Dr. Prashanthi

Ever wondered why you needed to share your family’s health history at a doctor’s clinic? Specific questions regarding health issues of your immediate family or close blood relatives give your doctor an insight into various health risks you might have now or in future. Those are medical conditions inherited by parents or grandparents through genes. Genes are passed from parents to children in DNA of eggs or sperms. Even a single mutation (fault) in gene can influence body systems and may lead to disorders. If any of the parents have a faulty gene, there are 50:50 chances of the child inheriting it.

Hereditary heart diseases are also a result of mutation in one or more genes and tend to run in families. Genes control almost all aspects of cardiovascular system including strengthening blood vessels, pumping capacity or communication of cells in the heart. A single genetic variation is enough to alter cardiovascular processes increasing the risk of developing a heart disease, attack or a stroke. Some of the most common hereditary cardiac disorders include; Arrhythmias, congenital heart diseases and cardiomyopathy. A family history of heart attack or stroke is also an established high-risk factor for the family members. High blood cholesterol, medically known as familial hypercholesterolemia also tends to run in families.

Unfortunately, many of these conditions cannot be prevented since they are acquired through genes. But there are many ways in which these could be managed before they become complicated or fatal.

Let’s look at some ways by which we can deal with hereditary heart diseases and increase a patient’s chances of survival:

1. Early Diagnosis And Treatment: When one person in the family is diagnosed with a heart disease, it is strongly advisable for other family members to go in for screening. An early diagnosis can help in better treatment and management of the disease and impacts positively on patients’ life. Medical screening of siblings is highly recommended in case a person suffers a sudden cardiac death especially at a young age.

2. Watch out for these symptoms at a young age: Abnormal heart rhythm, asthma that does not get better with inhaler, seizures that do not improve with medication, extreme fatigue or shortness of breath are warning signals and need immediate medical attention.

3. Genetic Testing: Family members may opt for genetic testing to check if they carried genes of an inherited disorder.

4. Genetic Counselling: Genetic counselling deals with problems like anxieties and fear of attacks, confusion over disease and emotional difficulties in accepting the situation.

We may not be able to change the family history but we can surely change our environment, lifestyle and habits. Eating healthy and following an active lifestyle does help in prevention and management of such diseases. Consult an expert & get answers to your questions!

LATE FUNCTIONAL PHASE  

The late functional phase is characterized by a full range of motion, no effusion, and improved muscle strength and flexibility.Advanced closed chain exercises are added at this stage. The pro fitter continues Proprioceptive and balances training. 

Stair master and versa climber are utilized to build muscular strength and endurance as well as aerobic conditioning.Quadriceps and hip musculature stretching are added as increased emphasis being placed on flexibility at this stage. 

Isokinetic exercises include the progression to velocity spectrum training(60 to 400 degrees/sec), depending on the needs of the individual patient.Running is initiated when quadriceps strength approaches 80 percent. 

At first, an underwater treadmill system is used since the buoyancy of the water decreases the amount of force is significantly less during retro running versus forward running. Retro running has also been found to increase quadriceps strength at slow Isokinetic speeds. when running forward the patient is encouraged to maintain a controlled sprint rather than a jog. 

By staying on the ball of the foot, vertical or compressive loading is decreased.Before allowing the patient to return to sports activity, the therapist needs to do more than achieve normal range of motion and muscle strength. 

The components of the patient’s sport or activity should be incorporated into the rehabilitation program as well. For example, basketball players need to jump and land. Therefore jumping activities should be included in their program.

More importantly, they should be taught how to land to protect their knees.

Golfers rely on a great deal of tibial rotation throughout the swing, their program, therefore, should include an assessment of their swing and a modification made if necessary. Agility drills in the form of figure eights, carioca, and cutting manoeuvres are included here as they replicate components of most team and racquet sports. 

Prior to discharge from rehabilitation and the full return to sports activity, a series of tests must be satisfactory: 

1. Full range of motion.
2. Flexibility acceptable for the needs of the activity. 
3. Total work within 10 percent of the non-involved extremity as muscle strength is measured isokinetically.
4. Muscular endurance within 10 percent of the non-involved extremity as measured by the number of leg press repetitions using one-half the patient’s body weight. 
5. Functional power as measured by standing broad jump. 
6. Proprioception power as measured on BAPS board. Apprehension (lack of) with sport specific activities.