon, Physiatrist and other associated healthcare providers should be aware.
Symptoms: Cardiac symptoms: ·rapid palpitations ·lightheadedness ·chest discomfort ·dyspnea
Non-cardiac symptoms: ·brain fog ·headache ·nausea ·tremulousness ·blurred or tunnelled vision ·poor sleep ·exercise intolerance ·fatigue

Defining Future Scope of Physical Medicine and Rehabilitation

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To identify the 'physiatry' in a single word is tough. This may be due that physiatry originated from two different fields, physical medicine and rehabilitation and emphases on assisting the general improvement of functional recovery in disabled patients. In addition, physiatry has new fields to develop; health and welfare. Therefore, the individuality of physiatry will change depending on how physiatrists act in these fields.
To endorse the progress of physiatry, physiatrists should apply their efforts in several directions. First, physiatrists must make efforts to treat the impairment itself in addition to use classical compensatory methods. Earlier, it was thought that the adult central nervous system was fixed and could not be repaired. Recently, growth of functional imaging techniques revealed that the adult central nervous system can get well from injury through neuroplasticity, and that this recovery can bring functional improvement. Because this recovery through neurop…

Treatments and Procedures Physiatrists Perform

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Especially in the inpatient setting, physiatrists provide general medical treatment like internal medicine to maintain medical stability and provide secondary prevention of disability. Physiatrists do not do operation yet have many procedural opportunities for diagnosis and treatment. Many of these procedures may require fellowship or innovative training to perform. These PM&R treatment procedures include:
EMG (electromyography): Introducing fine needle electrodes in muscles and observing the noted motor unit potentials when the muscles are activated to help distinguish whether weakness is due to muscle or nerve dysfunction (i.e., myopathy vs. neuropathy).
NCS (nerve conduction studies): Usage of electrodes to record motor and sensory responses that are propagated by electrical stimuli. This treatment can help distinguish the location of a nervous system lesion (radiculopathy, peripheral neuropathy, motor neuron disease, or neuromuscular junction).
Peripheral joint injections: Inject…

Recent Advances in Rehabilitation

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In Many countries, 13-14% of the population have some degree of disability. The demand for rehabilitation services will rise as evidence accrues for their usefulness and as more people survive longer with substantial disability. Recent evidence strongly supports the provision of well organized, coordinated, multidisciplinary rehabilitation services based on a problem-oriented method. In the future, specific interventions will be more evidence-based, leading to the more appropriate use of interventions and more appropriate referrals to professional facilities.
Rehabilitation has recently seen many practical inventions and new evidence for specific interventions, but the major advances in rehabilitation are theoretical rather than practical. Firstly, the approach to patients has moved from a mainly medical one to one in which psychological and sociocultural aspects are equally important. Secondly, the need for organized professional rehabilitation services—for example, for neurological d…

Current Trends in Rehabilitation

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The rehab equipment industry has changed extremely in the last few years. Some tools have gained popularity, others are on the failure and the market is filled with new products designed to improve patient care and make Physical therapists’ lives easier.
Many of these changes have been driven by altering reimbursement structures as clinic directors have had to adjust their practices to stay profitable. Still, other new developments have more to do with aging patient populations, the convenience of better technologies and parallel changes in surgical practices.
1. Water-Based Therapy
Water therapy is on the rise, particularly among elderly people and osteoarthritis patients. Water provides both buoyancy and resistance, a combination that may benefit people whose joints are too repressed or painful for land-based, full range of motion exercises.
Specifically, aquatic exercise is beneficial for patients who suffer from both knee and hip osteoarthritis, and that it may help them transition to…

Iliotibial band syndrome – Symptoms and Diagnosis

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Persons who exercise frequently, particularly runners, are prone to experience pain in the outer part of the knee. When this happens, iliotibial band syndrome may be the cause. Iliotibial (IT) band syndrome is frequently caused by repeatedly bending the knee during physical activities, such as running, cycling, swimming, and climbing.
The IT band is a group of fibers that run the length of the upper leg, from the hip to the top of the shin.
When overused, the IT band can become stiffened. The constriction can cause the band to rub against the outside of the knee. The brass rubbing can lead to pain and swelling.
IT band syndrome may begin as minor pain and increase if left untreated. The best treatment is often to stop doing the action that is producing the pain. In more severe cases, operating options may need to be considered.
Symptoms: Symptoms of IT band syndrome may vary a little from individual to individual in intensity and how they appear. Some symptoms include: ·pain when running or d…

Secretion Removal Techniques in People with Spinal Cord Injury through Physiotherapy

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Respiratory complications are a leading cause of injury and mortality in people with spinal cord injury (SCI) and are more pronounced in individuals with higher level and complete injuries. A major contributor to respiratory illness in individuals with SCI is secretion retention, particularly among individuals with cervical lesions. Higher levels of SCI result in greater denervation of the ventilatory muscles thereby decreasing both inspiratory capacity and expiratory muscle force and resulting in an impaired cough. The figure shows the innervation of the respiratory muscles. Cervical SCI also denervates sympathetic pathways leading to a state of parasympathetic dominance that may increase mucus production and contribute to airway hyper responsiveness. A diminishing cough combined with mucus hyper secretion can overwhelm mucociliary clearance in people with SCI.
The impact of SCI on normal airway clearance can be exemplified by examining the sequence of a cough. After full inspiration …