Improving functional independence with Feeding Assistance

By Bijal Shah

Feeding Assistance or making a person independent in feeding may not really seem like a physical therapy topic. Also, it is not that commonly encountered problem in orthopedic setting or high-level functioning individuals. Only until you start seeing patients with some neurological deficits or trauma. With my experience as a PT, one thing for sure is walking is an important aspect of independence but it is not the only aspect of functional independence. There are many tasks a person needs to do to perform his/her daily routine activities independently. Some of the examples of these are feeding, dressing, grooming, hygiene, moving in and out of bed, transferring on different surfaces and walking. You can add some more high-level activities like cooking, laundry, cleaning the house, grocery shopping and even driving but they are not really the basic tasks that a person will need to do on a daily basis. Continue reading “Improving functional independence with Feeding Assistance”

ALS: A Comprehensive Rehabilitation Guide

By Bijal Shah

ALS is otherwise also known by its full name amyotrophic lateral sclerosis. It is a type of progressive neurodegenerative disease that affects upper and lower motor neurons in the brain and the spinal cord. It comes from the Greek language where “A” means no. “Myo” refers to muscle, and “Trophic” means nourishment – “No muscle nourishment.” The motor neurons are responsible for initiating voluntary muscle movements. They also act as a bridge between the brain and the muscles for the crucial communication. So, as the name suggests, when a muscle does not have any nourishment, it “atrophies” or wastes away. As the motor neurons degenerate, it leads to a hardened area in the brain or scarring which is also known as “sclerosis”. Continue reading “ALS: A Comprehensive Rehabilitation Guide”

Stroke: Detecting Early Signs and Steps for Prevention

By Bijal Shah

Stroke is also known as a Cerebrovascular accident (CVA) in medical terminology. As per Center of Disease Control and American Stroke Association, stroke is one of the leading causes of death and major cause of disability in the United States. Different clinical symptoms can occur as a result of a stroke. This includes loss of consciousness, loss of sensory and or motor functions, loss or deficits in cognitive, swallowing and verbal capacity of an individual. A person after stroke may not be able to achieve full recovery. In at least 90% of cases, a person is not able to gain full recovery after a stroke. That means a patient has to leave with some residuals of stroke throughout his lifetime!! These residuals can be a physical impairment. But it can cause a major impact on person’s social and emotional state of mind. Thus, Stroke not only makes a person physically disabled but also causes depressions and isolation. The good thing is that in many cases it just does not show up at your door (in this case, in your brain!) with no early signs!. Stroke, for sure, is not going to wait for our invitation, but there are certain doors that we can close (signs that we consider) to prevent it coming(happening). This is a good thing. We have some control over it and with some efforts we can prevent it from happening. So let’s talk about some factors and early signs of stroke.

stroke prevention Continue reading “Stroke: Detecting Early Signs and Steps for Prevention”

Physical Therapy to Treat TBI : Treatment Approaches for Brain Injury Cases

By Bijal Shah

Traumatic Brain Injury (TBI) is anything that can impact normal function of a brain after birth (mostly caused due to an accident).  Rehab treatment approach varies as per what stage and how fresh the brain injury (TBI) is. It also depends on therapist’s experience level and belief in the treatment approach. For me, not one approach is a gold standard or right than other. I have also experienced that treatment approaches vary depending on patient’s prior level of function, age and comfort level. TBI

Some treatment will give excellent results with one patient while the other patient may complain of pain or discomfort with that same method. So the goal of this blog is to discuss some basic methods that therapists use to treat TBI patients. I will try to keep it real simple so not only therapists but other readers can also get some knowledge out of this article.  I discuss types and etiology of TBI here. The other thing to keep in mind is, the same treatment method can be used as the main treatment approach versus just a preventive measure depending on the acuity of an injury. So let’s talk about treatment methods for TBI patients. Continue reading “Physical Therapy to Treat TBI : Treatment Approaches for Brain Injury Cases”

What is Traumatic Brain Injury (TBI)

By Bijal Shah

Since I work with brain injury patients, Traumatic Brain Injury is my favorite topic to discuss and write. For me, it is difficult to put down words on Traumatic Brain Injury (TBI) as there is so much involved with TBI. But I also don’t want to write five pages long article and bore all my readers. So I am going to try to keep this a short and sweet article. In this article, I am going to discuss definition, types and some basic information on TBI. I discussed different treatment approaches of TBI here.  So let’s start! TBI

Brain injury is anything that can impact normal function of a brain. An acquired brain injury is when an injury happens after the birth. Here the brain is normally developed already.  There are two types of acquired brain injury: Traumatic and non-traumatic brain injury. Continue reading “What is Traumatic Brain Injury (TBI)”

Contracture Management – Definition and Treatment

By Bijal Shah

Contracture Definition:

A Contracture is a fixed loss of range of motion of a joint. It is usually due to any pathology of soft tissues like muscles, tendons, ligaments, cartilages, or connective tissues. 

contracture management

Types of Contracture:

There are two main types of contractures:

Orthosis in Gait training – Successful Story of recovery from Spinal Cord Injury (SCI)

By Bijal Shah

This is a case of 65 years old healthy woman who fell from seven steps and had a loss of consciousness for few minutes almost a year and a half ago.

Learning to walk again after SCI

The patient sustained C7 cervical spinal cord injury (SCI) from a fall. Her injury was classified as ASIA A SCI and she had to undergo cervical spinal fusion after the injury. She received basic rehabilitation at the hospital and had few complications like PNA and UTI during her hospitalization. She came to our facility for neurorehabilitation. Gait training was the most difficult task for my patient to achieve after her injury.  And of course, gait training was one of her main goals. This article summarizes her progress in rehab and the creative ideas I had to use during her gait training. Spinal cord injury Continue reading “Orthosis in Gait training – Successful Story of recovery from Spinal Cord Injury (SCI)”

Tale of a TBI survivor: From ventilation to Ambulation with Physical Therapy

By Bijal Shah

Traumatic brain injury is a type of injury that often results from an accident involves a long recovery process way past physical healing, and requires a lot of patience and persistence from all parties involved.  This is a case of 64 year old Traumatic Brain Injury(TBI) survivor who made significant progress to achieve his near normal function with aggressive rehabilitation, nursing and respiratory therapy.  

History and Examination:

A 64 year old male was admitted to my facility in March 2015 from a recent hospitalization with change in mental status and traumatic brain injury. Due to HIPAA, we are going to address him as a patient (Pt) or Mr. M.

At the time of evaluation, he was on ventilator at night. His cuff was inflated at all time, unable to tolerate deflation of cuff, or unable to tolerate capping or PMV. Due to this, he was not able to communicate at the time of evaluation.  During PT and OT evaluations, he demonstrated hypo tonicity on bilateral upper and lower extremities. He was unable to perform any active movement, unable to follow one step simple commands verbally, visually or with tactile cues. Continue reading “Tale of a TBI survivor: From ventilation to Ambulation with Physical Therapy”