Neuro Rehabilitation

A spinal cord injury involves damage to any part of the spinal cord. It also can include damage to nerves at the end of the spinal cord, known as the cauda equina. The spinal cord sends and receives signals between the brain and the rest of the body. A spinal cord injury often causes permanent changes in strength, feeling and other body functions below the site of the injury.

The ability to control your arms or legs after a spinal cord injury depends on two factors. One factor is where the injury occurred on the spinal cord. The other factor is how bad the injury is.

Loss of feeling and control of movement is known as paralysis. Paralysis from a spinal cord injury can be referred to as:

Tetraplegia (Quadriplegia):

This means that your arms, hands, trunk, legs and pelvic organs are all affected by your spinal cord injury.

Paraplegia:

This paralysis affects all or part of the trunk, legs and pelvic organs but not the arms.

Importance of Physical Rehabilitation:

Spine injuries encompass a wide range of conditions, from herniated discs to fractures and spinal cord injuries. The severity of these injuries can vary greatly, but one thing remains constant: the need for comprehensive rehabilitation. Physiotherapy is an essential component of this rehabilitation process, aiming to address pain, improve mobility, and enhance the patient’s overall quality of life.

Spine injuries can be devastating, affecting not only our physical health but also our overall well-being. Whether caused by accidents, sports injuries, or degenerative conditions, these injuries can lead to chronic pain, limited mobility, and a diminished quality of life. In such cases, the role of physiotherapy in spine injury rehabilitation cannot be overstated.

The Role of Physiotherapy in Spinal Cord Rehabilitation

An evaluation with a rehabilitation professional is recommended for anyone with severe head or neck injury, pain or numbness over back, arm or leg, changes in sensation of arm and leg. The rehabilitation professional will do a thorough examination including posture, movement of spine, strength of paraspinal muscles, pain analysis, spasm and tenderness assessment. Physiotherapy plays a key role in recovery and long-term management of spinal ailments and provides a multifaceted approach including pain management, mobility restoration, prevention of secondary ailments and recovery from ailment. Some of the aspects of rehabilitation are outlined below-

1. Pain Management	2. Mobility Restoration	3. Strengthening	4. Posture Correction	5. Functional Independence

Remember, with the right support and determination, it’s possible to regain your strength, mobility, and independence after a spine injury.

Cerebral Palsy

Cerebral palsy is a group of conditions that affect movement and posture. It's caused by damage that occurs to the developing brain, most often before birth.
Symptoms appear during infancy or preschool years and vary from very mild to serious Children with cerebral palsy may have exaggerated reflexes. The arms, legs and trunk may appear floppy. Or they may have stiff muscles, known as spasticity. Symptoms also can include irregular posture, movements that can't be controlled, a walk that's not steady or some combination of these.
Cerebral palsy may make it hard to swallow. It also can cause eye muscle imbalance, in which the eyes don't focus on the same object. People with the condition might have reduced range of motion in their joints due to muscle stiffness.
The cause of cerebral palsy and its effect on function vary from person to person. Some people with cerebral palsy can walk while others need assistance. Some people have intellectual disabilities, but others do not. Epilepsy, blindness or deafness also might affect some people with cerebral palsy. The symptoms of cerebral palsy may vary during the child's development, but the condition doesn't get worse. The condition generally stays the same over time.

How does physical therapy help?

Physical therapy is often the first step in treating cerebral palsy. It can help improve motor skills and can prevent movement problems from getting worse over time. Physical therapy implements strength and flexibility exercises, heat treatment, massages and special equipment to give children with cerebral palsy more independence.
The extent to which physical therapy helps depends on the severity and type of each case of cerebral palsy. Children with milder cases of CP may only require some physical therapy to treat their condition. In more severe cases, it may be used alongside other treatments or medications. Beginning physical therapy as early as possible usually gives children the best chances at improvement.

Benefits of physical therapy for cerebral palsy

There are many benefits of physical therapy, from improving mobility to preventing future issues such as contractures and joint dislocations by keeping the body strong and flexible. Many children with CP increase their level of self-reliance through physical therapy.

MND

Motor Neuron Disease is a rare, yet severe condition that impacts the nerve cells responsible for controlling voluntary muscle movement. These motor neurons gradually degenerate and die, leading to a loss of muscle function and coordination. MND can manifest in various forms, with ALS being the most common type. Other subtypes include Progressive Bulbar Palsy (PBP), Primary Lateral Sclerosis (PLS), and Progressive Muscular Atrophy (PMA).
The symptoms of motor neuron disease usually occur first in the arms or legs. Usually, the initial symptoms are mild, and include stumbling, dragging of a foot or difficulty gripping objects. Symptoms include progressive weakness, muscle wasting and spasticity or stiffness in the arms and legs. Muscle weakness and wasting in the muscles supplying the face and throat can also cause difficulties with speech, chewing and swallowing.
In the advanced stages of the disease, an individual may become almost totally immobile. The speed of disease progression, however, varies enormously from patient to patient.
There are no periods of remission with motor neuron disease but individuals may experience a "plateau" of weeks or even months where no deterioration occurs. Motor neuron disease generally has no impact at all on memory or intellect. Motor neuron disease also has no impact on sight, hearing, taste, smell, sensation or bladder and bowel function.

Role of Physiotherapy in MND

Physiotherapy plays a crucial role in the management of Motor Neuron Disease by addressing the physical challenges and complications associated with the condition. While physiotherapy cannot halt the progression of MND, it can significantly enhance the patient's quality of life, slow down muscle deterioration, and provide much-needed support to manage the symptoms effectively. Here are some key ways in which physiotherapy benefits MND patients:

1: Muscle Strength and Endurance:	2: Range of Motion:	3: Respiratory Care:	4: Posture and Balance	5: Pain and discomfort	6: Assistive Devices

Muscular Dystrophy

Muscular dystrophy is a genetic disease. It is caused by a change or mutation in one of the genes in a person’s DNA. It is not caused by an injury or harmful activity. Our genes determine our characteristics and traits. The genes that cause MD control the proteins that are needed for muscle health.
MD causes increasing muscle damage and muscle weakness, along with decreasing muscle size/volume over time. It affects people of all races and ages worldwide. Symptoms of MD can begin any time from birth to the teen years. Although boys have MD more often, girls can have it too. Girls may show less severe symptoms, or they may have no symptoms and just "carry" the gene mutation. Learn more about how genes are inherited (passed from parents to children) below.
According to the National Institutes of Health, there are nine main types of MD with many variations or subtypes. Overall, there are more than 30 different forms of MD. The most common types are:

1. Duchene Muscular Dystrophy (DMD): This is the most common and severe form of MD among children and into adulthood. It is sometimes called "DMD." It affects mostly males and results in loss of skeletal, heart, and lung muscle. With DMD, dystrophin (a protein in muscle cells) either changes, is missing, or there is not enough produced. Proteins are essential for muscle cell health. When these proteins do not function properly, the muscle cannot repair itself well and becomes weaker.
Gower’s sign is a characteristic patterns observed in patients with Duchenne muscular dystrophy wherein they 'climb up' their thighs with the aid of their hands to overcome the weakness of their pelvic and proximal lower limb muscles.

2. Becker’s Dystrophy: This type of MD is less severe than DMD. It commonly affects the hips, pelvic area, thighs, and shoulder muscles first. This type of MD also affects the heart muscle.

3. Myotonic Dystrophy: This is the most common form of MD among adults. It often causes lasting muscle contractions and affects multiple systems, including the. Muscles that move the limbs and trunk, Digestive system and Heart muscle.

4. Facioscapulohumeral Dystrophy: This type of MD most often causes weakness in the face, shoulder, and upper arm muscles. Facio means face, scapulo stands for shoulder, and humeral refers to the upper arm. It also can affect the.

Role of Physiotherapy

Physical therapists help children with MD maintain as much mobility and function as possible. Physical therapists help children with MD and their families manage complications such as muscle weakness, shortening, and stiffness. Each child with MD has unique needs based on age, the type of dystrophy, and the progression of their symptoms. Physical therapists work with children and their families in a clinic, at home, and at school. They also team with other health care providers to develop treatment plans specific to each child’s needs. A team approach to treatment can ensure the best care and help your child reach their full ability.
A physical therapist is an important partner in the overall health of anyone with MD. Physical therapy should begin as soon as possible after diagnosis, and before joint or muscle tightness develops.
Each physical therapy treatment plan is designed to meet the child's needs using a family-centered approach. Physical therapists work with each child to:

✔️ Keep muscles as flexible as possible. This helps to reduce or prevent contractures and makes it easier to move and be comfortable.

✔️ Keep muscles functioning as well as possible. This makes it easier to do daily activities with less help from others.

✔️ Teach the right kind of movement for safety and independent function throughout all stages of life.

✔️ Guide families to the right equipment to help support the body and increase independence and safety. These might be walking aids, braces, wheelchairs, or other devices.