Regular physical activity can provide health and social benefits for many pregnant women. Suggestions for exercise during pregnancy include walking, swimming and supervised classes such as yoga or Tai chi. Pelvic floor exercises are also important before, during and after pregnancy. Unless you have complications, it should be possible to enjoy some level of physical activity throughout most of your pregnancy.
The first step is to consult your doctor, physiotherapist or healthcare professional to make sure your exercise routine won’t harm you or your unborn baby. You may need to modify your existing exercise program or choose a suitable new one if you were sedentary before conceiving.
While exercise during pregnancy is usually encouraged, under some circumstances exercise can be detrimental to both the expecting mother and the growing foetus.
Benefits of physical activity during pregnancy
Exercise during pregnancy offers many physical and emotional benefits. Physical activity may also help manage some symptoms of pregnancy and you’ll feel better knowing you’re doing something good for yourself and your baby.
Some of the benefits of exercising regularly throughout your pregnancy include:
More energy
Stronger back muscles which can help manage back pain and strain as your belly grows
Improved posture
Weight control
Stress relief
Improved sleep and management of insomnia
Preparation for the physical demands of labour
Faster recuperation after labour
Faster return to pre-pregnancy fitness and healthy weight
Increased ability to cope with the physical demands of motherhood.
look better. Exercise increases the blood flow to your skin, giving you a healthy glow.
Reduce constipation by accelerating movement in your intestine
Prevent wear and tear on your joints (which become loosened during pregnancy due to normal hormonal changes) by activating the lubricating fluid in your joints
Changes associated with pregnancy
There are many changes that take place during pregnancy. Some will affect your ability to exercise.
Hormones such as relaxin loosen ligaments which could increase your risk of joint injuries (for example, sprains).
As pregnancy progresses, weight increases combine with changes in weight distribution and body shape. This results in the body’s centre of gravity moving forward, which can alter balance and coordination.
Pregnancy increases your resting heart rate, so it is not recommended to use target heart rate to work out the intensity of your exercise. In healthy pregnant women, exercise intensity can be monitored using a method known as Borg’s Rating of Perceived Exertion Scale (RPE). This measures how hard you feel (perceive) your body is working.
Your blood pressure drops in the second trimester, so it is important to avoid rapid changes of position – from lying to standing, and vice versa – so as not to experience dizzy spells.
General exercise suggestions during pregnancy
It is important to discuss your exercise plan with your doctor, as each pregnancy is different. In general, healthy women who have uncomplicated pregnancies can continue their previous exercise program after consultation with a doctor. It is also now considered safe to start a new exercise program during pregnancy if given the all-clear by your doctor.
If you have been cleared to exercise, it is recommended that you:
Engage in at least 30 minutes of moderate-intensity physical activity (according to the Perceived Exertion Scale) on most, if not all, days of the week.
Do no more than three sessions per week of vigorous exercise by the third trimester.
Let your body be your guide. You know you’re at a good intensity when you can talk normally and not become exhausted too quickly.
Be guided by your doctor, physiotherapist or health care professional.
Suggested exercise activities during pregnancy
Activities that are generally safe during pregnancy, even for beginners, include:
Walking
Swimming
Cycling – outdoors or on a stationary bicycle
Exercise in water (aquarobics)
Yoga
Stretching
Dancing
Pilates
Pregnancy exercise classes.
Some activities are safe when done in moderation by pregnant women who had already been participating in these activities prior to pregnancy. These include:
Running
Strength training.
General cautions for pregnancy exercise
While most forms of exercise are safe, there are some exercises that involve positions and movements that may be uncomfortable or harmful for pregnant women. Be guided by your doctor or physiotherapist, but general cautions include:
Avoid raising your body temperature too high – for example, don’t soak in hot spas or exercise to the point of heavy sweating. Reduce your level of exercise on hot or humid days.
Don't exercise to the point of exhaustion.
If weight training, choose low weights and medium to high repetitions – avoid lifting heavy weights altogether.
Don’t exercise if you are ill or feverish.
If you don’t feel like exercising on a particular day – then don’t! It is important to listen to your body to avoid unnecessarily depleting your energy reserves.
Be careful with:
-bouncing
-jarring (anything that would cause a lot of up and down movement)
-leaping
-a sudden change of direction
-a risk of abdominal injury
Exercises to avoid while pregnant
During pregnancy, avoid sports and activities with increased risk of falling. These include:
Contact sports or activities that carry a risk of falling (such as trampolining, rollerblading, downhill snow skiing, horse riding and basketball)
Competition sports – depending on the stage of pregnancy, the level of competition and your level of fitness
After about the fourth month of pregnancy, exercises that involve lying on your back – the weight of the baby can slow the return of blood to the heart. Try to modify these exercises by lying on the side.
In the later stages of pregnancy, activities that involve jumping, frequent changes of direction and excessive stretching (such as gymnastics).
If you're not sure whether a particular activity is safe during pregnancy, check with your healthcare professional.
Pelvic floor exercises and pregnancy
The pelvic floor muscles are weakened during pregnancy and during birth (vaginal delivery), so it is extremely important to begin conditioning the pelvic floor muscles from the start of the pregnancy. Appropriate exercises can be prescribed by a physiotherapist. It is important to continue with these throughout the pregnancy and resume as soon as is comfortable after the birth.
Abdominal exercises and pregnancy
Strong abdominal muscles support your spine. The internal core and pelvic floor abdominal muscles act as a natural ‘corset’ to protect the pelvis and lumbar spine. Traditional sit-ups or crunches can be ineffective during pregnancy and may make worse the condition known as diastasis recti abdominis (a painless splitting of the abdominal muscle at the midline).
Appropriate core stability exercises are recommended during pregnancy to strengthen the muscles of the abdomen:
Concentrate on drawing your belly button towards your spine.
Breathe out while pulling in your belly.
Hold the position and count to 10. Relax and breathe in.
Repeat 10 times, as many times a day as you are able.
You can perform this exercise sitting, standing or on your hands and knees.
Warning signs for exercising during pregnancy
If you experience any of the following during or after physical activity, stop exercising immediately and see your doctor:
Headache
Dizziness or feeling faint
Heart palpitations
Chest pain
Swelling of the face, hands or feet
Calf pain or swelling
Vaginal bleeding
Contractions
Deep back or pubic pain
Cramping in the lower abdomen
Walking difficulties
An unusual change in your baby’s movements
Amniotic fluid leakage
Referreces:
http://kidshealth.org/parent/pregnancy_center/your_pregnancy/exercising_pregnancy.html#
http://www.betterhealth.vic.gov.au/bhcv2/bhcpdf.nsf/
mardi 12 juillet 2011
HEMIPLEGIA
What is hemiplegia?
Childhood hemiplegia (sometimes called hemiparesis) is a condition affecting one side of the body (Greek ‘hemi’ = half). We talk about a right or left hemiplegia, depending on the side affected. It is caused by damage to some part of the brain, which may happen before, during or soon after birth, when it is known as congenital hemiplegia, or later in childhood, in which case it is called acquired hemiplegia. Generally, injury to the left side of the brain will cause a right hemiplegia and injury to the right side a left hemiplegia. Childhood hemiplegia is a relatively common condition, affecting up to one child in 1,000.
How does hemiplegia occur?
The causes of congenital hemiplegia are mostly unknown, and usually parents become aware of their child’s hemiplegia gradually during his or her infancy. There is a higher risk in premature babies, and it is unclear whether a difficult birth may be an occasional factor.
Congenital Hemiplegia
In this type, damage to a part of the brain may occur before, during or soon after birth. The cause of congenital Hemiplegia is unknown.
Acquired Hemiplegia
This type of Hemiplegia is seen later in life. The obstruction in the flow of blood to the brain may occur due to Stroke, accident or infection.
Stroke: it is the most common cause of Hemiplegia. The formation of a blood clot decreases the flow of blood to the brain. As a result, Hemiplegia occurs. Stroke may even cause a condition of the brain called Cerebral Palsy, which may then lead to Hemiplegia.
Accident: Any accident or trauma to the head may lead to bleeding from the vessels supplying the brain, thereby causing Hemiplegia.
Infection: Swellings resulting from infections such as Encephalitis (infection of the brain) and Meningitis (infection of the outer layer of the brain) may also lead to obstruction in the supply of blood to the brain.
Various other causes may lead to Hemiplegia, e.g. Tumor (cancer), Migraine, Multiple Sclerosis, etc.
Risk Factors
Congenital Hemiplegia
Premature babies
Difficulty at the time of birth
Acquired Hemiplegia
High Blood Pressure
High cholesterol
Obesity
Smoking
High alcohol consumption
Sedentary lifestyle
What are the effects of hemiplegia?
It is difficult to generalise: hemiplegia affects each child differently. The most obvious result is a varying degree of weakness and lack of control in the affected side of the body, rather like the effects of a stroke. In one child this may be very obvious (he or she may have little use of one hand, may limp or have poor balance); in another child it will be so slight that it only shows when attempting specific physical activities.
Common musculoskeletal problems in hemiplegia
The shoulder is adducted and internally rotated, the elbow is flexed and pronated, the wrist and fingers are flexed, the thumb is in the palm. The hip is flexed and internally rotated, the knee is flexed or extended, the ankle is in plantar flexion. The foot is generally in varus, although valgus deformity may also be seen. The hemiplegic side is short and atrophic depending on the severity of involvement.
Musculoskeletal problems in hemiplegia
Upper extremity
Shoulder - Internal rotation, Adduction
Elbow - Pronation, Flexion
Wrist – Flexion
Hand – Flexion , Thumb-in-palm
Lower extremity
Hip – Flexion, Internal rotation
Knee – Flexion, Extension
Ankle – Plantar flexion
Foot – Varus
Treatment consists of physiotherapy, occupational therapy, bracing, botulinum toxin injections and orthopaedic surgery. Some children may need speech therapy and antiepileptic medication.
Treatment in hemiplegia
Physiotherapy – Prevent contractures, Strengthen weak muscles, Establish a better walking pattern
Occupational therapy – Functional use of upper extremity, Activities of daily living
-Bracing
-Lower extremity –> Solid or hinged AFOs
-Upper extremity –> Functional or resting hand splints
Botulinum toxin A
-Lower extremity – Rectus femoris and gastroc spasticity
-Upper extremity – Pronator flexor spasticity
-Orthopaedic surgery – Correction of Pes equinovarus, Stiff knee, Femoral anteversion
Referrences:
http://www.cerebralpalsysymptoms.org/types-of-cp/hemiplegia/
http://www.hemihelp.org.uk/families
Childhood hemiplegia (sometimes called hemiparesis) is a condition affecting one side of the body (Greek ‘hemi’ = half). We talk about a right or left hemiplegia, depending on the side affected. It is caused by damage to some part of the brain, which may happen before, during or soon after birth, when it is known as congenital hemiplegia, or later in childhood, in which case it is called acquired hemiplegia. Generally, injury to the left side of the brain will cause a right hemiplegia and injury to the right side a left hemiplegia. Childhood hemiplegia is a relatively common condition, affecting up to one child in 1,000.
How does hemiplegia occur?
The causes of congenital hemiplegia are mostly unknown, and usually parents become aware of their child’s hemiplegia gradually during his or her infancy. There is a higher risk in premature babies, and it is unclear whether a difficult birth may be an occasional factor.
Congenital Hemiplegia
In this type, damage to a part of the brain may occur before, during or soon after birth. The cause of congenital Hemiplegia is unknown.
Acquired Hemiplegia
This type of Hemiplegia is seen later in life. The obstruction in the flow of blood to the brain may occur due to Stroke, accident or infection.
Stroke: it is the most common cause of Hemiplegia. The formation of a blood clot decreases the flow of blood to the brain. As a result, Hemiplegia occurs. Stroke may even cause a condition of the brain called Cerebral Palsy, which may then lead to Hemiplegia.
Accident: Any accident or trauma to the head may lead to bleeding from the vessels supplying the brain, thereby causing Hemiplegia.
Infection: Swellings resulting from infections such as Encephalitis (infection of the brain) and Meningitis (infection of the outer layer of the brain) may also lead to obstruction in the supply of blood to the brain.
Various other causes may lead to Hemiplegia, e.g. Tumor (cancer), Migraine, Multiple Sclerosis, etc.
Risk Factors
Congenital Hemiplegia
Premature babies
Difficulty at the time of birth
Acquired Hemiplegia
High Blood Pressure
High cholesterol
Obesity
Smoking
High alcohol consumption
Sedentary lifestyle
What are the effects of hemiplegia?
It is difficult to generalise: hemiplegia affects each child differently. The most obvious result is a varying degree of weakness and lack of control in the affected side of the body, rather like the effects of a stroke. In one child this may be very obvious (he or she may have little use of one hand, may limp or have poor balance); in another child it will be so slight that it only shows when attempting specific physical activities.
Common musculoskeletal problems in hemiplegia
The shoulder is adducted and internally rotated, the elbow is flexed and pronated, the wrist and fingers are flexed, the thumb is in the palm. The hip is flexed and internally rotated, the knee is flexed or extended, the ankle is in plantar flexion. The foot is generally in varus, although valgus deformity may also be seen. The hemiplegic side is short and atrophic depending on the severity of involvement.
Musculoskeletal problems in hemiplegia
Upper extremity
Shoulder - Internal rotation, Adduction
Elbow - Pronation, Flexion
Wrist – Flexion
Hand – Flexion , Thumb-in-palm
Lower extremity
Hip – Flexion, Internal rotation
Knee – Flexion, Extension
Ankle – Plantar flexion
Foot – Varus
Treatment consists of physiotherapy, occupational therapy, bracing, botulinum toxin injections and orthopaedic surgery. Some children may need speech therapy and antiepileptic medication.
Treatment in hemiplegia
Physiotherapy – Prevent contractures, Strengthen weak muscles, Establish a better walking pattern
Occupational therapy – Functional use of upper extremity, Activities of daily living
-Bracing
-Lower extremity –> Solid or hinged AFOs
-Upper extremity –> Functional or resting hand splints
Botulinum toxin A
-Lower extremity – Rectus femoris and gastroc spasticity
-Upper extremity – Pronator flexor spasticity
-Orthopaedic surgery – Correction of Pes equinovarus, Stiff knee, Femoral anteversion
Referrences:
http://www.cerebralpalsysymptoms.org/types-of-cp/hemiplegia/
http://www.hemihelp.org.uk/families
samedi 18 juin 2011
EXERCISEES AND PHYSICAL FITNESS
There are 1,440 minutes in every day. Schedule 30 of them for physical activity!
Regular exercise is a critical part of staying healthy.People who are active live longer and feel better.Exercise can help you maintain a healthy weight.It can delay or prevent diabetes, some cancers and heart problems.
Examples of exercises
1.walking briskly
2.mowing the lawn
3.Dancing
4.swimming for recreation or bicycling.
5.Stretching
7.weight training
How to find the right exercise
1. If it is fun, you are more likely to stay motivated.
2.You may want to walk with a friend,
3.join a class or plan a group bike ride.
4. If you've been inactive for awhile, use a sensible approach and start out slowly.
Effect of physical exercises
1.Burn calories and reduce body fat
2.Control and maintain your current weight
3.Improve chronic medical conditions such as diabetes, high blood pressure, and heart disease
4.Improve your fitness and ability to perform daily activities
5.Prevent diseases such as osteoporosis and depression
Regular exercise is a critical part of staying healthy.People who are active live longer and feel better.Exercise can help you maintain a healthy weight.It can delay or prevent diabetes, some cancers and heart problems.
Examples of exercises
1.walking briskly
2.mowing the lawn
3.Dancing
4.swimming for recreation or bicycling.
5.Stretching
7.weight training
How to find the right exercise
1. If it is fun, you are more likely to stay motivated.
2.You may want to walk with a friend,
3.join a class or plan a group bike ride.
4. If you've been inactive for awhile, use a sensible approach and start out slowly.
Effect of physical exercises
1.Burn calories and reduce body fat
2.Control and maintain your current weight
3.Improve chronic medical conditions such as diabetes, high blood pressure, and heart disease
4.Improve your fitness and ability to perform daily activities
5.Prevent diseases such as osteoporosis and depression
dimanche 6 mars 2011
KNEE JOINT PAIN
The knee is the largest joint in the body and normally one of the most stable. It has large ligaments which control its movement and large muscles to give it power and stability. Despite the strength of the knee it is often injured because of the very large forces placed on it in sports and recreational activities. Physiotherapists are closely involved in knee assessment and treatment.
There are many causes of knee pain, varying with the age of the person and the activities they pursue. Your physiotherapist can diagnose and treat your knee problem effectively.
Patello-femoral syndrome or anterior knee pain
The patello-femoral joint is between the knee cap and the front surface of the thigh bone at the knee. The kneecap tracks in the groove on the front of the thigh bone and a disturbance in the balance of the knee muscles can allow the kneecap to track more to the outside.
This can increase the pressure on the joint areas and cause pain. Any changes in the cartilage behind the kneecap can also contribute. A softening of the cartilage of the back of the kneecap is known as chondromalacia patella.
Physios can treat weakness of the quadriceps muscles and stretch out any tight structures which contribute to the problem.
Recurrent patellar dislocation
The kneecap can dislocate sideways to the outside under certain conditions, such as lunging or twisting on the knee whilst weight bearing. This is more common in hypermobile people, especially young women. Physiotherapy is used to strengthen the quadriceps, regain joint movement and improve stability and control.
Collateral ligament sprains
The major ligaments at each side of the knee prevent the knee from being forced into an abnormal amount of knock-knee or bow-leg. Both the lateral (outside) ligament and the medial (inside) ligament can be sprained, with the medial ligament the more commonly affected.
Medial knee pain causes are usually sudden impacts on the outside of the knee such as in football or rugby.
Sprains will heal with correct management which varies from plaster of Paris to splints to reduced weight bearing for a while. Physiotherapy is often required to regain joint movement and strength and to rehabilitate the knee back to sporting or other activities.
Cruciate ligament sprains and cruciate rupture
The cruciate ligaments are major internal ligaments of the knee joint. They give back and forwards stability to the knee. The anterior cruciate ligament is damaged much more often than the posterior cruciate ligament.
If the anterior cruciate ligament is damaged or torn the knee becomes unstable when the person twists whilst weight bearing on the knee. Rehabilitation can improve knee function but if there are still problems then anterior cruciate ligament reconstruction is the most favoured option.
Osgood-Schlatter Syndrome
This is a problem of sporty teenagers. They develop pain on activity over the tibial tuberosity, the small bump below the knee cap on the front of the shin bone. The condition is caused by too much traction or pulling on this area while the person is growing rapidly. Rest and gradual physio rehabilitation are the treatments.
Jumper’s knee
This is a condition of athletes who perform jumping or changing direction rapidly. The patellar tendon attaches to the lower point of the patella and it is this area which becomes irritated and causes pain. Physiotherapy treatment can improve the symptoms and prevent the problem from becoming a chronic condition.
Osteoarthritis
Osteoarthritis is the most common joint condition in the world. Knees are commonly affected with the symptoms being pain, swelling, stiffness, reduced range of movement, reduced mobility and disability. Exercise is a core management strategy and physiotherapists can assess the knee and plan a treatment.
If conservative treatments are unsuccessful then total knee replacement is a option with very high quality of life improvements.
CITATION OF THE PHYSIOTHERAPY SITE
Retrieved March 7,2011.
There are many causes of knee pain, varying with the age of the person and the activities they pursue. Your physiotherapist can diagnose and treat your knee problem effectively.
Patello-femoral syndrome or anterior knee pain
The patello-femoral joint is between the knee cap and the front surface of the thigh bone at the knee. The kneecap tracks in the groove on the front of the thigh bone and a disturbance in the balance of the knee muscles can allow the kneecap to track more to the outside.
This can increase the pressure on the joint areas and cause pain. Any changes in the cartilage behind the kneecap can also contribute. A softening of the cartilage of the back of the kneecap is known as chondromalacia patella.
Physios can treat weakness of the quadriceps muscles and stretch out any tight structures which contribute to the problem.
Recurrent patellar dislocation
The kneecap can dislocate sideways to the outside under certain conditions, such as lunging or twisting on the knee whilst weight bearing. This is more common in hypermobile people, especially young women. Physiotherapy is used to strengthen the quadriceps, regain joint movement and improve stability and control.
Collateral ligament sprains
The major ligaments at each side of the knee prevent the knee from being forced into an abnormal amount of knock-knee or bow-leg. Both the lateral (outside) ligament and the medial (inside) ligament can be sprained, with the medial ligament the more commonly affected.
Medial knee pain causes are usually sudden impacts on the outside of the knee such as in football or rugby.
Sprains will heal with correct management which varies from plaster of Paris to splints to reduced weight bearing for a while. Physiotherapy is often required to regain joint movement and strength and to rehabilitate the knee back to sporting or other activities.
Cruciate ligament sprains and cruciate rupture
The cruciate ligaments are major internal ligaments of the knee joint. They give back and forwards stability to the knee. The anterior cruciate ligament is damaged much more often than the posterior cruciate ligament.
If the anterior cruciate ligament is damaged or torn the knee becomes unstable when the person twists whilst weight bearing on the knee. Rehabilitation can improve knee function but if there are still problems then anterior cruciate ligament reconstruction is the most favoured option.
Osgood-Schlatter Syndrome
This is a problem of sporty teenagers. They develop pain on activity over the tibial tuberosity, the small bump below the knee cap on the front of the shin bone. The condition is caused by too much traction or pulling on this area while the person is growing rapidly. Rest and gradual physio rehabilitation are the treatments.
Jumper’s knee
This is a condition of athletes who perform jumping or changing direction rapidly. The patellar tendon attaches to the lower point of the patella and it is this area which becomes irritated and causes pain. Physiotherapy treatment can improve the symptoms and prevent the problem from becoming a chronic condition.
Osteoarthritis
Osteoarthritis is the most common joint condition in the world. Knees are commonly affected with the symptoms being pain, swelling, stiffness, reduced range of movement, reduced mobility and disability. Exercise is a core management strategy and physiotherapists can assess the knee and plan a treatment.
If conservative treatments are unsuccessful then total knee replacement is a option with very high quality of life improvements.
CITATION OF THE PHYSIOTHERAPY SITE
Retrieved March 7,2011.
vendredi 4 mars 2011
Back Injuries
Your back is an intricate structure of bones, muscles, and other tissues extending from your neck to your pelvis. Back injuries can result from sports injuries, work around the house or in the garden, or a sudden jolt such as a car accident.
At first, treatment of both sprains and strains usually involves resting the injured area, icing it, wearing a bandage or device that compresses the area, and medicines. Later treatment might include exercise and physical therapy.
Retried from MEDLINEPLUS March 04,2011.
http://www.zephizublogspot.com/BACK INJURIES
The lower back is the most common site of back injuries and back pain. Common back injuries include
A sprain is a stretched or torn ligament. Ligaments are tissues that connect bones at a joint. Falling, twisting, or getting hit can all cause a sprain. Ankle and wrist sprains are common. Symptoms include pain, swelling, bruising and being unable to move your joint. You might feel a pop or tear when the injury happens.
A strain is a stretched or torn muscle or tendon. Tendons are tissues that connect muscle to bone. Twisting or pulling these tissues can cause a strain. Strains can happen suddenly or develop over time. Back and hamstring muscle strains are common. Many people get strains playing sports. Symptoms include pain, muscle spasms, swelling and trouble moving the muscle. At first, treatment of both sprains and strains usually involves resting the injured area, icing it, wearing a bandage or device that compresses the area, and medicines. Later treatment might include exercise and physical therapy.
NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases
Your backbone, or spine, is made up of 26 bones called vertebrae. In between them are soft disks filled with a jelly-like substance. These disks cushion the vertebrae and keep them in place. A herniated disk is a disk that slips out of place or ruptures. If it presses on a nerve, it can cause back pain or sciatica.
Symptoms include
Symptoms include
- Back pain that spreads to the buttocks and legs, when the herniated disk is in your lower back
- Neck pain that spreads to the shoulders and upper arms, when the herniated disk is in your upper back
- Tingling or numbness
- Muscle spasms or weakness
- Fractured vertebrae
Retried from MEDLINEPLUS March 04,2011.
http://www.zephizublogspot.com/BACK INJURIES
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