Joint Mobilization

Joint mobilization or joint mob is a manual technique to improve joint accessory motion and to reduce joint pain by using specific oscillatory or sustained stretch technique. Mobilization is a manual therapy intervention and is classified by five grades of motion, each of which describes the range of motion of the target joint during the procedure.

Grade 1 - Activates Type I mechanoreceptors with a low threshold and which respond to very small increments of tension. Activates cutaneous mechanoreceptors.

Grade 2 - Similar effect as Grade I. By virtue of the large amplitude movement it will affect Type II mechanoreceptors to a greater extent.

Grade 3 - Similar to Grade II. Selectively activates more of the muscle and joint mechanoreceptors as it goes into resistance, and less of the cutaneous ones as the slack of the subcutaneous tissues is taken up.

Grade 4 - Similar to Grade III. With its more sustained movement at the end of range will activate the static, slow adapting, Type I mechanoreceptors, whose resting discharge rises in proportion to the degree of change in joint capsule tension.

Grade 5 - This is the same as joint manipulation. Use of the term Grade 5 is only valid if the joint is positioned near to its end range of motion during joint manipulation.

Knee joint mob

 Shoulder joint mob

I have uploaded videos of joint mobilization for each joint. Below is the link. So, happy studying...! =D

Hotfile - Joint Mobilization

Myotome

Myotome is a group of muscles innervated from a single spinal segment. The term myotome is also used to describe the muscles served by a single nerve root. It is the motor equivalent of a dermatome. Each muscle in the body is supplied by a particular level or segment of the spinal cord and by its corresponding spinal nerve. The muscle and its nerve make up a myotome.

Myotome testing can be an integral part of neurological examination as each nerve root coming from the spinal cord supplies a specific group of muscles. Testing of myotomes, in the form of isometric resisted muscle testing, provides the clinician with information about the level in the spine where a lesion may be present. During myotome testing, the clinician is looking for muscle weakness of a particular group of muscles. Results may indicate lesion to the spinal cord nerve root, or intervetebral disc herniation pressing on the spinal nerve roots.

Myotome distributions of the upper and lower extremity are as follows:

C3,4 and 5 supply the diaphragm (the large muscle between the chest and the belly that we use to breath).
C5 also supplies the shoulder muscles and the muscle that we use to bend our elbow .
C6 is for bending the wrist back.
C7 is for straightening the elbow.
C8 bends the fingers.
T1 spreads the fingers.
T1 –T12 supplies the chest wall & abdominal muscles.
L2 bends the hip.
L3 straightens the knee.
L4 pulls the foot up.
L5 wiggles the toes.
S1 pulls the foot down.
S3,4 and 5 supply the bladder. bowel and sex organs and the anal and other pelvic muscles.

*for further reading, you may go to this website:
           http://www.whiplash101.com/2009/11/myotomes-dermatomes-pain-help/

Clinical Practice - Transverse Myelitis

OK, today is my 3rd day of my clinical practice where I have learn how the physiotherapy department in hospital is managed. Besides, I can also see and learn how the physios are communicate and apply the hands on skill on the patient. I have been placed in Hospital Sungai Buloh and will be practising for 2 months and today is just my 3rd day. Hope I can learn more and more from this clinical practice. =)

For today, I have learn a disease call tranverse myelitis. A patient, female, 62 y/o come to the physio department with a weak right leg. She have been walking to the department by using the walking frame and accompanied by his daughter.

Transverse myelitis is a condition where the spinal cord especially the myelin sheath undergo inflammation. The causes is categorised as idiopathic which mean unknown and it can be related to the multiple sclerosis.

So, after she and I having some chats about the disease and collecting her personal details, i have done some objective assessment on her. Below are the list of a few assessments I have done on her::

1. sensation test using pin prick test.
2. Joint senses
3. coordination test, heel shin test.
4. functional test, rolling on bed, getting up from lyin, standing

The treatment I have done is just a few, some of them are,
Gait training
going up stair
standing up
dynamic and static balance

I hope, I can learn more about the disease and can manage well on this patient in the future. =)

*for more information about the transverse myelitis, below is the link for the website:

http://www.myelitis.org/tm.htm

Things To Do Before Exercise - Stretching

Below is the link for the complete guideline of stretching. Hope we all can use this guideline to have a better and proper technique of stretching and hope that any injury occurence can be minimised. Happy reading!! =D

http://hotfile.com/dl/118438387/a50df6a/Stretching.pdf.html

Things To Do Before Exercise - Warming Up

There has been some controversy in recent years about stretching before warm up. If you gonna stretch, will you injured if you stretch without specifically warming up first? NO...if you stretch comfortably and strenously. However I suggest that you do several minutes of general movement like walking, swinging arm to warm the muscles and related soft tissue before you stretch. This will get the blood moving.

Some runners have reported they are more likely to get injured if they dont warm up before stretching. It is possible to get hurt stretching if:
1) too much of a hurry, not relaxed
2) push too far, too soon, overstretching
3) not paying attention to the stretching

Here's my advice, if you are engaging in an activity such as running or cycling, warm up by doing the activity you are about to do, but at lower intensity. Example, if you are about to run, walk or jog for 2 to 5 minutes until become slightly sweat. This will increase muscle and blood temperature. Then stretch.

So, lastly from me, have a good health with a proper technique of exercise preparation so that injury can be prevented. Good luck!! =D

Joints

Now, we are going to next component in our body, that is the joints. You can learn more about joints from the link below.
Happy studying!!! =D

*credit to Gerard J. Tortora and colleague, Principles of Anatomy and Physiology

http://hotfile.com/dl/118412708/356ea3f/09_-_Joints.ppt.html

Anatomy or Body Structure - Bones

Next component that important for a physiotherapist to know is the skeletal system. Below are the links that describe more detail about skeletal system. Happy studying!! =)


 *credit to Gerard J. Tortora and colleague, Principles of Anatomy and Physiology.

http://hotfile.com/dl/118106148/1c96247/07_-_The_Skeletal_System_-_The_Axial_Skeleton.ppt.html

http://hotfile.com/dl/118107211/c6eaae5/08_-_The_Skeletal_System_-_The_Appendicular_Skeleton.ppt.html

Parkinson's Disease

Do you know who is this? Yeah, you're right!! =) The one and only man in this world who can beat George Foreman in knock out, Muhammad Ali. Great boxer, a great man, a great father who have also a great daughter, Laila Ali.
But, a great and strong man like him can't even escape from the power of nature, that is having disease that he is now many people know as Parkinson's Disease. Some have said that the disease is came from the blow by George Foreman. Maybe true because that kind of blows physically to Ali is like defending from being hit by a truck. If you didnt watch the match yet, just search in Youtube. What a great match to watch.

Alright, now, what we are discussing here is about the Parkinson's disease, how does it happen, the symptoms and how to overcome them.

Parkinson's disease is a chronic degenerative disease of the central nervous system that produce movement disorder and changes in mood and cognition. The movement disorder in this disease as you can see how Ali is walking, shaked hand, slow movement, gait pattern abnormalities and shuffling gait.

The disease occur is because there is a deplete production of dopamine in the brain. Dopamine reduces the influence of the indirect pathway while increasing the actions of the direct pathway within the basal ganglia. Reduced number of dopamine will lead to the symptom described above, loses the ability to execute smooth, controlled movements.
If you want to know more about basal ganglia, you can watch this video
     http://www.youtube.com/watch?v=J3po7dUCCoE

how the dopamine can be depleted? It is because of aging process, environmental factor and genetic factor. And in Muhammad Ali case?? I think it is because aging process. PLUS, damage done during his boxing career to the brain. =D (I guest)

So, how to treat patient with Parkinson disease physically?

}Gait re-education

}Improve balance and flexibility

}Facilitate initiation of movement

}Improve or maintain general(cardiovascular) fitness

}Increase functional independence

}Ensuring safety within at home

}To prevent muscle contracture

 

 Below is the link for a powerpoint presentation describing more on detail about Parkinson's disease treatment in physiotherapy

http://www.mediafire.com/?83icwl730b02050

Anatomy or Body Structure - Muscles

The human muscles are the component that a physiotherapy must know and master. The origin and insertion for each muscle, nerve that supply the muscle and how does it work. For example, the biceps is to bend the elbow joint. 

1 Community, 1 Medical Team

sounds like 1Malaysia right? haha

The medical team is responsible to provide quality home care services in private homes and senior communities. The team is comprised of doctor, physiotherapist, nurses, occupational therapist and medical social workers.

Interesting to know that in other country, such as Australia, they have one medical team in one street. Just compare to our country, we still far behind to reach that situation. 

Malaysian people view on physiotherapist

OK, let us ask our parent about physiotherapist. Do they know actually about it? If u decide to further study in this course, especially for SPM and Matriculation student, do our parent agree with our decision? And of course, they will come with a lot of question, how about the study, how about the job chances and so on.

When I was finishing my matriculation year, I was choosed to study in physiotherapy, my parent said 'OK'. Then, when I went to the hospital for medical checkup, the counterman asked me. What course do you study further? I said, physio. Then he said, ohh, the person that give massage arr?? That is the counterman in HOSPITAL !!!

Quite surprising that many people dont know the real job for this field, eventhough the person who work in the hospital.
Yeah, of course, one of the job of physio is giving massage or soft tissue manipulation, but there are a lot more. Here are some of the job that covered by a physiotherapist:
Neurological disease patient such as stroke, parkinson's disease or cerebral palsy
musculoskeletal injury such as motor vehicle accident, sports injury or daily routine injury
cardiorespiratory complications such as asthmatic patient, lung complication and bedridden patient.




So, these are some of the job that done and covered by physiotherapist. I hope, with this writing, it can give a brief idea about what the physiotherapy is about especially to student who wanted to further their study in this field.

Official Malaysian Physiotherapy Association (MPA) Website

You can access to the website with the link http://www.mpa.net.my/main.php

This website is suitable to those who are interested to further their study in this field, especially to SPM 'fresher'. This course may be consider new in our country and in ongoing to 'grow' further. So, let's check it out!