pt of transverse myelitis.pptx

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1. Concepts in physical therapy for Transverse Myelitis ANKIT PACHORI M.I.A.P M.P.T in Neurology and Psychosomatic disorders

2. Transverse Myelitis can be a devastating condition with life changing consequences Physiotherapy can help at all stages to M anage symptoms R educe secondary consequences R educe impairment I ncrease activity Maximize functional ability Increase participation

3. Stages of Intervention Acute phase Recovery phase Long term

4. Acute Phase Respiratory problems Muscle weakness / altered tone Soft tissue shortening Positioning Pain Mobility Balance

5. Recovery Phase Muscle weakness / imbalance / tonal issues Soft tissue shortening / joint stiffness Sensory issues Postural control Mobility Balance Stamina Pain control

6. Musculo-skeletal issues Wheelchair skills Re-education of normal movement Gait re-education Function independent

7. Long Term Management Musculo-skeletal issues Pain control Seating and postural control Mobility Bladder re-training Fitness A D L Function

8. A physiotherapist can intervene at any level By treating an impairment By reducing an activity restriction By problem solving a participation restriction

9. Physiotherapy goals and management Stretching programme – to prevent contractures Strengthening Transfers Gait training Wheelchair training Reduce risk of pressure ulcers Aid control of spasticity Pain reduction/management

10. ROM exercises Muscle stretching Joint control (propeoception) Pain control Hydrotherapy Breathing exercise Chest clearance technique (postural drainage or suctioning)

11. Provision of orthosis and wheelchair Teach transfer ( getting in and from wheelchair, bed ,car, toilet etc) Increase muscle strength Reduce spasticity Bladder training

12. Bladder Problems Immediately after the onset of TM, there is frequently a period of transient loss or reduction of neural activity below the involved spinal cord lesion; this is known as “spinal shock,” and generally lasts approximately 6 to 12 weeks, although it can persist for 6 months or more.

13. At this stage, two general problems can affect the bladder. The bladder can become overly sensitive, and empty after only a small amount of urine has collected, OR the bladder comes relatively insensitive, and thus becomes over extended and tends to overflow.

14. Thank you Have a nice and healthy day