~ Why Down Syndrome Physiotherapy Should Be Started Early

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There is a great need for immediate intervention for children with Down syndrome.  Physiotherapy does not fix the problem; development will still be slowed.  However, it can address problems that are unique to Down syndrome children. 

Early Down syndrome physiotherapy focuses on four problems that are common for these children.  One is called hypotonia.  This means that the child's muscles lack tone.  That is why, when you lay a Down syndrome child in his crib, he will flop out like a rag doll.  Hypotonia needs to be treated because it affects the ability of the child to learn motor skills or to support himself correctly. 

Another problem that can be helped by Down syndrome physiotherapy is laxity of the ligaments.  The ligaments are so loose that they do not support the bones adequately.  In infancy, it can be seen in the way they lie down with their legs splayed apart.  In later years, their ankles and other joints will be loose enough to cause support problems. 

Down syndrome physiotherapy is essential in helping these children overcome muscular weakness.  If they are not exercised to correct the problem, they will develop behaviors that will make up for their lack of strength.  Some of these behaviors may be harmful.  For example, they may lock their knees to make up for having weak legs. 

One problem these children face is in their body shape.  Their arms and legs are generally shorter compared to their trunks than in most people.  This leads to all kinds of problems sitting and climbing.  Just reaching the table to eat can be a chore.  Down syndrome physiotherapy can help with this problem. 

In early intervention Down syndrome physiotherapy, the emphasis is on overcoming weakness and learning gross motor skills.  Rolling over, sitting, crawling, and walking will all happen eventually, anyway.  However, with Down syndrome physiotherapy, they can take place with solid physical foundations. 

There is a concern with Down syndrome physiotherapy of parents notifying the doctors of problems that might require the help of a physiotherapist.  A parent may be at a loss as to what is to be considered worthy of attention.  After all, they already know that their child is not like other children who do not have Down syndrome. 

If parents see a Down syndrome child having trouble holding up her neck, it is essential to call it to the attention of the doctor so that physiotherapy can be ordered to strengthen neck muscles.  This is one example of many where a physiotherapist might help. 

Once Down syndrome physiotherapy is started, it is best to keep up a life-long program to maintain health.  Prevention of age-related problems with bones, ligaments, and muscles is becoming increasingly important.  This is because people with Down syndrome are living to older ages.  In fact there are more Down syndrome people over the age of 60 than ever before.  Physiotherapy can help them live quality lives. 

Down syndrome physiotherapy is often ignored until much damage has been done.  The children are left with weaknesses, odd behaviors, and disfigurements that need not have happened.  If Down syndrome physiotherapy is started early enough, the child will have a much healthier life. 
The Busy Field of Geriatric Physiotherapy

Clinics that specialize in geriatric physiotherapy never run low on work.  The elderly have diseases and disorders in greater numbers than any other age group.  Their care is difficult, but rewarding. 

Geriatric physiotherapy became a specialty of physical therapy study in 1989.  Since then, physiotherapists have worked to understand the problems of the aging.  There is a long list of problems dealt with in geriatric physiotherapy. 

Alzheimer's, arthritis, balance disorders, cancer, cardiovascular disease, incontinence, joint replacement, pulmonary disease, stroke, and osteoporosis are only a few of the problems covered by geriatric physiotherapy.  Physiotherapists have a whole range of therapies for these ailments. 

The types of problems faced in geriatric physiotherapy are grouped into three different categories.  One category is the problems that happen because the patient simply does not use their limbs or does not exercise.  These problems can be addressed by reconditioning through range-of-motion exercises and other exercises. 

Another category geriatric physiotherapy deals with is cardiovascular disease, like heart disease and stroke.  The physiotherapy professional has an array of tools at her disposal to work with these conditions.  Exercise, aqua therapy, electrical stimulation, and more can be used. 

The third category is skeletal problems. Geriatric physiotherapy helps people who have these disorders, such as osteoporosis and osteoarthritis.  These problems require special attention as osteoporosis makes patients frailer, and osteoarthritis is very painful. 

Because falls are such a problem, the osteoporosis therapy is crucial.  Along with that, geriatric physiotherapy is responsible for preventing many falls because of work with balance and gait.  Some clinics focus entirely on balance issues for the elderly. 

Much of the work of geriatric physiotherapy is not aimed at returning patients to their earlier states of health.  The most important goals are to be able to function at their best abilities.  Doing everyday tasks and living an unconfined life are valuable assets. 

At the same time, geriatric physiotherapy can have a profound affect on a person's ability to enjoy physical activities.  Golf is an activity that many seniors enjoy.  It can be a very hazardous sport for the elderly if they are not in condition to play.  It does have many health benefits, too. 

Geriatric physiotherapy can focus on physical training to get an older adult in shape to play sports like golf.  This strengthens them in many ways.  The fact that it allows them to play golf will make them even healthier, both physically and psychologically.  Since depression is a growing problem among the elderly, any help they can get in this area is needed. 

Another role of geriatric physiotherapy is to help with rehabilitation after knee or hip replacement surgeries.  People who have these operations are likely to walk differently.  It affects their abilities to do daily chores, and their quality of life.  Physiotherapists can help. 

Some people turn to physiotherapy as a means of better functioning.  Others are referred to physiotherapy clinics by their doctors for specific problems.  Still others end up in geriatric physiotherapy care in hospitals or nursing homes after accidents or illnesses.  All of these people can be helped. 
The History of Physiotherapy

At least as early as the days of Hippocrates, massage was used and the history of physiotherapy was begun.  The practice of physiotherapy has evolved through the centuries from the earliest forms to the complex system of treatment it is now. 

In 460 B.C. Hector was using a type of physiotherapy called hydrotherapy, or water therapy.  Professionals use this type of therapy today, although it is more specialized for each type of condition that the patients have. 

In 1894, there is the first evidence of a group of nurses in the history of physiotherapy with a Chartered Society.  Within twenty years, physiotherapy programs were set up in other countries.  New Zealand's started in 1913 and America's in 1914. 

The first American professionals in the history of physiotherapy were from the Walter Reed College and Hospital in Portland Oregon.  Rather than being called physiotherapists, they were called reconstruction aides.  These aides were nurses and they had a physical education background.  They were important in the recovery of many World War I veterans. 

Research has been done throughout the modern history of physiotherapy.  In fact, right near the very beginning, a research study was done in the US.  It was published in 1921.  Physiotherapy research continues today in a myriad of specialties. 

Also in 1921, the Physical Therapy Association was formed by Mary McMillan.  This group later became the APTA, arguably the most influential organization in the American history of physiotherapy. 

The Georgia Warm Springs Foundation was started in 1924 to deal with the ever-growing epidemic of polio.  The foundation offered physiotherapy for these patients.  Sister Kinney was known nationally for her work with polio victims.  She practiced at the Mayo Clinic.  The polio epidemic was a turning point in the history of physiotherapy. 

After the polio epidemic had waned, the treatments of choice were massage, exercise, and traction.  In about 1950, chiropractic manipulations came on the scene in the history of physiotherapy.  This was most common in Great Britain. 

After that time, the history of physiotherapy moved from hospitals into other arenas of service.  There were, and are, physiotherapists working in clinics, private practices, nursing homes, and schools.  The Orthopedics specialty of physiotherapy was born about this time, also. 

The International Federation of Orthopaedic Manipulative Therapy came onto the scene, and began making changes and has influenced the profession ever since.  Mariano Rocabado was a physiotherapist who had a profound impact.  Freddy Kaltenborn, from Norway, influenced physiotherapy on the east coast of the US.  At the same time, Geoffrey Maitland of Australia changed the way training was done in the history of physiotherapy. 

The focus during the 1980s history of physiotherapy was on technology.  New procedures came about that used computers, ultrasound, electrical stimulation, and other devices.  By the 1990s, interest had shifted to manual therapy, with Freddy Kaltenborn again leading the way. 

During the history of physiotherapy, training and practice have changed and improved.  Many brilliant pioneers have left their marks in the literature and organizations of the field.  Physiotherapy is a well-respected profession as a result.
Types of Physiotherapy That Help Lower Back Pain

Lower back pain plagues Americans to the extent that 80% will suffer from it at some time in their lives.  It is one of the most common reasons people visit the doctor.  For many, the problem is more than a passing incident; they need physiotherapy. 

Physiotherapy of different types can be used to treat lower back pain.  Acupuncture is fast becoming an important method for the relief of such pain.  The doctor has the patient lie face-down and inserts the acupuncture needles across the back.  The doctor then finishes the procedure for lower back pain.  Pain relief after a series of treatments usually lasts months.

Massage is also used for lower back pain.  The massage used must be done by someone well-versed in the treatment of lower back pain.  A massage done by an untrained person may do more harm than good. 

These methods are called passive therapies, or modalities.  They are done to the patient and not by the patient.  There are other modalities that are commonly used.  Heat and ice packs are a well-known form of passive physiotherapy.  They can be used separately, or they can be used alternately by a person who is suffering from acute lower back pain. 

A transcutaneous electrical nerve stimulator (TENS) can be used as another modality for lower back pain.  The patient will feel the sensation of the stimulator instead of his pain.  If the TENS unit seems to work well for him, he will be sent home with one to use at his convenience. 

Ultrasound is especially useful as a passive therapy for anyone with acute lower back pain.  It delivers heat deep into the muscles of the lower back.  This not only relieves pain.  It can also speed healing. 

Back exercises may be assigned by a physiotherapist.  These exercises will help with lower back pain if one does them correctly and faithfully.  The only exception is if the back is in an acute condition requiring emergency care or surgery. 

The exercises that will help with lower back pain the most will be assigned and supervised by a physiotherapist.  They may be done at home, but it will be necessary to follow instructions and check in frequently. 

These exercises include ones for lower back pain that stretch or extend the back and ones that strengthen it.  One is an exercise where one lies prone and moves as if swimming.  This protects the back while giving the surrounding muscles a workout. 

Lower back pain exercises called flexion exercises strengthen the midsection to provide support for the back.  If the lower back pain is reduced when one sits, these exercises are important.  One is a knee-to-chest exercise. 

Aerobic exercise such as walking is excellent for reducing and preventing lower back pain as well.  Massage and acupuncture can be counted on to relieve pain for most patients.  Exercises can make the back stronger to both relieve and prevent lower back pain.  Any physiotherapy that can help relieve lower back pain will help millions of people. 
The Types of Neurological Conditions and Physiotherapy Used

Neurological conditions may be very severe.  They can be life-threatening at times, and they can certainly affect the quality of the patient's life.  There are many neurological conditions and physiotherapy can help many of them. 

Alzheimer's disease takes away the declining years of many older people.  It is surprising to note that it can occur in people 40 years old or younger.  ALS or Lou Gehrig's disease is a disease that robs the brain and spinal cord of the ability to move.  Both of these are neurological diseases that can be helped by physiotherapy. 

MS, another of the neurological conditions that affects the brain and spinal cord, can lead to a long, slow decline.  Parkinson's disease is another of the neurological conditions of the brain.  This one can cause shaking and loss of coordination, and problems moving and walking.  Physiotherapy offers some relief to these patients. 

Guillain Barre Syndrome is one of the types of neurological conditions that affect the brain and spinal cord too.  It is a case of the person's own immune system attacking outside these areas.  It can be severe enough to require emergency hospitalization.  Physiotherapy offers help with regaining strength and adapting to life with the disease. 

Neurological conditions that are autoimmune diseases are difficult to treat.  Myasthenia Gravis is one such illness.  It causes muscular weakness because of a lack of communication between nerves and muscles.  Like other neurological conditions, it can be very debilitating. 

A great amount of physiotherapy is needed to help Myasthenia Gravis patients to live with their neurological conditions.  This includes strength training, training in the use of supportive devices, and help with common tasks.  One problem physiotherapists face when working with MG patients is that too much exercise will make their condition worse and not better. 

Many of the patients with neurological conditions cannot carry on daily functions such as caring for themselves and their homes.  It is not uncommon for these people to be unable to work.  They may even have trouble walking or getting up and down stairs at all. 

Difficulty swallowing or breathing; dizziness, poor balance and falls, and a total lack of endurance plague many of these patients who have neurological conditions.  Medications or surgeries can help with some of their problems, but many problems are ones they will have to abide.  Physiotherapy can offer solutions that other branches of medicine cannot. 

Exercises, as in most physiotherapy, include strengthening and stretching exercises.  In whatever way is possible, patients with neurological conditions need to get aerobic exercise.  Physiotherapists may be able to make a plan so that this is possible. 

Part of this plan for patients with neurological conditions would include balance training and coordination training.  With these two skills in place, the patient will have a more advanced ability to do aerobic and other exercises.  Aquatic exercise is also used. 

Patients with neurological conditions must live with many problems of lack of movement and function.  Physiotherapy can help them to overcome some of these problems.  It can make their lives easier and more pleasant, besides. 
Using Physiotherapy to Deal with Occupational Injury

There is less occupational injury going on in the last few years than before.  This is partly because of the influence of physiotherapy on the workplace.  Physiotherapy principles are being used to design better work places and work habits.  They are also important in dealing with the occupational injury that does happen. 

Occupational injury problems include back and neck problems, carpal tunnel syndrome, shoulder and knee dislocations, tennis elbow, and leg and ankle strains.  Physiotherapy can be used to treat any of these conditions. 

Back and neck problems are major examples of occupational injury.  They happen because of improper lifting, lifting while turning, repetitive turning, or sitting improperly.  Workman's comp will probably take care of treatment if the occupational injury is more than a slight one. 

Carpal tunnel syndrome is often seen in offices.  However, it may also occur in other jobs, such as on assembly lines.  Tennis elbow can be an occupational injury as well, occurring any time one repetitively twists one's wrists.  This movement is often done in packing plants, for example, as workers twist products into containers. 

Patients who have an occupational injury are often put on light duty.  Some are even laid off.  Physiotherapists can step in and help the patients recover their strength and health.  Physiotherapy techniques may include exercises, massage, and ultrasound. 

A physiotherapist will certainly give instructions about how to do home treatment.  When the occupational injury is sufficiently healed, the patient will be given the go-ahead to return to work.  If the patient was on light duty, he will be told when to go back to regular duty.  If he was off work, he will be told when he can go onto light duty, and then the full daily routine. 

Physiotherapy ideas can also be used to construct a better work environment.  The work station in an office can be set up to accommodate the proper positioning of the body.  This will ward off occupational injury caused by repetitive movements, like carpal tunnel syndrome. 

Occupational injury caused by awkward movements in the workplace can also be eliminated if the work environment is set up in an ergonomic fashion.  Physiotherapists have much knowledge about the way the workplace should be constructed. 

Physiotherapists know what equipment is best used to avoid occupational injury.  Ergonomic keyboards are recommended and correct mouse placement is crucial.  The physiotherapist will suggest that you use a touch pad instead of a mouse if at all possible. 

Physiotherapists can be very helpful in preventing  

occupational injury in any other type of workplace.  They may be called in to consult with employers and ergonomics specialists about what changes need to be made to make the work environment acceptable for their patients.   

Work environments are safer than they once were.  Ergonomics principles are used and in many cases are required by law to be used if requested by workers.  Workers who are injured have good  available to them.  However, until there is no occupational injury, physiotherapy will continue to have value in the workplace. 

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