Shanjida Rahman Sultana

Balance: This is the ability to keep the body in equilibrium in either the static or dynamic positions. The inability to balance or to coordinate movement may be due to weak muscles as a result of inactivity or it may be due to neurological deficit. As a general principle balance is developed progressively by moving from the most stable to the least stable position. So balance training is given progressively in different position according to following order- • Forearm support prone lying • Forearm support prone kneeling • Prone kneeling • Prone kneeling with one limb lifted from the ground. • Prone kneeling with two limbs lifted from the ground. • Kneeling • Half kneeling • Sitting • Long sitting, • Walk standing • Stride standing • Closed standing • Standing on unaffected limb • Standing on affected limb Placing the patient in different position, the patient is asked to maintain his position by his own muscular contraction. Here resistance is applied ...

A. Bone is a living tissue that renews itself. B. Structure: Compact and Spongy i. Compact bone contains bone cells (osteocytes) in lacunae, which are tiny chambers arranged in concentric circles around Haversian canals. The canals contain blood vessels and nerves. ii. A matrix that has protein fibers of collagen and mineral deposits of calcium and phosphorus salts separates lacunae. iii. Spongy bone has bony bars and plates separated by irregular spaces. iv. Spongy bone is lighter than compact bone. v. Spaces in spongy bone are filled with red bone marrow. Located in hipbone and sternum of adult. vi. Bone marrow is where RBC's are made. vii. The cavity of long one has yellow bone marrow where fat is stored. viii. Bone covered by periosteum (outer membrane). ix. Osteocytes have canaliculi. A. Bone growth/constant renewal i. During prenatal development skeleton is made of cartilage. ii. Replaced by bone. Osteoblast (bone forming cell) does this. iii. Primary ost...

1) A clinician must always receive verbal consent from the patient prior to the application of the tape. 2) The patient may be asked the following questions in order to minimize the risk of skin irritation due to the tape: • Are you allergic to tape? • Does your skin get irritated when you use an adhesive bandage? * Do you know if you have extra sensitive skin? 3) If the answer is "yes" to any of the above questions,it may be wise to apply tape to a small test patch first and re-assess the effects of the test patch on the skin at the next treatment session. 4) If indicated, shave the area to be taped, as hair will limit the effectiveness of taping. 5) If there is residual lotion or oil on the skin, the tapes will not stick.The skin area must be washed or wiped off with an alcohol swab before tape application. 6) Usually, a hypo-allergic tape is applied on the skin to minimize the potential risk of skin irritation related t...

Scapulohumeral rhythm: This is the movement relationship between the glenohumeral joint & scapulothoracic articulation. The ratio of glenohumeral movement to scapulothoracic movement in abduction is 2:1 (Smith, Weiss, & Lehmkuhl, 1996). (Describes the timing of movement at these joints during shoulder elevation.) 1. first 30 degrees of shoulder eleva tion involves a "setting phase": • The movement is largely glenohumeral. • Scapulothoracic movement is small and inconsistent. 2. after the first 30 degrees of shoulder elevation: • The glenohumeral and scapulothoracic joints move simultaneously. • Overall 2:1 ratio of glenohumeral to scapulothoracic movement. Scapulohumeral rhythm serves at least two purposes. 1. It preserves the length-tension relationships of the glenohumeral muscles; the muscles do not shorten as much as they would without the scapula's upward rotation, and so can sustain their force production through a larger portion of the range...

The movement of one joint may require the motion over the proximal and distal joints, and sometimes it may not be required. Two types of kinematic chains are present. 1. Closed kinematic chains (CKC) 2. Open kinematic chains (OKC) Closed Kinematic Chain In human body the joints are having interlink with each other, so the motion occurs in one particular joint causes motion over the other joints in predictable manner. In the closed kinematic chain the proximal and distal joint will be moving to produce the movement over one particular joint. Example: (I) Performing the sit-ups and (2) performing the push-ups. In the first example the hip joint flexion and the ankle joint dorsiflexion occurs to produce the flexion over the knee to go for the sitting posture. The proximal joint (hip) is moving towards the distal (ankle) joint but the distal joint is fixed without any movement. In the second example the shoulder extension and wrist extension produce the elbow fl...

In one joint muscle the movement may not be restricted by the proximal or distal joint motion. But it is not possible in the two or multi-joint muscles, the ROM may be changing depends on the proximal and distal joint movement. If the muscles are crossing more than one joint, there is possibility for active and passive insufficient said by Brunnstrom. Active ins ufficiency The muscle cannot go for further shortening while performing the activity around the joints, which the muscle crosses. It occurs to the agonists. Example: Flexor compartment muscles of the forearm. These muscles responsible for elbow flexion, MCP flexion PIP and DIP flexion. If the above said movements are done in the same sequence, the person feels difficult in flexing the MCP and finger after flexing the elbow and wrist, because the muscles are already shortened by the elbow and wrist flexion. So, further shortening is difficult, this is called as active insufficiency (Tenodesis). Passive Insu...

Good flexibility is known to bring positive benefits in the muscles and joints. It aids with injury prevention, helps to minimize muscle soreness, and improves efficiency in all physical activities. Increasing flexibility can also improve quality of life and functional independence. Good flexibility aids in the elasticity of the muscles and provides a wider range of motion in the joint s. It provides ease in body movements and everyday activities. A simple daily task such as bending over and tying shoes is accomplished better with flexibility. Benefits of Stretching The following are several chronic training benefits gained from using a regular stretching program: • Improved flexibility, stamina (muscular endurance), and muscular strength. The degree of benefit depends on how much stress is put on the muscle. Medium or heavy stretches are recommended. You can do this by building up to doing long stretches of high intensity (see the next section for a detailed explana...

Background Physiotherapy is a first contact, autonomous, client-focused health profession dedicated to: • Improving and maintaining functional independence and physical performance, • Preventing and managing pain, physical impairments, disabilities and limits to participation; and • Promoting fitness, health a nd wellness. The heart of the physiotherapy profession is understanding how and why movement and function take place. Physiotherapists are independent and caring health professionals who seek to provide safe, quality client-centred physiotherapy through a commitment to service availability, accessibility and excellence. The profession continues to be shaped by scientific evidence and the education and competence of the physiotherapists delivering the services. Physiotherapy is grounded in the belief that, to be effective, its services must respond to the changing needs of populations. Primary Functions of physiotherapists Physiotherapists apply a collaborative and rea...

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