TREATMENT PHYSIOTHERAPY IN THE FIRST STAGE (FLACCID MAINLY):
Turning over from supine to side lying .
One of first activities the physiotherapist should work for in treatment is that of turning over to either side. The patient should not always remain in the supine position but should soon learn to use his trunk; i.e. his shoulder girdle and pelvis to turn over and lie on his side for some part of the day.
If patient rolls over and lies on the sound side, with the affected arm uppermost, the shoulder and arm should be moved well forward, the elbow should be extended, and the affected leg lie in a natural position of semi-flexion.If patient rolls over and lies on the affected side, the shoulder of that side should again, be placed forward with the elbow extended and in supination.
This position helps to prevent shoulder retraction and the development of flexor spasticity with pronation of the affected arm.Patients clasps hands, he then raises arms. In this shoulder girdle is moved forward and upwards. Patient’s arms are then moved, with clasped hands to chest. With clasped hands, patient turns towards sound side keeping shoulder well forward.
Lying down from sitting
The physiotherapist holds affected hand of the patient, his arm externally rotated and extended diagonally forward at shoulder height, while the patient slowly lies down, using his sound arm for support. In this way, physiotherapist will prevent retraction of the shoulder and flexion of the affected arm. The patient then lifts the sound leg on the bed. If at all possible, he should then bend the affected leg at the knee and move it into the bed, the nurse giving a little help by lifting from under the knee.
Sitting and standing up
A foam rubber mat should be placed in front of the bed for standing. The therapist never be on patient’s sound side when he sits, stands or walks, since he can use his sound side. If he takes weight on his affected side, the patient will gradually overcome his fear of falling.
EXERCISES IN PRONE LYING AND KNEELING
He is asked to lift sound arm so that all pressure comes to the affected side. Poor balance and arm support on left affected side. Rocking backwards and forward , balancing on affected knee.
Weight is on affected side but note slight retraction on affected side.
EXERCISES IN SITTING
Weight bearing on the affected upper limb:
The therapist sits behind the patient and maintains the arm in slight abduction and extension with elbow extension. The patient should be encouraged to weight bear with the arm in this position. As the patient improves the support given by the therapist should be gradually reduced.Facilitating weight transmission through affected side.
The nervous system is the lifeline of the human body and a minor problem can trigger life-threatening troubles. Brain, spinal cord and nerves control our body and once any disorder occurs, our body comes into huge trouble. To keep these problems at bay, consult these top 10 neurologists in Delhi.
Dr. Bhupesh Kumar
MBBS, MD Medicine, DNB Neurology
Consultation Fees: Rs 700
Dr. Bhupesh Kumar is specialized in Migraines, Headaches, Sleep Disorders, Seizures, and Epilepsy. He has completed his MBBS (Bachelor of Medicine and Bachelor of Surgery) from the University of Australia in 2011, MD Medicine from the University of Australia in 2013 and DNB Neurology from National Board of Examination in 2015. He is very popular in Delhi. You can visit him at Neuro Wellness at C6/6106, Gate Number 5 Road, Opposite DPS school, Vasant Kunj, Delhi, Delhi.
Dr. Dhruv Zutshi
MBBS, MD - General Medicine
Consultation Fees: Rs 500-800
Dr. Dhruv Zutshi is one of the top neurologists in Delhi. He holds an experience of more than 11 years and has many happy patients. He is known for his transparency with his patients and is appreciated for the way he explains the health conditions and risk. You can visit him at Apollo Spectra, A-19/A, Near Kailash Colony Metro Station, Kailash Colony Road, Block A, Sector 19, New Delhi.
Dr. Aparna Gupta
DNB (Neurology), MD/MBBS - General Medicine
Consultation Fees: Rs 900- 1400
Dr. Aparna Gupta treats neurological disorders such as stroke, epilepsy -headache movement disorders- dementia- peripheral neuropathy- Parkinson's disease-sleep disorder and others. She was earlier associated with esteemed Sir Ganga Ram Hospital where she was a Senior Resident in the Dept. of Cardiology and Neurology. She has an experience of more than 15 years and treats patients at Indian Spine Injuries Centre, Opposite Vasant Valley School, Sector-C, Vasant Kunj, Delhi.
Dr. Vivek Kumar
DM - Neurology, MBBS, MD
Consultation Fees: Rs 800- 1200
Dr. Vivek Kumar is one of the top neurologists in Delhi. He has experience of more than 27 years. He treats his patients at Kumar's Neurology Center. You can visit Dr. Kumar at 5/C, Mahagun Mansion, Vaibhav Khand, apposite God green city Indirapuram, Ghaziabad.
Dr. Sonia Lal Gupta
MBBS, Diplomate of American Board of Psychiatry and Neurology
Consultation Fees: Rs. 800- 1200
Dr. Sonia Lal Gupta holds the degree of MBBS, Diplomate of American Board of Psychiatry and Neurology. She of very popular neurologists in Delhi. She holds an experience of more than 10 years and has treated patients with many complicated neuro problems. You can visit her at W - 33, Greater Kailash 1 Road, W Block, Greater Kailash I, Delhi.
Dr. Anwar Alam
DM - Neurology, M D MEDICINE
Consultation Fees: Rs 400
Dr. Anwar Alam is one of the top neurologists in Delhi. He treated many patients who were suffering from critical neuro diseases. He holds an experience of more than 12 years. You can visit him at Dr. Anwar’s neuro Clinic, P 617 DOCTOR COLONY MALAHI PAKRI CHOWK KANKARBAGH, Delhi
Dr. Jaideep Bansal
DM - Neurology, MD - Medicine, MBBS
Consultation Fees: Rs 800
Dr. Jaideep Bansal holds an experience of more than 25 years. He is known for his transparency with his patients and is appreciated for the way he explains the health conditions and risk. He is currently associated with The Neurology Clinic at c-8/388 sector 8 rohini near Madhuban chowk, Delhi.
Dr. S Venkataraman
MBBS, MD (Medicine), DM (Neurology)
Consultation Fees: Rs 500
Dr. S Venkataraman is the top neurologists in Delhi. He holds an experience of more than 50 years and has treated many patients who were suffering from critical neuro problems. You can visit him at Bhagya Poly Clinic, RZ5B, Palam Vihar, Sector 6, Dwarka, Delhi.
Dr. Sumanto Chatterji
DM - Neurology, MBBS, MD - Internal Medicine
Consultation Fees: Rs 700
Dr. Sumanto Chatterji holds an experience of over 15 years. She has many happy patients and you can consult Dr. Sumanto Chatterjee at Dr. Sumanto Chatterjee Clinic in Chittaranjan Park, E-791 UGF, Chittaranjan Park, Delhi.
Dr. Sanjay Kumar Chaudhary
MBBS, MD - General Medicine, DM - Neurology
Consultation Fees: Rs 1000
Dr. Sanjay Kr Chaudhary is the top neurologists in Delhi. He holds an experience of more than 25 years. He is appreciated by many patients because of his calm behavior. In his experience, he has treated many patients who were suffering from critical neuro problems. You can visit him at the Institute of Brain and Spine, 73, Ring Road, Lajpat Nagar III, Delhi.
Study of the brain has fascinated specialists all over the globe since time immemorial. The brain being the most vital organ for survival and coordination is perhaps the most complex of them all too. This has led to a limited understanding of its working in spite of the available advanced technology. However, with the advent of techniques for diagnosis and treatment, therapeutic strategies are evolving. This is a major step towards rendering Neurosurgery safer than ever in the history of mankind.
Neurosurgery through the 20th Century-
During the beginning of the 20th century, Neurosurgery was considered as a specialty. The clinical-neurologist would draw conclusions related to lesions in the brain through neurological examination and clinical history. It enabled diagnosis of vascular lesions, spinal disorders, and brain tumors. During the second and third decades of the 20th century, vascular pathologies and brain tumors could be diagnosed indirectly through techniques like angiography, ventriculography, and pneumoencephalography. But since the operative techniques were too crude and the lack of skilled professionals were rampant, there were high rates of morbidity and mortality due to neurological conditions. Generally, after diagnosing the nature of brain lesion and its site, surgery was performed with inadequate maintenance and control of intracranial pressure and through not too sophisticated surgical instruments.
During the fifth and sixth decades of the 20th century, chemotherapy and radiation treatment came into the picture for treating malignant brain tumors, thereby reducing mortality to a good extent.
During the seventh decade of the 20th century, Computed Tomography (CT) scan provided a better understanding of the location of lesions in the brain which slightly substantiated the earlier techniques. Then, the procedures for cerebrospinal fluid diversion significantly improved management of intracranial pressure during surgery.
It was only during the last decade of the 20th century that the Neurology saw a giant progressive leap through the introduction of Magnetic Resonance Imaging (MRI) and powerful high magnification microscopes. Combined with Neuroanesthesia and Intracranial Pressure Management, this aided surgeons to work on a relaxed brain. This promoted safe removal of the brain tumor and better management of vascular lesions. Moreover, the understanding of micro-surgical anatomy improved drastically, leading to a boost in confidence levels of the micro-neurosurgeons performing the operation.
Neurosurgery in the 21st Century-
The 21st century is actually a revolutionary era that uses powerful computers in almost all the fields possible. Computer-based applications such as Neuro-imaging, Neuronavigation, Intra-operative Neuro-monitoring, and Neuro-modulation are now used in standard neurosurgical practice as a part of the routine. Extremely powerful CT scans and MRIs are used for diagnosis before surgery. The advent of nanotechnology and its application in Neurosurgery is doing great and has a promising future ahead based on the current study of scenarios. Moreover, there is a possibility of most of the Neurosurgical procedures becoming minimally invasive. Frameless Stereotaxy is another technique that helps in locating the exact position of the tumor, which further helps the neurosurgeon in navigating with great precision the very sensitive, high-risk areas of the brain. Such techniques, to a great extent, have lowered mortality and morbidity, lessened the rate of recovery, and chances of infection related to Neurosurgery.
A number of techniques for diagnosis and precise location of the tumor in the brain have made Neurosurgery much safer today, due to advancement in science and technology, than it ever had been in the history of mankind.