Stroke is a medical condition in which the flow of blood towards the brain is poor and causes the death of certain cells. There are two common types of stroke: 

1. Ischemic- due to lack of blood flow
2. Hemorrhagic- due to bleeding

Signs and symptoms of stroke 

Problems with movement
Inability to feel  on one side of the body
Problems understanding or in speech
Vertigo
Loss of vision
Difficulty in carrying out everyday activities
Role of Physiotherapy for Patients with Stroke

The main focus of physiotherapy is to help you use your arms and legs to regain as much strength and movement as possible. 
If you have one-sided paralysis, correct positioning is important to prevent spasm or injury.
It helps you to sit up as this will help you avoid blood clots in your legs, improve your breathing and help you recover quickly.
If you are unable to move, you may be given chest physiotherapy to keep your lungs free of infection.
What does a Physiotherapist do?

A physiotherapist advises you on how you should be positioned when lying or sitting, and how often you need to be moved.
Motivates you to be actively involved in your physiotherapy sessions to help you relearn normal patterns of movement
Decides when you should begin to start walking and what equipment is needed to move or support you
Provides therapy to strengthen your limbs and teach you how to move again as independently as possible
Takes care of the fact that no complications should arise and you have a smooth recovery.
Treatment Techniques:

Strength Training: It is evident that strength training can improve upper-limb strength and function without increasing tone or pain in individuals with stroke.
Gaming: Goal orientated computer gaming has proven to significantly reduce upper limb impairment in stroke survivors.
Virtual Reality: Virtual reality training has been shown to be effective in restoring upper limb motor impairments and motor-related functional abilities.
Mirror Therapy: Mirror therapy has been shown to have a beneficial effect on motor control and function compared to conventional therapy.
Robot-Assisted Therapy: It has been shown to have a beneficial effect on motor recovery and function.
In the upper extremity with severe impairment and/or poor prognosis for recovery, Chedoke McMaster Stroke Assessment (CMSA) of Arm and Hand < Stage 4) treatment should focus on maintaining a comfortable, pain-free, mobile arm and hand. Engage in repetitive and intense use of novel tasks that challenge the stroke survivor to acquire necessary motor skills to use the involved upper limb during functional tasks and activities. Engage in motor-learning training including the use of imagery.

Stroke - How Physiotherapy Can Help With It?

What is Palpitation?
Palpitation is a feeling of awareness of your own heart beat. It is usually described as heart rate being either too fast (racing), too slow or a sensation of missing a beat.

Types of palpitations?
Normal (Benign)
- These palpitations occur as a response to physical or mental stress like exercise, fever, pain, fear, anxiety etc. 
- They are harmless and settle on their own once the precipitating factors disappear. They do not require any medical treatment.

Abnormal
- These palpitations occur due to some underlying abnormality in either the structure of heart or the beating of heart. 
- These can be dangerous and at times life threatening. They may or may not settle on their own and require some medical treatment.

Warning signs that suggest palpitations are abnormal?
Palpitations are abnormal, if they are associated with chest heaviness, chest pain, uneasiness, sweating, weakness, giddiness, feeling of black out, fainting, nausea, vomiting, seizures. Palpitations are more likely to be abnormal in people who have some existing heart disease and these patients should report to their doctor at the earliest.

What to do during palpitations?
1. Stay calm. 
2. Call for help. If u are alone avoid driving, use a taxi or auto, go to your nearest hospital/doctor and try to get an ECG during the palpitations. If you are helping someone having palpitations, if they faint, call for help, start CPR if they remain unresponsive and take them to the nearest hospital. 

Which doctor can treat palpitations?
Doctors who specialise in the treatment of palpitations are called Electrophysiologists. They specialise in heart rhythm and are capable of performing a variety of complex tests to identify and treat different types of palpitations.

Which investigations are used to diagnose palpitations?
ECG: Taken during palpitations and when the patient is normal is a very helpful tool. 
Holter: Externally applied recorder, which continuously records heart rhythm for 24 hrs. 
ELR: Extended loop recorder, is like holter, but it records rhythm for longer durations. 
ILR:  Internal loop recorder is attached within the body for recording rhythm for long duration. 
EPS: Electrophysiology study, is the most sure shot test to diagnose, identify and treat 
Palpitations.

What is EPS?
EPS stands for Electrophysiology study. By this test a trained Electrophysiologist studies the conduction and formation system of heart beat, to understand the source, cause and type of palpitation. It is a simple and safe procedure of 2 to 3 hours and can be done as a day care procedure (by admitting the patient for a few hours in hospital, with discharge on same day).

It requires fasting for 4 hrs, some standard blood investigations and is done with local anaesthesia and if required it can be combined with treatment like ablation in the same sitting.In the procedure Electrophysiologist take catheters into your heart to study and stimulate the palpitations and understand them. Once found they can use various techniques to stop the palpitations, the techniques are called Ablation.

What are the treatment options available for palpitations?
There are many options depending upon the nature of palpitations and condition of the patient: 
- Drug therapy 
- Cardioversion where either a drug or electric shock is given to stop palpitations immediately. 

Ablations using many sophisticated computer softwares 
Device Therapy like ICD (Internal cardiac defibrillator) 
Combination of all the above therapies.

Your Electrophysiologist and you as a team can make a choice about the options that will be best for you.

Palpitations - Everything You Need to Know

Cystic fibrosis is a genetic condition, which primarily affects the lungs and persistence of this condition might lead to severe breathing problems and loss of lung function. If you have inherited two copies of the defective gene from your parents, you are likely to suffer from this disease. Cystic Fibrosis causes a buildup of thick mucus in your lungs and affects other organs such as the kidneys, pancreas and the intestines in your body.

It isn't very uncommon as one out of fifty people in Asia is a carrier of this disease. The disease gets its name from the cysts formed in the pancreas of the sufferer. However, this disease can be detected by testing the quantity of salt present in your sweat. Prenatal testing for Fibrosis is another method to test if your newborn is likely to contract a lung infection.

Complications faced due to cystic fibrosis include:
1. Serious sinus infections
2. Serious damage in lungs due to inflammation and incessant infection
3. Malnutrition
4. Complication in breaking down protein
5. Respiratory tract contamination

If you observe one or more of the following symptoms, you might be suffering from Cystic Fibrosis:
1. Salty-tasting skin
2. Bowel obstruction caused due to meconium ileus (obstruction of the bowels)
3. Mucus amiss in your alveoli
4. Persistent coughing with phlegm discharge
5. Shortness of breath while engaging in a physical task
6. Stunted or measly growth despite healthy lifestyle habits
7. Infertility in males

If you're suffering from cystic fibrosis, there isn't any particular treatment which is recommended due to the varying degrees of it found in people. However, consultation with a medical practitioner and an individualised treatment plan can help you minimise the risks and lead a better life.

Some therapies you can opt for are:
a) Airway clearance: This therapy helps sift the thick layer of mucus around your organs. Some people have also chosen to use the inflatable vest which vibrates around your chest, thereby, thinning and loosening the layer of mucus.

b) Inhaled medicines: Another breakthrough in the field of respiratory medicine, this method requires the patient to sniff a liquid consisting of mist, which is inhaled with the aid of a nebuliser. This method is known to be beneficial for opening airways.

c) Pancreatic enzyme supplements: Along with multivitamins, these specially designed supplements are known to cater to your pancreas with the much-needed nutrients and they need to be consumed with every meal.

Cystic Fibrosis: All You Need to Know

Stroke is one of the major reasons for disability in adults. In the US alone, 7 million people suffer from a stroke in a year. After a stroke, the affected individual suffers from lots of health issues. They feel week and fatigued. An ache in one side of the body, inability to walk, and social disability are experienced. Emotional and cognitive functioning is disturbed. Continuum care is recommended for the affected individuals and they need interdisciplinary care to ensure they can do things independently. This is where occupational therapy plays a vital role.

What does the therapist do? 

Using a range of evidence-based methods, the occupational therapists can address the physical, emotional, and mental challenges caused by the stroke. Occupational therapy does not concentrate only on the ailment. It takes into account the emotional needs, desires, limitations, and activities of the stroke survivors. It helps them to recoup the skill to get the daily chores done independently. An occupational therapist surveys the home of the stroke survivor and evaluates the risk of hazards. The practitioner also helps the affected individuals in coping with the loss of vision and memory. The physical strength and fortitude are augmented. The major focus will be on making the affected reach the heights of performance in the valued occupations.

How does it help? 

Studies prove that occupational therapy does not only help one to recover faster, but also prevents worsening of the condition further. The stroke survivor, who receives the occupational therapy, is independent when it comes to daily living chores. Wouldn t it be a great improvement on the emotional health when the affected feels he or she can get things done with little or occasional help? Also, this reduces the caregiver burden. The family is relieved that the survivor can eat, bath, and take a few things without someone having to sit closer and help. This mentally boosts the caregivers and the family to motivate the survivor. The stroke survivor also looks forward to the rehabilitation treatment as the occupational therapy makes them feel great.

Transitional and community integration services can make sure that the patients are engaged in their specific environments, once they get back home after occupational therapy in the specialized care center. After a certain period, when the stroke survivors show considerable improvement, the practitioner again evaluates to find if activities like driving can be resumed by the clients. Community mobility of different choices is recommended if the client is not fit for driving. There are driver rehab programs and the driving skills can be regained.

An occupational therapist spends more time with the client than any other healthcare professional. This is because the practitioner is responsible for alleviating the challenges faced by the affected individual emotionally and physically. The practitioner not only helps the client to achieve the goals but also ensures that the client is psychologically motivated whenever he or she is discouraged. Rehabilitation can reverse the damage done to the brain. But it takes lots of efforts to learn the things to do them in a different way. An occupational therapist makes this goal easier for his or her clients.

Occupational Therapy For People Recovering From A Stroke! 

Blood pressure is one of the vital life signs in medicine, which, along with other vitals is widely used to assess the overall health of the patient. High blood pressure is very dangerous as normally it has no symptoms or signs and can fluctuate almost instantly. But, it could be managed. High blood pressure is said to be of higher than 120 (systolic) and 80 (diastolic).

A nap in a day might help in lowering blood pressure. According to certain research findings, people who sleep in the daytime had regular blood pressure as compared to people who do not sleep or do not have a short nap. Napping can effectively help lowering blood pressure. It helps the blood to control stress hormones and also helps the nervous system to keep a person healthy.

Daytime napping surely helps in boosting energy levels and efficiency throughout the day. Blood pressure increases after a nap caused by the body s normal circadian rhythm (for influencing and regulating sleep-wake pattern for a healthy cycle in a day). At the time of the morning, the body releases hormones such as noradrenaline and adrenaline. If the blood pressure increases too high, it could cause harmful effects. Blood pressure is usually lower at night while a person is sleeping. The blood pressure begins to increase a few hours before a person wakes up. The blood pressure continues to increase during the day, normally extreme in the mid of the afternoon. The blood pressure starts dropping again in the evening and late afternoon. Sleep helps the blood to regulate stress hormones.

Napping, since it helps in lowering blood pressure, definitely helps in reducing the risk of Sleeping for about seven to eight hours in the night might play a vital role in the prevention of high blood pressure. New research suggests that an afternoon nap is as productive as consuming a pill for lowering the blood pressure. Scientists have found that the people who take a midday nap are more likely to drop their blood pressure as compared to adults who don t take a midday nap and stay awake. Napping, since it helps in lowering blood pressure, definitely helps in reducing the risk of cardiovascular events like a stroke or a heart attack. It is as effective as other lifestyle changes, according to credible researches in medicine. It is interesting to note that napping, even when it reduces the blood pressure by 2 mm Hg only, reduces the risk of cardiovascular events by 10%.

Napping is a sort of shortcut and an effective method for lowering the blood pressure and could also be easily adopted and does not cost anything. Short midday sleep is important for our well-being. And, we can utilize this simple information very effectively for its potential health-related benefits simply by managing our daily schedule.

Napping & Low Blood Pressure - How Can Former Help Latter?

Congestive heart failure is a chronic progressive condition that affects the pumping power of your heart muscles. Simply referred to as heart failure, congestive heart failure can be life-threatening. It does not mean that the heart has stopped working. Rather, it means that the heart pumping power is weaker than normal. As a result, the heart cannot pump enough oxygen and nutrients to meet the body s needs. Over a period of time, the reduced ability of the heart causes the organs to receive less amount of oxygenated blood.

Signs and symptoms of congestive heart failure: In the early stages of congestive heart failure, you most likely won t notice any changes in your health. If your condition progresses, you will experience gradual changes in your body. The hallmark and the most common symptom of congestive heart failure is shortness of breath and it may occur while you are at rest, doing any activity that exerts your body, when you are lying flat or while getting up from sleep. Some of the other most common symptoms of congestive heart failure include a persistent and unexplained cough, swelling in the legs, ankles, abdomen, or hands, tiredness, changes in thinking and memory, nausea, rapid heart rate, and dizziness or light-headedness.

Causes of congestive heart failure: Congestive heart failure is most likely to occur in people who have other conditions that weaken the heart. The risk also increases by several lifestyle factors that are bad for the heart. Risk factors for congestive heart failure include congenital heart defects, high blood pressure or cholesterol, obesity, asthma, chronic pulmonary disease, coronary heart disease, heart infection, reduced kidney function, a history of heart attack, irregular heart rhythms, abuse of alcohol and drugs, smoking, and old age. Though there are over a hundred other less common causes of heart failure, the exact cause of congestive heart failure is often idiopathic or unknown. Congestive heart failure might also exacerbate by unhealthy lifestyle habits. Specific habits such as smoking, excessive use of alcohol, obesity, lack of exercise, high salt intake, noncompliance with medications, and other therapies may increase the risk of congestive heart failure.

Diagnosis of congestive heart failure: A doctor or cardiologist will perform a physical exam. This may involve listening to the heart for abnormal heart rhythm. Some common tests that are done to help with the diagnosis of congestive heart failure include an electrocardiogram, chest X-ray, series of blood tests, echocardiography, stress test, magnetic resonance imaging (MRI) and cardiac catheterization.

Treatment of congestive heart failure: The goal of treatment for congestive heart failure is to have the heart beat more efficiently so that it can meet the energy needs of the body. Specific treatment depends upon the underlying cause of heart failure. You and your doctor may consider different treatment, depending on your overall health and how far your condition has progressed. There are several medications that can be used to treat congestive heart failure. ACE inhibitors open up narrowed blood vessels to improve blood flow. Vasodilators are another option if you cannot tolerate ACE inhibitors. Beta blockers can reduce blood pressure and slow a rapid heart rhythm. Diuretics reduce your body s fluid content. A surgery such as angioplasty is recommended if medications are not effective on their own.

Congestive Heart Failure - Signs & Symptoms You Must Not Ignore!

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